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38 U.S.C. § 1745 — Nursing home care, adult day health care, and medications for veterans with service-connected disabilities
Federal law — U.S. Code and appendices · legal_authorities
**(a)**
(1) The Secretary shall enter into a contract (or an agreement) with each State home for payment by the Secretary for nursing home care provided in the home, in any case in which such care is provided to any veteran as follows:
(A) Any veteran in need of such care for a service-connected disability.
(B) Any veteran who—
(i) has a service-connected disability rated at 70 percent or more; and
(ii) is in need of such care.
(2) Payment under each contract (or agreement) between the Secretary and a State home under paragraph (1) shall be based on a methodology, developed by the Secretary in consultation with the State home, to adequately reimburse the State home for the care provided by the State home under the contract (or agreement).
(3) Payment by the Secretary under paragraph (1) to a State home for nursing home care provided to a veteran described in that paragraph constitutes payment in full to the State home for such care furnished to that veteran.
(4)
(A) An agreement under this section may be authorized by the Secretary or any Department official authorized by the Secretary, and any such action is not an award for purposes of such laws that would otherwise require the use of competitive procedures for the furnishing of hospital care, medical services, and extended care services.
(B)
(i) Except as provided in the agreement itself, in clause (ii), and unless otherwise provided in this section or regulations prescribed pursuant to this section, a State home that enters into an agreement under this section is not subject to, in the carrying out of the agreement, any provision of law to which providers of services and suppliers under the Medicare program under title XVIII of the Social Security Act ([42 U.S.C. 1395](https://uscode.h
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Source location: Title 38, Chapter 17, § 1745; chapter-017-hospital-nursing-home-domiciliary-and-medical-care.md
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**(a)**
(1) The Secretary shall enter into a contract (or an agreement) with each State home for payment by the Secretary for nursing home care provided in the home, in any case in which such care is provided to any veteran as follows:
(A) Any veteran in need of such care for a service-connected disability.
(B) Any veteran who—
(i) has a service-connected disability rated at 70 percent or more; and
(ii) is in need of such care.
(2) Payment under each contract (or agreement) between the Secretary and a State home under paragraph (1) shall be based on a methodology, developed by the Secretary in consultation with the State home, to adequately reimburse the State home for the care provided by the State home under the contract (or agreement).
(3) Payment by the Secretary under paragraph (1) to a State home for nursing home care provided to a veteran described in that paragraph constitutes payment in full to the State home for such care furnished to that veteran.
(4)
(A) An agreement under this section may be authorized by the Secretary or any Department official authorized by the Secretary, and any such action is not an award for purposes of such laws that would otherwise require the use of competitive procedures for the furnishing of hospital care, medical services, and extended care services.
(B)
(i) Except as provided in the agreement itself, in clause (ii), and unless otherwise provided in this section or regulations prescribed pursuant to this section, a State home that enters into an agreement under this section is not subject to, in the carrying out of the agreement, any provision of law to which providers of services and suppliers under the Medicare program under title XVIII of the Social Security Act ([42 U.S.C. 1395](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1395&num=0&edition=prelim) et seq.) are not subject.
(ii) A State home that enters into an agreement under this section is subject to—
(I) all provisions of law regarding integrity, ethics, or fraud, or that subject a person to civil or criminal penalties;
(II) all provisions of law that protect against employment discrimination or that otherwise ensure equal employment opportunities; and
(III) all provisions in this subchapter.
(iii) Notwithstanding subparagraph (B)(ii)(I), a State home that enters into an agreement under this section may not be treated as a Federal contractor or subcontractor for purposes of chapter 67 of title 41 (known as the “McNamara-O’Hara Service Contract Act of 1965”).
**(b)** The Secretary shall furnish such drugs and medicines as may be ordered on prescription of a duly licensed physician as specific therapy in the treatment of illness or injury to any veteran as follows:
(1) Any veteran who—
(A) is not being provided nursing home care for which payment is payable under subsection (a); and
(B) is in need of such drugs and medicines for a service-connected disability.
(2) Any veteran who—
(A) has a service-connected disability rated at 50 percent or more;
(B) is not being provided nursing home care for which payment is payable under subsection (a); and
(C) is in need of such drugs and medicines.
