§ 8111. Sharing of Department of Veterans Affairs and Department of Defense health care resources

Legislative history

Reconstructed from this section’s Code source credit and amendment notes, resolved against the local Statutes at Large. Editorial notes are evidence, not the law that made the change.

1. 1979

   Veterans’ Health Care Amendments of 1979

   Pub. L. 96–22 title III § 301(a) · 93 Stat. 47

   Enacted · 38 U.S.C. § 8111

   Added Pub. L. 96–22, title III, § 301(a), June 13, 1979, 93 Stat. 60, § 5011

   Source evidence

   Code source credit
   Added Pub. L. 96–22, title III, § 301(a), June 13, 1979, 93 Stat. 60, § 5011

   Enacted provision · exact public law section
   (a) Subchapter I of chapter 81 is amended to read as follows: “Subchapter I— Acquisition and Operation of Medical Facilities “§5001. Definitions “For the purposes of this subchapter: “(1) The term ‘alter’, with respect to a medical facility, means to repair, remodel, improve, or extend such medical facility. “(2) The terms ‘construct’ and ‘alter’, with respect to a medical facility, include such engineering, architectural, legal, fiscal, and economic investigations and studies and such surveys, designs, plans, working drawings, specifications, procedures, and other similar actions as are necessary for the construction or alteration, as the case may be, of such medical facility and as are carried out after the completion of the advanced planning (including the development of project requirements and preliminary plans) for such facility. “(3) The term ‘medical facility’ means any facility or part thereof which is, or will be, under the jurisdiction of the Administrator for the provision of health-care services (including hospital, nursing home, or domiciliary care or medical services), including any necessary building and auxiliary structure, garage, parking facility, mechanical equipment, trackage facilities leading thereto, abutting sidewalks, accommodations for attending personnel, and recreation facilities associated therewith. “(4) The term ‘committee’ means the Committee on Veterans’ Affairs of the House of Representatives or the Committee on Veterans’ Affairs of the Senate, and the term ‘committees’ means both such committees. “§5002. Acquisition of medical facilities “(a) The Administrator shall provide medical facilities for veterans entitled to hospital, nursing home, or domiciliary care or medical services under this title. “(b) No medical facility may be constructed or otherwise acquired or altered except in accordance with the provisions of this subchapter. “(c) In carrying out this subchapter, the Administrator— Functions. “(1) shall provide for the construction and acquisition of medical facilities in a manner that results in the equitable distribution of such facilities throughout the United States, taking into consideration the comparative urgency of the need for the services to be provided in the case of each particular facility; and “(2) shall give due consideration to excellence of architecture and design. “§5003. Authority to construct and alter, and to acquire sites for, medical facilities “(a) Subject to section 5004 of this title, the Administrator— “(1) may construct or alter any medical facility and may acquire, by purchase, lease, condemnation, donation, exchange, or otherwise, such land or interests in land as the Administrator considers necessary for use as the site for such construction or alteration; “(2) may acquire, by purchase, lease, condemnation, donation, exchange, or otherwise, any facility (including the site of such facility) that the Administrator considers necessary for use as a medical facility; and “(3) in order to assure compliance with section 5010(a)(2) of this title, in the case of any outpatient medical facility for which it is proposed to lease space and for which a qualified lessor and an appropriate leasing arrangement are available, shall execute a lease for such facility within 12 months after funds are made available for such purpose. “(b) Whenever the Administrator considers it to be in the interest of the United States to construct a new medical facility to replace an existing medical facility, the Administrator (1) may demolish the existing facility and use the site on which it is located for the site of the new medical facility, or (2) if in the judgment of the Administrator it is more advantageous to construct such medical facility on a different site in the same locality, may exchange such existing facility and the site of such existing facility for the different site. “(c) Whenever the Administrator determines that any site acquired for the construction of a medical facility is not suitable for that purpose, the Administrator may exchange such site for another site to be used for that purpose or may sell such site. “§5004. Congressional approval of certain medical facility acquisitions “(a) In order to ensure the equitable distribution of medical facilities throughout the United States, taking into consideration the comparative urgency of the need for the services to be provided in the case of each particular facility— “(1) no appropriation may be made for the construction, alteration, or acquisition (not including exchanges) of any medical facility which involves a total expenditure of more than $2,000,000 unless each committee has first adopted a resolution approving such construction, alteration, or acquisition and setting forth the estimated cost thereof; and “(2) no appropriation may be made for the lease of any space for use as a medical facility at an average annual rental of more than $500,000 unless each committee has first adopted a resolution approving such lease and setting forth the estimated cost thereof. “(b) In the event that the President or the Administrator proposes to the Congress the funding of any construction, alteration, lease, or other acquisition to which subsection (a) of this section is applicable, the Administrator shall submit to each committee, on the same day, a prospectus of the proposed medical facility. Such prospectus shall Contents. include— “(1) a detailed description of the medical facility to be constructed, altered, leased, or otherwise acquired under this subchapter, including a description of the location of such facility; “(2) an estimate of the cost to the United States of the construction, alteration, lease, or other acquisition of such facility (including site costs, if applicable); and “(3) an estimate of the cost to the United States of the equipment required for the operation of such facility. “(c) The estimated cost of any construction, alteration, lease, or Cost increase, limitation. other acquisition that is approved under this section, as Set forth in the pertinent resolutions described in subsection (a) of this section, may be increased by the Administrator in the contract for such construction, alteration, lease, or other acquisition by an amount equal to the percentage increase, if any, as determined by the Administrator, in construction, alteration, lease, or other acquisition costs, as the case may be. from the date of such approval to the date of contract, but in no event may the amount of such increase exceed 10 per centum of such estimated cost. “(d) In the case of any medical facility approved for construction, Rescinding of approval. alteration, lease, or other acquisition by each committee under