,i  #aaeth ,,congress  #ast ,session    
,h4 ,r4 #dgf  ,,in ,,the ,,house ,,of   
,,representatives  ,january #ab1        
#bjag,mr4 ,newhouse 7for himself1 ,mr4  
,gohmert1 ,mr4 ,hensarling1 ,mr4 ,jones1
 ,mr4 ,marshall1 ,mr4 ,olson1 ,mrs4     
,radewagen1 and ,mr4 ,young of ,iowa7   
introduced the following bill2 which was
 referred to the ,committee on          
,veterans' ,affairs  ,a ,,bill  ,to     
amend title #ch1 ,united ,states ,code1 
to clarify the emergency hospital care  
furnished by the ,secretary of ,veterans
 ,affairs to certain veterans4  #a4     
,short title ,this ,act may be cited as 
the ,veterans ,emergency ,treatment ,act
 or the ,,vet ,act4  #b4 ,clarification 
of emergency hospital care furnished by 
the ,secretary of ,veterans ,affairs to 
certain veterans  7a7 ,in general       
,chapter #ag of title #ch1 ,united      
,states ,code1 is amended by inserting  
after section #agcj;,a the following new
 section3  #agcj;,b4 ,examination and   
treatment for emergency medical         

conditions and women in labor  7a7      
,medical screening examinations ,in     
carrying out this chapter1 if any       
enrolled veteran requests1 or a request 
is made on behalf of the veteran1 for   
examination or treatment for a medical  
condition1 regardless of whether such   
condition is service-connected1 at a    
hospital emergency department of a      
medical facility of the ,department1 the
 ,secretary shall ensure that the       
veteran is provided an appropriate      
medical screening examination within the
 capability of the emergency department1
 including ancillary services routinely 
available to the emergency department1  
to determine whether an emergency       
medical condition exists4  7b7          
,necessary stabilizing treatment for    
emergency medical conditions and labor  
7#a7 ,if an enrolled veteran comes to a 
medical facility of the ,department and 
the ,secretary determines that the      
veteran has an emergency medical        
condition1 the ,secretary shall provide 

either--  7,a7 such further medical     
examination and such treatment as may be
 required to stabilize the medical      
condition2 or  7,b7 for the transfer of 
the veteran to another medical facility 
of the ,department or a non-,department 
facility in accordance with subsection  
7c74  7#b7 ,the ,secretary is deemed to 
meet the requirement of paragraph       
7#a77;,a7 with respect to an enrolled   
veteran if the ,secretary offers the    
veteran the further medical examination 
and treatment described in such         
paragraph and informs the veteran 7or an
 individual acting on behalf of the     
veteran7 of the risks and benefits to   
the veteran of such examination and     
treatment1 but the veteran 7or          
individual7 refuses to consent to the   
examination and treatment4 ,the         
,secretary shall take all reasonable    
steps to secure the written informed    
consent of such veteran 7or individual7 
to refuse such examination and          
treatment4  7#c7 ,the ,secretary is     

deemed to meet the requirement of       
paragraph 7#a7 with respect to an       
enrolled veteran if the ,secretary      
offers to transfer the individual to    
another medical facility in accordance  
with subsection 7c7 of this section and 
informs the veteran 7or an individual   
acting on behalf of the veteran7 of the 
risks and benefits to the veteran of    
such transfer1 but the veteran 7or      
individual7 refuses to consent to the   
transfer4 ,the hospital shall take all  
reasonable steps to secure the written  
informed consent of such veteran 7or    
individual7 to refuse such transfer4    
7c7 ,restriction of transfers until     
veteran stabilized  7#a7 ,if an enrolled
 veteran at a medical facility of the   
,department has an emergency medical    
condition that has not been stabilized1 
the ,secretary may not transfer the     
veteran to another medical facility of  
the ,department or a non-,department    
facility unless--  7,a7  7i7 the veteran
 7or a legally responsible individual   

acting on behalf of the veteran71 after 
being informed of the obligation of the 
,secretary under this section and of the
 risk of transfer1 requests in writing a
 transfer to another medical facility2  
7ii7 a physician has signed a           
certification 7including a summary of   
the risks and benefits7 that1 based upon
 the information available at the time  
of transfer1 the medical benefits       
reasonably expected from the provision  
of appropriate medical treatment at     
another medical facility outweigh the   
increased risks to the veteran and1 in  
the case of labor1 to the unborn child  
from effecting the transfer2 or  7iii7  
if a physician is not physically present
 in the emergency department at the time
 a veteran is transferred1 a qualified  
medical person 7as defined by the       
,secretary in regulations7 has signed a 
certification described in clause 7ii7  
after a physician1 in consultation with 
the person1 has made the determination  
described in such clause1 and           

subsequently countersigns the           
certification2 and  7,b7 the transfer is
 an appropriate transfer as described in
 paragraph 7#b74  7#b7 ,an appropriate  
transfer to a medical facility is a     
transfer--  7,a7 in which the           
transferring medical facility provides  
the medical treatment within the        
capacity of the facility that minimizes 
the risks to the health of the enrolled 
veteran and1 in the case of a woman in  
labor1 the health of the unborn child2  
7,b7 in which the receiving facility--  
7i7 has available space and qualified   
personnel for the treatment of the      
veteran2 and  7ii7 has agreed to accept 
transfer of the veteran and to provide  
appropriate medical treatment2  7,c7 in 
which the transferring facility sends to
 the receiving facility all medical     
records 7or copies thereof71 related to 
the emergency condition for which the   
veteran has presented1 available at the 
time of the transfer1 including records 
related to the emergency medical        