(3) Any veteran who has been determined by the Secretary to be catastrophically disabled, as defined in section 17.36(e) of title 38, Code of Federal Regulations, or successor regulations, and on whose behalf the Secretary is paying a per diem for nursing home or domiciliary care in a State home under this chapter.
**(c)** Any State home that requests payment or reimbursement for services provided to a veteran under this section shall provide to the Secretary such information as the Secretary considers necessary to identify each individual veteran eligible for payment under such section.
**(d)**
(1) The Secretary shall enter into an agreement with each State home for payment by the Secretary for medical supervision model adult day health care provided to a veteran described in subsection (a)(1) on whose behalf the State home is not in receipt of payment for nursing home care from the Secretary.
(2)
(A) Payment under each agreement between the Secretary and a State home under paragraph (1) for each veteran who receives medical supervision model adult day health care under such agreement shall be made at a rate established through regulations prescribed by the Secretary to adequately reimburse the State home for the care provided by the State home, including necessary transportation expenses.
(B) The Secretary shall consult with the State homes in prescribing regulations under subparagraph (A).
(C) The rate established through regulations under subparagraph (A) shall not take effect until the date that is 30 days after the date on which those regulations are published in the Federal Register.
(3) Payment by the Secretary under paragraph (1) to a State home for medical supervision model adult day health care provided to a veteran described in that paragraph constitutes payment in full to the State home for such care furnished to that veteran.
(4) In this subsection, the term “medical supervision model adult day health care” means adult day health care that includes the coordination of physician services, dental services, nursing services, the administration of drugs, and such other requirements as determined appropriate by the Secretary.
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Federal law — U.S. Code and appendices · legal_authorities
**(a)**
(1) The Secretary (subject to paragraph (4)) shall furnish hospital care and medical services which the Secretary determines to be needed—
(A) to any veteran for a service-connected disability; and
(B) to any veteran who has a service-connected disability rated at 50 percent or more.
(2) The Secretary (subject to paragraph (4)) shall furnish hospital care and medical services, and may furnish nursing home care, which the Secretary determines to be needed to any veteran—
(A) who has a compensable service-connected disability rated less than 50 percent or, with respect to nursing home care during any period during which the provisions of [section 1710A(a) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title38-section1710A/a&num=0&edition=prelim) are in effect, a compensable service-connected disability rated less than 70 percent;
(B) whose discharge or release from active military, naval, air, or space service was for a disability that was incurred or aggravated in the line of duty;
(C) who is in receipt of, or who, but for a suspension pursuant to [section 1151 of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title38-section1151&num=0&edition=prelim) (or both a suspension and the receipt of retired pay), would be entitled to disability compensation, but only to the extent that such veteran’s continuing eligibility for such care is provided for in the judgment or settlement provided for in such section;
(D) who is a former prisoner of war, who was awarded the medal of honor under section 7271, 8291, or 9271 of title 10 or section 491 11 See References in Text note below. of title 14, or who was awarded the Purple Heart;
(E) who is a veteran of—
(i) the Mexican border period;
(
Source: Supplied U.S. Code snapshot — release unconfirmed · 38 U.S.C. § 1710
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Federal law — U.S. Code and appendices · legal_authorities
This chapter may be cited as the “Social Security Act”.
Source: Supplied U.S. Code snapshot — release unconfirmed · 42 U.S.C. § 1305
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Federal law — U.S. Code and appendices · legal_authorities
**(a) Conditions of participation; protection of individual rights; notification of State entities; use of home health aides; medical equipment; individual’s plan of care; compliance with Federal, State, and local laws and regulations** The conditions of participation that a home health agency is required to meet under this subsection are as follows:
(1) The agency protects and promotes the rights of each individual under its care, including each of the following rights:
(A) The right to be fully informed in advance about the care and treatment to be provided by the agency, to be fully informed in advance of any changes in the care or treatment to be provided by the agency that may affect the individual’s well-being, and (except with respect to an individual adjudged incompetent) to participate in planning care and treatment or changes in care or treatment.
(B) The right to voice grievances with respect to treatment or care that is (or fails to be) furnished without discrimination or reprisal for voicing grievances.
(C) The right to confidentiality of the clinical records described in section 1395x(o)(3) of this title.
(D) The right to have one’s property treated with respect.