subsection la) of this section for which funds have not been appropriated within one year after the date of such approval, either such committee may by resolution rescind its approval at any time thereafter before such funds are appropriated. “(e) In any case in which the Administrator proposes that funds be used for a purpose other than the purpose for which such funds were appropriated, the Administrator shall promptly notify each committee, in writing, of the particulars involved and the reasons why such funds were not used for the purpose for which appropriated. “(f) The Administrator may accept gifts or donations for any of the Gifts or donations. purposes of this subchapter. “§5005. Structural requirements “(a) Each medical facility (including each nursing home facility for which the Administrator contracts under section 620 of this title and 38 USC 620. each State home facility constructed or altered under section 5031 of this title) shall be of fire, earthquake, and other natural disaster 38 USC 5031. resistant construction in accordance with standards which the Administrator shall prescribe on a State or regional basis after surveying appropriate State and local laws, ordinances, and building codes and climatic and seismic conditions pertinent to each such facility. When an existing structure is acquired for use aS a medical facility, it shall be altered to comply with such standards. “(b) (1) In order to carry out this section, the Administrator shall Advisory Committee on Structural Safety of Veterans’ Administration Facilities; membership. appoint an advisory committee to be known as the Advisory Committee on Structural Safety of Veterans’ Administration Facilities’, on which shall serve at least one architect and one structural engineer who are experts in structural resistance to fire, earthquake, and other natural disasters and who are not employees of the Federal Government. “(2) Such advisory committee shall advise the Administrator on all Function. matters of structural safety in the construction and altering of medical facilities in accordance with the requirements of this section and shall review and make recommendations to the Administrator on the regulations prescribed under this section. “(3) The Associate Deputy Administrator, the Chief Medical Director Ex officio members. or the designee of the Chief Medical Director, and the Veterans’ Administration official charged with the responsibility for construction shall be ex officio members of such advisory committee. “§5006. Construction contracts “(a) The Administrator may carry out any construction or alteration authorized under this subchapter by contract if the Administrator considers it to be advantageous to the United States to do so. “(b) (1) The Administrator may obtain, by contract or otherwise, the services of individuals who are architects or engineers and of architectural and engineering corporations and firms, to the extent that the Administrator may require such services for any medical facility authorized to be constructed or altered under this subchapter. “(2) No corporation, firm, or individual may be employed under the authority of paragraph (1) of this subsection on a permanent basis. “(c) Notwithstanding any other provision of this section, the Administrator shall be responsible for all construction authorized under this subchapter, including the interpretation of construction contracts, the approval of materials and workmanship supplied pursuant to a construction contract, approval of changes in the construction contract, certification of vouchers for payments due the contractor, and final settlement of the contract. “§5007. Reports to congressional committees “(a) In order to promote effective planning for the orderly construction, replacement, and alteration of medical facilities in accordance with the comparative urgency of the need for the services to be provided by such facilities, the Administrator shall submit to each committee an annual report on the construction, replacement, and alteration of medical facilities. Such report shall be submitted to the Contents. committees on the same day each year and shall contain— “(1) a five-year plan for the construction, replacement, or alteration of those medical facilities that, in the judgment of the Administrator, are most in need of construction, replacement, or alteration; “(2) a list, in order of priority, of not less than ten hospitals that, in the judgment of the Administrator, are most in need of construction or replacement; and “(3) general plans (including projected costs, site location, and, if appropriate, necessary land acquisition) for each medical facility included in the five-year plan required under clause (1) of this subsection or the list required under clause (2) of this subsection. The first such report shall be submitted not later than September 1, 1979, and each succeeding report shall be submitted not later than June 30 of each year. “(b) The Administrator shall submit to each committee not later than January 31 of each year (beginning in 1981) a report showing the location, space, cost, and status of each medical facility the construction, alteration, lease, or other acquisition of which has been Ante, p. 56. approved under section 5004(a) of this title and, in the case of the second and each succeeding report made under this subsection, which was uncompleted as of the date of the last preceding report made under this subsection. “§5008. Contributions to local authorities “The Administrator may make contributions to local authorities toward, or for, the construction of traffic controls, road improvements, or other devices adjacent to a medical facility if considered necessary for safe ingress or egress. “§5069. Garages and parking facilities “(a) The Administrator may construct, alter, operate, and maintain, on reservations of medical facilities, garages and parking facilities for the accommodation of privately owned vehicles of employees of such facilities and vehicles of visitors and other individuals having business at such facilities. “(b) (1) The Administrator may establish and collect (or provide for Fees. the collection of) fees for the use of such garages and parking facilities at such rate or rates which the Administrator determines would be reasonable under the particular circumstances; but no fee may be charged for the accommodation of any publicly or privately owned vehicle used in connection with the transportation of a veteran to or from any medical facility for the purposes of examination or treatment or in connection with any visit to any patient in such facility. Employees using such garages shall make such reimbursement therefor as the Administrator may deem reasonable. “(2) The Administrator may contract, by lease or otherwise, with Lease of parking facilities, responsible persons, firms, or corporations for the operation of such parking facilities, under such terms and conditions as the Administrator shall prescribe, and without regard to the laws concerning advertising for competitive bids. “(c) (1) There are authorized to be appropriated such amounts as are Appropriation authorization. necessary to finance in part the construction, alteration, operation, and maintenance of garages and parking facilities (other than the construction or alteration of any garage or parking facility involving the expenditure of more than $2,000,000). Amounts appropriated Revolving fund. under the authority of this section, and all income from fees collected for the use of such garages and parking facilities, shall be administered as a revolving fund to effectuate the provisions of this section, but only to the extent provided for in appropriation Acts. “(2) The revolving fund shall be deposited in a checking account with the Treasurer of the United States, except that such amounts thereof as the Administrator may determine to be necessary to establish and maintain operating accounts for the various garages and parking facilities may be placed in depositories selected by the Administrator. “§5010. Operation of medical facilities “(a) (1) The Administrator, subject to the approval of the President, is authorized to establish and operate not less than one hundred and twenty-five thousand hospital beds in medical facilities over which the Administrator has direct jurisdiction for the care and treatment of eligible veterans. The Administrator shall staff and maintain, in such a manner as to ensure the immediate acceptance and timely and complete care of patients, sufficient beds and other treatment capacities to accommodate, and provide such care to, eligible veterans applying for admission and found to be in need of hospital care or medical services. “(2) The Administrator shall maintain the bed and treatment capacities of all Veterans’ Administration medical facilities so as to ensure the accessibility and availability of such beds and treatment capacities to eligible veterans in all States and to minimize delays in admissions and in the provision of hospital, nursing home, and domiciliary care, and of medical services furnished pursuant to section 612 of this title. 38 USC 612; ante, p. 47. Analysis of treatment facilities. “(3) The Chief Medical Director shall periodically analyze agencywide admission policies and the records of those eligible veterans who apply for hospital care and medical services but are rejected or not immediately admitted or provided such care or services, and the Administrator shall annually advise each committee of the results of such analysis and the number of any additional beds and treatment capacities and the appropriate staffing and funds therefor found necessary to meet the needs of such veterans for such necessary care and services. “(b) The Administrator, subject to the approval of the President, is authorized to establish and operate not less than twelve thousand beds during fiscal year 1980, and during each fiscal year thereafter, for the furnishing of nursing home care to eligible veterans in facilities over which the Administrator has direct jurisdiction. The beds authorized by this subsection shall be in addition to the beds provided for in subsection (a) of this section. “(c) When the Administrator determines, in accordance with regulations which the Administrator shall prescribe, that a Veterans’ Administration facility serves a substantial number of veterans with limited English-speaking ability, the Administrator shall establish and implement procedures, upon the recommendation of the Chief Medical Director, to ensure the identification of sufficient numbers of individuals on such facility’s staff who are fluent In both the language most appropriate to such veterans and in English and whose responsibilities shall include providing guidance to such veterans and to appropriate Veterans’ Administration staff members with respect to cultural sensitivities and bridging linguistic and cultural differences. “§5011. Use of Armed Forces facilities “The Administrator and the Secretary of the Army, the Secretary of the Air Force, and the Secretary of the Navy may enter into agreements and contracts for the mutual use or exchange of use of hospital and domiciliary facilities, and such supplies, equipment, and material as may be needed to operate such facilities properly, or for the transfer, without reimbursement of appropriations, of facilities, supplies, equipment, or material necessary and proper for authorized care for veterans, except that at no time shall the Administrator enter into any agreement which will result in a permanent reduction of Veterans’ Administration hospital and domiciliary beds below the number established or approved on June 22, 1944, plus the estimated number required to meet the load of eligibles under this title, or in any way subordinate or transfer the operation of the Veterans’ Administration to any other agency of the Government. “§5012. Partial relinquishment of legislative jurisdiction “The Administrator, on behalf of the United States, may relinquish to the State in which any lands or interests therein under the supervision or control of the Administrator are situated, such measure of legislative jurisdiction over such lands or interests as is necessary to establish concurrent jurisdiction between the Federal Filing of notice with Governor of State. Government and the State concerned. Such partial relinquishment of legislative jurisdiction shall be initiated by filing a notice thereof with the Governor of the State concerned, or in such other manner as may be prescribed by the laws of such State, and shall take effect upon acceptance by such State. “§5013. Property formerly owned by National Home for Disabled Volunteer Soldiers “If by reason of any defeasance or conditional clause or clauses contained in any deed of conveyance of property to the National Home for Disabled Volunteer Soldiers, which property is owned by the United States, the full and complete enjoyment and use of such property is threatened, the Attorney General, upon request of the President, shall institute in the United States district court for the district in which the property is located such proceedings as may be proper to extinguish all outstanding adverse interests. The Attorney General may procure and accept, on behalf of the United States, by gift, purchase, cession, or otherwise, absolute title to, and complete jurisdiction over, all such property. “§5014. Use of federally owned facilities; use of personnel “(a) The Administrator, subject to the approval of the President, may use as medical facilities such suitable buildings, structures, and grounds owned by the United States on March 3, 1925, as may be available for such purposes, and the President may by Executive order transfer any such buildings, structures, and grounds to the control and jurisdiction of the Veterans’ Administration upon the request of the Administrator. “(b) The President may require the architectural, engineering, constructing, or other forces of any of the departments of the Government to do or assist In the construction and alteration of medical facilities, and the President may employ for such purposes individuals and agencies not connected with the Government, if in the opinion of the President such is desirable, at such compensation as the President may consider reasonable. “§5015. Acceptance of certain property “The President may accept from any State or other political subdivision, or from any person, any building, structure, equipment, or grounds suitable for the care of disabled persons, with due regard to fire or other hazards, state of repair, and all other pertinent considerations. The President may designate which agency of the Federal Government shall have the control and management of any property so accepted.“.

