shall be deemed to have incurred such disability in the active miliary, naval, or air service. P.L. 85-857, Sept. 2, 1958, 72 Stat. 1141, §602; P.L. 90–77, 203(a), Aug. 31, 1967, 81 Stat. 183; P.L. 97-295, §4(16), Oct. 12, 982, 96 Stat. 1306; P.L. 99–576, § 701(20), Oct. 28, 1986, 100 Stat. 292; P.L. 102-25, §334(b), Apr. 6, 1991, 105 Stat. 88; renumbered 1702, P.L. 102–83, § 5(a), Aug. 6, 1991, 105 Stat. 406.) 1703. Contracts for hospital care and medical services in non-Department facilities (a) When Department facilities are not capable of furnishing ecoComical hospital care or medical services because of geographical accessibility or are not capable of furnishing the care or services equired, the Secretary, as authorized in section 1710 of this title, may contract with non-Department facilities in order to furnish ny of the following: (1) Hospital care or medical services to a veteran for the treatment of (A) a service-connected disability; (B) a disability for which a veteran was discharged or released from the active military, naval, or air service; or (C) a disability of a veteran who has a total disability permanent in nature from a service-connected disability. (2) Medical services for the treatment of any disability of(A) a veteran described in section 1710(a)(1)(B) of this title; (B) a veteran who (i) has been furnished hospital care, nursing home care, domiciliary care, or medical services, and (ii) requires medical services to complete treatment incident to such care or services; or (C) a veteran described in section 1710(a)(2)(E) of this title, or a veteran who is in receipt of increased pension, or additional compensation or allowances based on the need of regular aid and attendance or by reason of being permanently housebound (or who, but for the receipt of retired pay, would be in receipt of such pension, compensation, or allowance), if the Secretary has determined, based on an examination by a physician employed by the Department (or, in areas where no such physician is available, by a physician carrying out such function under a contract or fee arrangement), that the medical condition of such veteran precludes appropriate treatment in Department facilities. (3) Hospital care or medical services for the treatment of medical emergencies which pose a serious threat to the life or health of a veteran receiving medical services in a Department facility or nursing home care under section 1720 of this title until such time following the furnishing of care in the non-Department facility as the veteran can be safely transferred to a Department facility. (4) Hospital care for women veterans. (5) Hospital care, or medical services that will obviate the need for hospital admission, for veterans in a State (other than the Commonwealth of Puerto Rico) not contiguous to the con tiguous States, except that the annually determined hospital patient load and incidence of the furnishing of medical services to veterans hospitalized or treated at the expense of the Department in Government and non-Department facilities in each such noncontiguous State shall be consistent with the patien: load or incidence of the furnishing of medical services for veter ans hospitalized or treated by the Department within the 48 contiguous States and the Commonwealth of Puerto Rico. (6) Diagnostic services necessary for determination of elig bility for, or of the appropriate course of treatment in connec tion with, furnishing medical services at independent Depart ment out-patient clinics to obviate the need for hospital admis sion. (7) Outpatient dental services and treatment, and related dental appliances, for a veteran described in section 1712(a)(1)(F) of this title. (8) Diagnostic services (on an inpatient or outpatient basis for observation or examination of a person to determine elig bility for a benefit or service under laws administered by the Secretary. (b) In the case of any veteran for whom the Secretary contracts to furnish care or services in a non-Department facility pursuant to a provision of subsection (a) of this section, the Secretary shall periodically review the necessity for continuing such contractual ar rangement pursuant to such provision. (c) The Secretary shall include in the budget documents which the Secretary submits to Congress for any fiscal year a detailed report on the furnishing of contract care and services during the most recently completed fiscal year under this section, sections 1712A 1720, 1720A, 1724, and 1732 of this title, and section 115 of the Veterans' Benefits and Services Act of 1988 (Public Law 100-322 102 Stat. 501). (Added P.L. 99-272, § 19012(b)(1), Apr. 7, 1986, 100 Stat. 380 § 603; amended P.L. 99-166, § 102(b)(1), Dec. 3, 1985, 99 Stat. 943. P.L. 99-272, § 19012(c)(5)(A), Apr. 7, 1986, 100 Stat. 382; P.L. 100– 322, §§ 101(e)(3), 104, 112(a), May 20, 1988, 102 Stat. 492, 493, 499; P.L. 100-687, § 1503(a)(1), Nov. 18, 1988, 102 Stat. 4133; P.L 102-54, § 14(b)(9), June 13, 1991, 105 Stat. 283; renumbered § 1703 and amended P.L. 102-83, §§ 4(a)(1), (3)–(5), (b)(1), (2)(E), 5(a. (c)(1), Aug. 6, 1991, 105 Stat. 403-406; P.L. 102-585, §501, Nov. 4, 1992, 106 Stat. 4955; P.L. 104-262, § 104(b), Oct. 9, 1996, 110 Stat. 3184.) § 1704. Preventive health services: annual report Not later than October 31 each year, the Secretary shall submit to the Committees on Veterans' Affairs of the Senate and House of Representatives a report on preventive health services. Each such report shall include the following: (1) A description of the programs and activities of the Department with respect to preventive health services during the preceding fiscal year, including a description of the following (A) The programs conducted by the Department (i) to educate veterans with respect to health promotion and disease prevention; and (ii) to provide veterans with preventive health screenings and other clinical services, with such description setting forth the types of resources used by the Department to conduct such screenings and services and the number of veterans reached by such screenings and services. (B) The means by which the Secretary addressed the specific preventive health services needs of particular groups of veterans (including veterans with service-connected disabilities, elderly veterans, low-income veterans, women veterans, institutionalized veterans, and veterans who are at risk for mental illness). (C) The manner in which the provision of such services was coordinated with the activities of the Medical and Prosthetic Research Service of the Department and the National Center for Preventive Health. (D) The manner in which the