condition of the veteran1 observations  
of signs or symptoms1 preliminary       
diagnosis1 treatment provided1 results  
of any tests and the informed written   
consent or certification 7or copy       
thereof7 provided under paragraph       
7#a77;,a71 and the name and address of  
any on-call physician 7described in     
subsection 7d77#a77;,c7 of this section7
 who has refused or failed to appear    
within a reasonable time to provide     
necessary stabilizing treatment2  7,d7  
in which the transfer is effected       
through qualified personnel and         
transportation equipment1 as required   
including the use of necessary and      
medically appropriate life support      
measures during the transfer2 and  7,e7 
that meets such other requirements as   
the ,secretary may find necessary in the
 interest of the health and safety of   
veterans transferred4  7d7 ,charges     
7#a7 ,nothing in this section may be    
construed to affect any charges that the
 ,secretary may collect from a veteran  

or third party4  7#b7 ,the ,secretary   
shall treat any care provided by a      
non-,department facility pursuant to    
this section as care otherwise provided 
by a non-,department facility pursuant  
to this chapter for purposes of paying  
such non-,department facility for such  
care4  7e7 ,nondiscrimination ,a medical
 facility of the ,department or a       
non-,department facility1 as the case   
may be1 that has specialized            
capabilities or facilities 7such as burn
 units1 shock-trauma units1 neonatal    
intensive care units1 or 7with respect  
to rural areas7 regional referral       
centers as identified by the ,secretary 
in regulation7 shall not refuse to      
accept an appropriate transfer of an    
enrolled veteran who requires such      
specialized capabilities or facilities  
if the facility has the capacity to     
treat the veteran4  7f7 ,no delay in    
examination or treatment ,a medical     
facility of the ,department or a        
non-,department facility1 as the case   

may be1 may not delay provision of an   
appropriate medical screening           
examination required under subsection   
7a7 or further medical examination and  
treatment required under subsection 7b7 
of this section in order to inquire     
about the method of payment or insurance
 status of an enrolled veteran4  7g7    
,whistleblower protections ,the         
,secretary may not take adverse action  
against an employee of the ,department  
because the employee refuses to         
authorize the transfer of an enrolled   
veteran with an emergency medical       
condition that has not been stabilized  
or because the employee reports a       
violation of a requirement of this      
section4  7h7 ,definitions ,in this     
section3 7#a7 ,the term emergency       
medical condition means--  7,a7 a       
medical condition manifesting itself by 
acute symptoms of sufficient severity   
7including severe pain7 such that the   
absence of immediate medical attention  
could reasonably be expected to result  

in--  7i7 placing the health of the     
enrolled veteran 7or1 with respect to an
 enrolled veteran who is a pregnant     
woman1 the health of the woman or her   
unborn child7 in serious jeopardy2  7ii7
 serious impairment to bodily functions2
 or  7iii7 serious dysfunction of any   
bodily organ or part2 or  7,b7 with     
respect to an enrolled veteran who is a 
pregnant woman having contractions-- 7i7
 that there is inadequate time to effect
 a safe transfer to another hospital    
before delivery2 or  7ii7 that transfer 
may pose a threat to the health or      
safety of the woman or the unborn child4
  7#b7 ,the term enrolled veteran means 
a veteran who is enrolled in the health 
care system established under section   
#agje7;a7 of this title4  7#c7 ,the term
 to stabilize means1 with respect to an 
emergency medical condition described in
 paragraph 7#a77;,a71 to provide such   
medical treatment of the condition as   
may be necessary to assure1 within      
reasonable medical probability1 that no 

material deterioration of the condition 
is likely to result from or occur during
 the transfer of the enrolled veteran   
from a facility1 or1 with respect to an 
emergency medical condition described in
 paragraph 7#a77;,b71 to deliver        
7including the placenta74  7#d7 ,the    
term stabilized means1 with respect to  
an emergency medical condition described
 in paragraph 7#a77;,a71 that no        
material deterioration of the condition 
is likely1 within reasonable medical    
probability1 to result from or occur    
during the transfer of the individual   
from a facility1 or1 with respect to an 
emergency medical condition described in
 paragraph 7#a77;,b71 that the woman has
 delivered 7including the placenta74    
7#e7 ,the term transfer means the       
movement 7including the discharge7 of an
 enrolled veteran outside the facilities
 of a medical facility of the           
,department at the direction of any     
individual employed by 7or affiliated or
 associated1 directly or indirectly1    

with7 the ,department1 but does not     
include such a movement of an individual
 who--  7,a7 has been declared dead2 or 
7,b7 leaves the facility without the    
permission of any such person4  4  7b7  
,clerical amendment ,the table of       
sections of such chapter is amended by  
inserting after the item relating to    
section #agcj;,a the following new item3
  #agcj;,b4 ,examination and treatment  
for emergency medical conditions and    
women in labor4  4