2. 1982

   Veterans’ Administration and Department of Defense Health Resources Sharing and Emergency Operations Act

   Pub. L. 97–174 § 3(b)(1) · 96 Stat. 70

   Substituted · 38 U.S.C. § 8111

   Pub. L. 97–174, § 3(b)(1), substituted “Sharing of Veterans’ Administration and Department of Defense health-care resources” for “Use of Armed Forces facilities” in section catchline

   Source evidence

   Code amendment note
   Pub. L. 97–174, § 3(b)(1), substituted “Sharing of Veterans’ Administration and Department of Defense health-care resources” for “Use of Armed Forces facilities” in section catchline.

   Enacted provision · exact public law section
   (1) The heading of such section is amended to read as follows: 38 USC 5011. “§ 5011. Sharing of Veterans’ Administration and Department of Defense health-care resources”.

3. 1982

   Veterans’ Administration and Department of Defense Health Resources Sharing and Emergency Operations Act

   Pub. L. 97–174 § 3(a)(1) · 96 Stat. 70

   1. Amended · 38 U.S.C. § 8111(a)

      Pub. L. 97–174, § 3(a)(1), (2), designated existing provisions as subsec. (a)

   2. Substituted · 38 U.S.C. § 8111(a)

      Pub. L. 97–174, § 3(a)(1), (2), substituted “material, and other resources as may be needed to operate such facilities properly, except that the Administrator may not enter into an agreement that would result (1) in a permanent reduction in the total number of authorized Veterans’ Administration hospital beds and nursing home beds to a level below the minimum number of such beds required by section 5010(a)(1) of this title to be authorized, or (2) in a permanent reduction in the total number of such beds operated and maintained to a level below the minimum number of such beds required by such section to be operated and maintained” for “and material as may be needed to operate such facilities properly, or for the transfer, without reimbursement of appropriations, of facilities, supplies, equipment, or material necessary and proper for authorized care for veterans, except that at no time shall the Administrator enter into any agreement which will result in a permanent reduction of Veterans’ Administration hospital and domiciliary beds below the number established or approved on June 22, 1944, plus the estimated number required to meet the load of eligibles under this title,”

   Source evidence

   Code amendment note
   Subsec. (a). Pub. L. 97–174, § 3(a)(1), (2), designated existing provisions as subsec. (a) and substituted “material, and other resources as may be needed to operate such facilities properly, except that the Administrator may not enter into an agreement that would result (1) in a permanent reduction in the total number of authorized Veterans’ Administration hospital beds and nursing home beds to a level below the minimum number of such beds required by section 5010(a)(1) of this title to be authorized, or (2) in a permanent reduction in the total number of such beds operated and maintained to a level below the minimum number of such beds required by such section to be operated and maintained” for “and material as may be needed to operate such facilities properly, or for the transfer, without reimbursement of appropriations, of facilities, supplies, equipment, or material necessary and proper for authorized care for veterans, except that at no time shall the Administrator enter into any agreement which will result in a permanent reduction of Veterans’ Administration hospital and domiciliary beds below the number established or approved on June 22, 1944, plus the estimated number required to meet the load of eligibles under this title,”.

   Enacted provision · exact public law section
   (1) by inserting “(a)” before “The Administrator” the first place it appears;

4. 1982

   Veterans’ Administration and Department of Defense Health Resources Sharing and Emergency Operations Act

   Pub. L. 97–174 § 3(a)(3) · 96 Stat. 70

   Added · 38 U.S.C. § 8111(b)(g)

   Pub. L. 97–174, § 3(a)(3), added subsecs. (b) to (g)

   Source evidence

   Code amendment note
   Subsecs. (b) to (g). Pub. L. 97–174, § 3(a)(3), added subsecs. (b) to (g).