(E) The right to be fully informed orally and in writing (in advance of coming under the care of the agency) of—
(i) all items and services furnished by (or under arrangements with) the agency for which payment may be made under this subchapter,
(ii) the coverage available for such items and services under this subchapter, subchapter XIX, and any other Federal program of which the agency is reasonably aware,
(iii) any charges for items and services not covered under this subchapter and any charges the individual may have to pay with respect to items and services furn
Source: Supplied U.S. Code snapshot — release unconfirmed · 42 U.S.C. § 1395
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Federal law — U.S. Code and appendices · legal_authorities
For the purposes of this title—
(1) The terms “Secretary” and “Department” mean the Secretary of Veterans Affairs and the Department of Veterans Affairs, respectively.
(2) The term “veteran” means a person who served in the active military, naval, air, or space service, and who was discharged or released therefrom under conditions other than dishonorable.
(3) The term “surviving spouse” means (except for purposes of chapter 19 of this title) a person who was the spouse of a veteran at the time of the veteran’s death, and who lived with the veteran continuously from the date of marriage to the date of the veteran’s death (except where there was a separation which was due to the misconduct of, or procured by, the veteran without the fault of the spouse) and who has not remarried.
(4)
(A) The term “child” means (except for purposes of chapter 19 of this title (other than with respect to a child who is an insurable dependent under subparagraph (B) or (C) of section 1965(10) of such chapter) and [section 8502(b) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title38-section8502/b&num=0&edition=prelim)) a person who is unmarried and—
(i) who is under the age of eighteen years;
(ii) who, before attaining the age of eighteen years, became permanently incapable of self-support; or
(iii) who, after attaining the age of eighteen years and until completion of education or training (but not after attaining the age of twenty-three years), is pursuing a course of instruction at an approved educational institution;
and who is a legitimate child, a legally adopted child, a stepchild who is a member of a veteran’s household or was a member at the time of the veteran’s death, or an illegitimate child but, as to the alleged father, onl
Source: Supplied U.S. Code snapshot — release unconfirmed · 38 U.S.C. § 101
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Federal law — U.S. Code and appendices · legal_authorities
**(a)**
(1) Subject to subsection (b) of this section, the Secretary may transfer to a non-Department nursing home, for care at the expense of the United States—
(A) a veteran—
(i) who has been furnished care by the Secretary in a facility under the direct jurisdiction of the Secretary; and
(ii) who the Secretary determines—
(I) requires a protracted period of nursing home care which can be furnished in the non-Department nursing home; and
(II) in the case of a veteran who has been furnished hospital care in a facility under the direct jurisdiction of the Secretary, has received maximum benefits from such care; and
(B) a member of the Armed Forces—
(i) who has been furnished care in a hospital of the Armed Forces;
(ii) who the Secretary concerned determines has received maximum benefits from such care but requires a protracted period of nursing home care; and
(iii) who upon discharge from the Armed Forces will become a veteran.
(2) The Secretary may transfer a person to a nursing home under this subsection only if the Secretary determines that the cost to the United States of the care of such person in the nursing home will not exceed—
(A) the amount equal to 45 percent of the cost of care furnished by the Department in a general hospital under the direct jurisdiction of the Secretary (as such cost may be determined annually by the Secretary); or
(B) the amount equal to 50 percent of such cost, if such higher amount is determined to be necessary by the Secretary (upon the recommendation of the Under Secretary for Health) to provide adequate care.
(3) Nursing home care may not be furnished under this subsection at the expense of the United States for more than six months in the aggregate in connection with any one tra
Source: Supplied U.S. Code snapshot — release unconfirmed · 38 U.S.C. § 1720
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Federal law — U.S. Code and appendices · legal_authorities
**(a)**
(1) Except as provided in [section 1745 of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title38-section1745&num=0&edition=prelim), the Secretary shall pay each State at the per diem rate of—
(A) $8.70 for domiciliary care; and
(B) $20.35 for nursing home care and hospital care,
for each veteran receiving such care in a State home, if such veteran is eligible for such care under the laws administered by the Secretary.
(2) The Secretary may pay each State per diem at a rate determined by the Secretary for each veteran receiving extended care services described in any of paragraphs (4) through (6) of [section 1710B(a) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title38-section1710B/a&num=0&edition=prelim) under a program administered by a State home, if such veteran is eligible for such care under laws administered by the Secretary.
**(b)** In no case shall the payments made with respect to any veteran under this section exceed one-half of the cost of the veterans’ care in such State home.