provision of such services was integrated into training programs of the Department, including initial and continuing medical training of medical students, residents, and Department staff. (E) The manner in which the Department participated in cooperative preventive health efforts with other governmental and private entities (including State and local health promotion offices and not-for-profit organizations). (F) The specific research carried out by the Department with respect to the long-term relationships among screening activities, treatment, and morbidity and mortality out comes. (G) The cost effectiveness of such programs and activities, including an explanation of the means by which the costs and benefits (including the quality of life of veterans who participate in such programs and activities) of such programs and activities are measured. (2) A specific description of research activities on preventive health services carried out during that period using employees, funds, equipment, office space, or other support services of the Department, with such description setting forth (A) the source of funds for those activities; (B) the articles or publications (including the authors of the articles and publications) in which those activities are described; (C) the Federal, State, or local governmental entity or private entity, if any, with which such activities were carried out; and (D) the clinical, research, or staff education projects for which funding applications were submitted (including the source of the funds applied for) and upon which a decision is pending or was denied. (3) An accounting of the expenditure of funds during that period by the National Center for Preventive Health under section 7318 of this title. dded P.L. 102-585, § 512(a), Nov. 4, 1992, 106 Stat. 4957.) § 1705. Management of health care: patient enrollment system (a) In managing the provision of hospital care and medical services under section 1710(a) of this title, the Secretary, in accordance with regulations the Secretary shall prescribe, shall establish and operate a system of annual patient enrollment. The Secretary shall manage the enrollment of veterans in accordance with the following priorities, in the order listed: (1) Veterans with service-connected disabilities rated 50 percent or greater. (2) Veterans with service-connected disabilities rated 30 percent or 40 percent. (3) Veterans who are former prisoners of war, veterans with service-connected disabilities rated 10 percent or 20 percent, and veterans described in subparagraphs (B) and (C) of section 1710(a)(2) of this title. (4) Veterans who are in receipt of increased pension based on a need of regular aid and attendance or by reason of being permanently housebound and other veterans who are catastrophically disabled. (5) Veterans not covered by paragraphs (1) through (4) who are unable to defray the expenses of necessary care as determined under section 1722(a) of this title. (6) All other veterans eligible for hospital care, medical services, and nursing home care under section 1710(a)(2) of this title. (7) Veterans described in section 1710(a)(3) of this title. (b) In the design of an enrollment system under subsection (a), the Secretary (1) shall ensure that the system will be managed in a manner to ensure that the provision of care to enrollees is timely and acceptable in quality; (2) may establish additional priorities within each priority group specified in subsection (a), as the Secretary determines necessary; and (3) may provide for exceptions to the specified priorities where dictated by compelling medical reasons. (c)(1) Effective on October 1, 1998, the Secretary may not provide hospital care or medical services to a veteran under paragraph (2) or (3) of section 1710(a) of this title unless the veteran enrolls in the system of patient enrollment established by the Secretary under subsection (a). (2) The Secretary shall provide hospital care and medical services under section 1710(a)(1) of this title, and under subparagraph (B) of section 1710(a)(2) of this title, for the 12-month period following such veteran's discharge or release from service, to any veteran referred to in such sections for a disability specified in the applicable subparagraph of such section, notwithstanding the failure of the veteran to enroll in the system of patient enrollment referred to in subsection (a) of this section. (Added P.L. 104-262, § 104(a)(1), Oct. 9, 1996, 110 Stat. 3182.) § 1706. Management of health care: other requirements (a) In managing the provision of hospital care and medical services under section 1710(a) of this title, the Secretary shall, to the extent feasible, design, establish and manage health care programs in such a manner as to promote cost-effective delivery of health care services in the most clinically appropriate setting. (b)(1) In managing the provision of hospital care and medical services under such section, the Secretary shall ensure that the Department maintains its capacity to provide for the specialized treatment and rehabilitative needs of disabled veterans (including veterans with spinal cord dysfunction, blindness, amputations, and mental illness) within distinct programs or facilities of the Department that are dedicated to the specialized needs of those veterans in a manner that (A) affords those veterans reasonable access to care and services for those specialized needs, and (B) ensures that overall capacity of the Department to provide such services is not reduced below the capacity of the Department, nationwide, to provide those services, as of the date of the enactment of this section. The Secretary shall carry out this paragraph in consultation with the Advisory Committee on Prosthetics and Special Disabilities Programs and the Committee on Care of Severely Chronically Mentally Ill Veterans. (2) Not later than April 1, 1997, April 1, 1998, and April 1, 1999, the Secretary shall submit to the Committees on Veterans' Affairs of the Senate and House of Representatives a report on the Secretary's compliance, by facility and by service-network, with the requirements of this subsection. (Added P.L. 104-262, § 104(a)(1), Oct. 9, 1996, 110 Stat. 3183.) SUBCHAPTER II-HOSPITAL, NURSING HOME OR § 1710. Eligibility for hospital, nursing home, and domiciliary care (a)(1) 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 (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; (B) whose discharge or release from active military, naval, or air service was for a compensable 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 (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 continu |