   Enacted provision · exact public law section
   (3) by adding at the end the following new subsections: “(b) (1) In order to promote the sharing of health-care resources Veterans’ Administration/Department of Defense Health-Care Resources Sharing Committee. Establishment. between the Veterans’ Administration and the Department of Defense (hereinafter in this section referred to as the ‘agencies’), there is established an interagency committee to be known as the Veterans’ Administration/Department of Defense Health-Care Resources Sharing Committee (hereinafter in this subsection referred to as the ‘Committee’). “(2) The Committee shall be composed of— “(A) the Chief Medical Director and such other officers and employees of the Veterans’ Administration as the Chief Medical Director may designate; and “(B) the Assistant Secretary of Defense for Health Affairs (hereinafter in this section referred to as the ‘Assistant Secretary’) and such other officers and employees of the Department of Defense as the Assistant Secretary may designate, except that the size of the Committee shall be mutually determined by the Chief Medical Director and the Assistant Secretary. During fiscal years 1982 and 1983, the Chief Medical Director shall be the chairman of the Committee. During fiscal year 1984, the Assistant Secretary shall be the chairman of the Committee. Thereafter, the chairmanship of the Committee shall alternate each fiscal year between the Chief Medical Director and the Assistant Secretary. The agencies shall provide administrative support services for the Committee at a level sufficient for the efficient operation of the Committee and shall share the responsibility for the provision of such services on an equitable basis. “(3) In order to enable the Committee to make recommendations Duties. under paragraph (4) of this subsection, the Committee shall on a continuing basis— “(A) review existing policies, procedures, and practices relating to the sharing of health-care resources between the agencies; “(B) identify and assess further opportunities for the sharing of health-care resources between the agencies that would not, in the judgment of the Committee, adversely affect the range of services, the quality of care, or the established priorities for care provided by either agency; “(C) identify changes in policies, procedures, and practices that would, in the judgment of the Committee, promote such sharing of health-care resources between the agencies; “(D) monitor plans of the agencies for the acquisition of additional health-care resources, including the location of new facilities and the acquisition of major equipment, in order to assess the potential impact of such plans on further opportunities for such sharing of health-care resources; and “(E) monitor the implementation of activities designed to promote the sharing of health-care resources between the agencies. “(4) Within nine months of the date of the enactment of this subsection Recommendations to VA Administrator or DOD Secretary. and at such times thereafter as the Committee considers appropriate, the Committee shall make recommendations to the Administrator or the Secretary of Defense, or both, with respect to (A) changes in policies, procedures, and practices that the Committee has identified under paragraph (3)(C) of this subsection pertain-ing to the sharing of health-care resources described in such paragraph, and (B) such other matters as the Committee considers appropriate in order to promote such sharing of health-care resources. “(c) (1) After considering the recommendations made under subsection (b)(4) of this section, the Administrator and the Secretary of Defense shall jointly establish guidelines to promote the sharing of health-care resources between the agencies. Guidelines established under this subsection shall provide for such sharing consistent with the health-care responsibilities of the Veterans’ Administration under this title and with the health-care responsibilities of the 10 USC 1071 et seq. Department of Defense under chapter 55 of title 10 and so as not to adversely affect the range of services, the quality of care, or the established priorities for care provided by either agency. “(2) Guidelines established under paragraph (1) of this subsection shall authorize the heads of individual medical facilities of the agencies to enter into health-care resources sharing agreements in accordance with subsection (d) of this section and shall include guidelines for such agreements. “(d) (1) The head of each medical facility of either agency is authorized to enter into sharing agreements with the heads of medical facilities of the other agency in accordance with guidelines established under subsection (c) of this section. Under any such agreement, an individual who is a primary beneficiary of one agency may be provided health care at a facility of the other agency that is a party to the sharing agreement. “(2) Each such agreement shall identify the health-care resources to be shared. “(3) Each such agreement shall provide, and shall specify procedures designed to ensure, that the availability of direct health care to individuals who are not primary beneficiaries of the providing agency (A) is on a referral basis from the facility of the other agency, and (B) does not (as determined by the head of the facility of the providing agency) adversely affect the range of services, the quality of care, or the established priorities for care provided to the primary beneficiaries of the providing agency. “(4) Each such agreement shall provide that a providing agency shall be reimbursed for the cost of the health-care resources provided under the agreement and that the rate for such reimbursement shall be determined in accordance with the methodology agreed to pursuant to subsection (e) of this section. “(5) Each proposal for an agreement under paragraph (1) of this subsection shall be submitted to the Chief Medical Director and the Assistant Secretary and shall be effective as an agreement in accordance with its terms (A) on the forty-sixth day after the receipt of such proposal by both such officials, unless earlier disapproved by either such official, or (B) if earlier approved by both such officials, on the date of such approval. “(e) Reimbursement under any sharing agreement entered into under subsection (d) of this section shall be based upon a methodology that is agreed upon by the Chief Medical Director and the Assistant Secretary and that provides appropriate flexibility to the heads of the facilities concerned to take into account local conditions and needs and the actual costs to the providing agency’s facility of the health-care resources provided. Any funds received through such a reimbursement shall be credited to funds that have been allotted to the facility that provided the care or services. “(f) At the time the President’s Budget is transmitted to Congress Report to Congress. in any year pursuant to section 201(a) of the Budget and Accounting Act, 1921 (31 U.S.C. 11(a)), the Administrator and the Secretary of Defense shall submit a joint report to Congress on the implementation of this section during the fiscal year that ended during the previous calendar year. Each such report shall include— “(1) the guidelines prescribed under subsection (c) of this section (and any revision of such guidelines); “(2) the assessment of further opportunities identified under clause (B) of subsection (b)(3) of this section for sharing of health-care resources between the agencies; “(3) any recommendation made under subsection (b)(4) of this section during such fiscal year; “(4) a review of the sharing agreements entered into under subsection (d) of this section and a summary of activities under such agreements during such fiscal year; “(5) a summary of other planning and activities involving either agency in connection with promoting the coordination and sharing of Federal health-care resources during the preceding fiscal year; and “(6) such recommendations for legislation as the Administrator and the Secretary consider appropriate to facilitate the sharing of health-care resources between the agencies. “(g) For the purposes of this section: Definitions. “(1) The term ‘beneficiary’ means a person who is a primary beneficiary of the Veterans’ Administration or of the Department of Defense. “(2) The term ‘direct health care’ means health care provided to a beneficiary in a medical facility operated by the Veterans’ Administration or the Department of Defense. “(3) The term ‘head of a medical facility’ (A) with respect to a medical facility of the Veterans’ Administration, means the director of the facility, and (B) with respect to a medical facility of the Department of Defense, means the medical or dental officer in charge or the contract surgeon in charge. “(4) The term ‘health-care resource’ includes hospital care, medical services, and rehabilitative services, as those terms are defined in paragraphs (5), (6), and (8), respectively, of section 601 of this title, any other health-care service, and any health-care support or administrative resource. “(5) The term ‘primary beneficiary’ (A) with respect to the Veterans’ Administration means a person who is eligible under this title (other than under section 611(b) or 613 or subsection 38 USC 611, 613. (d) of this section) or any other provision of law for care or services in Veterans’ Administration medical facilities, and (B) with respect to the Department of Defense, means a member or former member of the Armed Forces who is eligible for care under section 1074 of title 10. “(6) The term ‘providing agency’ means the Veterans’ Administration, in the case of care or services furnished by a facility of the Veterans’ Administration, and the Department of Defense, in the case of care or services furnished by a facility of the Department of Defense.”.