**(c)** Whenever the Secretary makes a determination pursuant to [section 1720(a)(2)(A) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title38-section1720/a/2/A&num=0&edition=prelim) that the cost of care furnished by the Department in a general hospital under the direct jurisdiction of the Secretary has increased, the Secretary may, effective no earlier than the date of such determination, increase the rates paid under subsection (a) of this section by a percentage not greater than the percentage by which the Secretary has determined that such cost of care has increased.
**(d)** Subject to [section 1743 of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-
Source: Supplied U.S. Code snapshot — release unconfirmed · 38 U.S.C. § 1741
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Federal law — U.S. Code and appendices · legal_authorities
Page 477
TITLE 38—VETERANS’ BENEFITS
§ 1745
(Added Pub. L. 108–422, title II, § 201(a)(1), Nov.
30, 2004, 118 Stat. 2380.)
Statutory Notes and Related Subsidiaries
IMPLEMENTATION
Pub. L. 108–422, title II, § 201(b), Nov. 30, 2004, 118 Stat.
2382, provided that: ‘‘The Secretary of Veterans Affairs
shall implement section 1744 of title 38, United States
Code, as added by subsection (a), as expeditiously as
possible. The Secretary shall establish such interim
procedures as necessary so as to ensure that payments
are made to eligible States under that section com-
mencing not later than June 1, 2005, notwithstanding
that regulations under subsection (j) of that section
may not have become final.’’
§ 1745. Nursing home care, adult day health care,
and medications for veterans with service-
connected disabilities
(a)(1) The Secretary shall enter into a con-
tract (or an agreement) with each State home
for payment by the Secretary for nursing home
care provided in the home, in any case in which
such care is provided to any veteran as follows:
(A) Any veteran in need of such care for a
service-connected disability.
(B) Any veteran who—
(i) has a service-connected disability rated
at 70 percent or more; and
(ii) is in need of such care.
(2) Payment under each contract (or agree-
ment) between the Secretary and a State home
under paragraph (1) shall be based on a method-
ology, developed by the Secretary in consulta-
tion with the State home, to adequately reim-
burse the State home for the care provided by
the State home under the contract (or agree-
ment).
(3) Payment by the Secretary under paragraph
(1) to a State home for nursing home care pro-
vided to a veteran described in that paragraph
constitutes payment in full to the State home
for such care
Source: Supplied 2024 U.S. Code historical extraction · 38 U.S.C. § 1745
Stored review status: historical_2024_not_currentness_verified. Same stored citation; legal effect and authority still require review.
Federal law — U.S. Code and appendices · legal_authorities
Page 2893
TITLE 42—THE PUBLIC HEALTH AND WELFARE
§ 1395a
(i) shared savings and competitive bidding in FFS
Medicare;
(ii) use of MA-negotiated rates to set FFS Medicare
rates; and
(iii) novel approaches to information development
and sharing that may enable markets to lower cost and
improve quality for FFS Medicare beneficiaries.
SEC. 10. Reducing Obstacles to Improved Patient Care.
Within 1 year of the date of this order, the Secretary
shall propose regulatory changes to the Medicare pro-
gram to reduce the burden on providers and eliminate
regulations that create inefficiencies or otherwise un-
dermine patient outcomes.
SEC. 11. Maximizing Freedom for Medicare Patients and
Providers. (a) Within 180 days of the date of this order,
the Secretary, in coordination with the Commissioner
of Social Security, shall revise current rules or policies
to preserve the Social Security retirement insurance
benefits of seniors who choose not to receive benefits
under Medicare Part A, and propose other administra-
tive improvements to Medicare enrollment processes
for beneficiaries.
(b) Within 1 year of the date of this order, the Sec-
retary shall identify and remove unnecessary barriers
to private contracts that allow Medicare beneficiaries
to obtain the care of their choice and facilitate the de-
velopment of market-driven prices.
SEC. 12. General Provisions. (a) Nothing in this order
shall be construed to impair or otherwise affect:
(i) the authority granted by law to an executive de-
partment or agency, or the head thereof; or
(ii) the functions of the Director of the Office of Man-
agement and Budget relating to budgetary, administra-
tive, or legislative proposals.
(b) This order shall be implemented consistent with
applicable law and subject to the
Source: Supplied 2024 U.S. Code historical extraction · 42 U.S.C. § 1395
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