5. 1983

   Pub. L. 97–452 § 2(e)(4) · 96 Stat. 2467

   Substituted · 38 U.S.C. § 8111(f)

   Pub. L. 97–452 substituted “section 1105 of title 31” for “section 201(a) of the Budget and Accounting Act, 1921 (31 U.S.C. 11(a))”

   Source evidence

   Code amendment note
   Subsec. (f). Pub. L. 97–452 substituted “section 1105 of title 31” for “section 201(a) of the Budget and Accounting Act, 1921 (31 U.S.C. 11(a))”.

   Enacted provision · exact public law section
   (4) Sections 5010(a)(1) and 5011(f) are each amended by striking 38 USC 5010, ante, p. 70 out “section 201(a) of the Budget and Accounting Act, 1921 (31 U.S.C. 11(a))” and substituting “section 1105 of title 31”.

6. 1991

   Department of Veterans Affairs Health-Care Personnel Act of 1991

   Pub. L. 102–40 § 402(b)(1) · 105 Stat. 187

   Changed · 38 U.S.C. § 8111

   Pub. L. 102–40, § 402(b)(1), renumbered section 5011 of this title as this section

   Source evidence

   Code amendment note
   Pub. L. 102–40, § 402(b)(1), renumbered section 5011 of this title as this section.

   Enacted provision · exact public law section
   (1) Each section contained in any of chapters 51, 53, 55, 57, 59, 61, 71, 72, 76, 78 (as redesignated by subsection (a)), 81, 83, and 85 is redesignated so that the first two digits of the section number of that section are the same as the chapter number of the chapter containing that section.

7. 1991

   Department of Veterans Affairs Health-Care Personnel Act of 1991

   Pub. L. 102–40 § 402(d)(1) · 105 Stat. 187

   Substituted · 38 U.S.C. § 8111(a)

   Pub. L. 102–40, § 402(d)(1), substituted “8110(a)(1)” for “5010(a)(1)”

   Target inherited from the preceding amendment note.

   Source evidence

   Code amendment note
   Pub. L. 102–40, § 402(d)(1), substituted “8110(a)(1)” for “5010(a)(1)”.

   Enacted provision · exact public law section
   (1) Each provision of title 38, United States Code, that contains a reference to a section redesignated by section 401(a)(4) or by subsection (b) is amended so that the reference refers to the section as redesignated.

8. 1991

   Pub. L. 102–83 § 4(a)(3) · 105 Stat. 378

   Substituted · 38 U.S.C. § 8111

   Pub. L. 102–83, § 4(a)(3), (4), substituted “Sharing of Department” for “Sharing of Veterans’ Administration” in section catchline

   Target inherited from the preceding amendment note.

   Source evidence

   Code amendment note
   Pub. L. 102–83, § 4(a)(3), (4), substituted “Sharing of Department” for “Sharing of Veterans’ Administration” in section catchline.

   Enacted provision · exact public law section
   (3) Such title is further amended by striking out “Veterans’ Administration” each place it appears (other than as amended under paragraphs (1) and (2) and as specified in paragraph (4)) and inserting in lieu thereof “Department”.

9. 1991

   Pub. L. 102–83 § 4(b)(1) · 105 Stat. 378

   Substituted · 38 U.S.C. § 8111(a)

   Pub. L. 102–83, § 4(b)(1), (2)(E), substituted “Secretary” for “Administrator” in two places

   Source evidence

   Code amendment note
   Subsec. (a). Pub. L. 102–83, § 4(b)(1), (2)(E), substituted “Secretary” for “Administrator” in two places.

   Enacted provision · exact public law section
   (1) Title 38 is further amended by striking out “Administrator” and “Administrator’s” each place they appear (except as provided in paragraphs (2) and (9) and including where they appear in section headings and tables of sections) and inserting in lieu thereof “Secretary” and “Secretary’s”, respectively.

10. 1991

    Pub. L. 102–83 § 4(a)(3) · 105 Stat. 378

    Substituted · 38 U.S.C. § 8111(a)

    Pub. L. 102–83, § 4(a)(3), (4), substituted “Department” for “Veterans’ Administration” in two places

    Target inherited from the preceding amendment note.

    Source evidence

    Code amendment note
    Pub. L. 102–83, § 4(a)(3), (4), substituted “Department” for “Veterans’ Administration” in two places.

    Enacted provision · exact public law section
    (3) Such title is further amended by striking out “Veterans’ Administration” each place it appears (other than as amended under paragraphs (1) and (2) and as specified in paragraph (4)) and inserting in lieu thereof “Department”.

11. 1991

    Pub. L. 102–83 § 4(b)(1) · 105 Stat. 378

    Substituted · 38 U.S.C. § 8111(b)

    Pub. L. 102–83, § 4(b)(1), (2)(E), substituted “Secretary” for “Administrator” in par. (4)

    Source evidence

    Code amendment note
    Subsec. (b). Pub. L. 102–83, § 4(b)(1), (2)(E), substituted “Secretary” for “Administrator” in par. (4).

    Enacted provision · exact public law section
    (1) Title 38 is further amended by striking out “Administrator” and “Administrator’s” each place they appear (except as provided in paragraphs (2) and (9) and including where they appear in section headings and tables of sections) and inserting in lieu thereof “Secretary” and “Secretary’s”, respectively.

12. 1991

    Pub. L. 102–83 § 4(a)(3) · 105 Stat. 378

    Substituted · 38 U.S.C. § 8111(b)

    Pub. L. 102–83, § 4(a)(3), (4), substituted “Department” for “Veterans’ Administration” wherever appearing in pars. (1) and (2)(A)

    Target inherited from the preceding amendment note.

    Source evidence

    Code amendment note
    Pub. L. 102–83, § 4(a)(3), (4), substituted “Department” for “Veterans’ Administration” wherever appearing in pars. (1) and (2)(A).

    Enacted provision · exact public law section
    (3) Such title is further amended by striking out “Veterans’ Administration” each place it appears (other than as amended under paragraphs (1) and (2) and as specified in paragraph (4)) and inserting in lieu thereof “Department”.

13. 1991

    Pub. L. 102–83 § 4(b)(1) · 105 Stat. 378

    Substituted · 38 U.S.C. § 8111(c)(1)

    Pub. L. 102–83, § 4(b)(1), (2)(E), substituted “Secretary” for “Administrator”

    Source evidence

    Code amendment note
    Subsec. (c)(1). Pub. L. 102–83, § 4(b)(1), (2)(E), substituted “Secretary” for “Administrator”.

    Enacted provision · exact public law section
    (1) Title 38 is further amended by striking out “Administrator” and “Administrator’s” each place they appear (except as provided in paragraphs (2) and (9) and including where they appear in section headings and tables of sections) and inserting in lieu thereof “Secretary” and “Secretary’s”, respectively.

14. 1991

    Pub. L. 102–83 § 4(a)(3) · 105 Stat. 378

    Substituted · 38 U.S.C. § 8111(c)(1)

    Pub. L. 102–83, § 4(a)(3), (4), substituted “Department” for “Veterans’ Administration”

    Target inherited from the preceding amendment note.

    Source evidence

    Code amendment note
    Pub. L. 102–83, § 4(a)(3), (4), substituted “Department” for “Veterans’ Administration”.

    Enacted provision · exact public law section
    (3) Such title is further amended by striking out “Veterans’ Administration” each place it appears (other than as amended under paragraphs (1) and (2) and as specified in paragraph (4)) and inserting in lieu thereof “Department”.

15. 1991

    Pub. L. 102–83 § 4(b)(1) · 105 Stat. 378

    Substituted · 38 U.S.C. § 8111(f)

    Pub. L. 102–83, § 4(b)(1), (2)(E), substituted “Secretary” for “Administrator” in introductory provisions and in par. (6)

    Source evidence

    Code amendment note
    Subsec. (f). Pub. L. 102–83, § 4(b)(1), (2)(E), substituted “Secretary” for “Administrator” in introductory provisions and in par. (6).

    Enacted provision · exact public law section
    (1) Title 38 is further amended by striking out “Administrator” and “Administrator’s” each place they appear (except as provided in paragraphs (2) and (9) and including where they appear in section headings and tables of sections) and inserting in lieu thereof “Secretary” and “Secretary’s”, respectively.

16. 1991

    Pub. L. 102–83 § 5(c)(1) · 105 Stat. 378

    1. Substituted · 38 U.S.C. § 8111(g)

       Pub. L. 102–83, § 5(c)(1), substituted “1701” for “601” in par. (5)

    2. Substituted · 38 U.S.C. § 8111(g)

       Pub. L. 102–83, § 5(c)(1), substituted “1711(b) or 1713” for “611(b) or 613” in par. (5)

    Source evidence

    Code amendment note
    Subsec. (g). Pub. L. 102–83, § 5(c)(1), substituted “1701” for “601” in par. (4) and “1711(b) or 1713” for “611(b) or 613” in par. (5).

    Enacted provision · exact public law section
    (1) Each provision of title 38, United States Code, that contains a reference to a section redesignated by subsection (a) is amended so that the reference refers to the section as redesignated.

17. 1991

    Pub. L. 102–83 § 4(a)(3) · 105 Stat. 378

    Substituted · 38 U.S.C. § 8111(g)

    Pub. L. 102–83, § 4(a)(3), (4), substituted “Department” for “Veterans’ Administration” wherever appearing

    Target inherited from the preceding amendment note.

    Source evidence

    Code amendment note
    Pub. L. 102–83, § 4(a)(3), (4), substituted “Department” for “Veterans’ Administration” wherever appearing.

    Enacted provision · exact public law section
    (3) Such title is further amended by striking out “Veterans’ Administration” each place it appears (other than as amended under paragraphs (1) and (2) and as specified in paragraph (4)) and inserting in lieu thereof “Department”.

18. 1992

    Veterans’ Medical Programs Amendments of 1992

    Pub. L. 102–405 title III § 302(c)(1) · 106 Stat. 1972

    Substituted · 38 U.S.C. § 8111(b)(2); 38 U.S.C. § 8111(d)(5); 38 U.S.C. § 8111(b)(e)

    Pub. L. 102–405 substituted “Under Secretary for Health” for “Chief Medical Director” wherever appearing

    Source evidence

    Code amendment note
    Subsecs. (b)(2), (d)(5), (e). Pub. L. 102–405 substituted “Under Secretary for Health” for “Chief Medical Director” wherever appearing.

    Enacted provision · exact public law section
    (1) Title 38, United States Code, is amended by striking out “Chief Medical Director” and “Chief Benefits Director” each place they appear (including in headings and tables but not including the sentences added by paragraphs (2) and (3)) and inserting in lieu thereof “Under Secretary for Health” and “Under Secretary for Benefits”, respectively.

19. 1994

    Veterans’ Benefits Improvements Act of 1994

    Pub. L. 103–446 § 1201(g)(8)(A) · 108 Stat. 4645

    1. Substituted · 38 U.S.C. § 8111(b)(2)

       Pub. L. 103–446, § 1201(g)(8)(A), in concluding provisions, substituted “During odd-numbered fiscal years” for “During fiscal years 1982 and 1983”

    2. Substituted · 38 U.S.C. § 8111(b)(2)

       Pub. L. 103–446, § 1201(g)(8)(A), in concluding provisions, substituted “During even-numbered fiscal years” for “During fiscal year 1984”

    3. Struck · 38 U.S.C. § 8111(b)(2)

       Pub. L. 103–446, § 1201(g)(8)(A), in concluding provisions, struck out after third sentence “Thereafter, the chairmanship of the Committee shall alternate each fiscal year between the Under Secretary for Health and the Assistant Secretary.”

    Source evidence

    Code amendment note
    Subsec. (b)(2). Pub. L. 103–446, § 1201(g)(8)(A), in concluding provisions, substituted “During odd-numbered fiscal years” for “During fiscal years 1982 and 1983” and “During even-numbered fiscal years” for “During fiscal year 1984” and struck out after third sentence “Thereafter, the chairmanship of the Committee shall alternate each fiscal year between the Under Secretary for Health and the Assistant Secretary.”

    Enacted provision · exact public law section
    (A) in paragraph (2)— (i) by striking out “During fiscal years 1982 and 1983” in the second sentence and inserting in lieu thereof “During odd-numbered fiscal years”; (ii) by striking out “During fiscal year 1984” in the third sentence and inserting in lieu thereof “During even-numbered fiscal years”; and (iii) by striking out the fourth sentence; and

20. 1994

    Veterans’ Benefits Improvements Act of 1994

    Pub. L. 103–446 § 1201(g)(8)(B) · 108 Stat. 4645

    Substituted · 38 U.S.C. § 8111(b)(4)

    Pub. L. 103–446, § 1201(g)(8)(B), substituted “At such times as” for “Within nine months of the date of the enactment of this subsection and at such times thereafter as”

    Source evidence

    Code amendment note
    Subsec. (b)(4). Pub. L. 103–446, § 1201(g)(8)(B), substituted “At such times as” for “Within nine months of the date of the enactment of this subsection and at such times thereafter as”.

    Enacted provision · exact public law section
    (B) in paragraph (4), by striking out “Within nine months of the date of the enactment of this subsection and at such times thereafter as” and inserting in lieu thereof “At such times as”.

21. 1994

    Veterans’ Benefits Improvements Act of 1994

    Pub. L. 103–446 § 1201(i)(10) · 108 Stat. 4645

    Inserted · 38 U.S.C. § 8111(f)(6)

    Pub. L. 103–446, § 1201(i)(10), inserted “of Defense” after second reference to “Secretary”

    Source evidence

    Code amendment note
    Subsec. (f)(6). Pub. L. 103–446, § 1201(i)(10), inserted “of Defense” after second reference to “Secretary”.

    Enacted provision · exact public law section
    (10) Section 8111(f)(6) is amended by inserting “of Defense” after “the Secretary” the second place it appears.

22. 2002

    Department of Veterans Affairs Health Care Programs Enhancement Act of 2001

    Pub. L. 107–135 § 208(e)(6)(A) · 115 Stat. 2446

    Inserted · 38 U.S.C. § 8111(g)(4)

    Pub. L. 107–135, § 208(e)(6)(A), inserted “services under sections 1782 and 1783 of this title” after “of this title,”

    Source evidence

    Code amendment note
    Subsec. (g)(4). Pub. L. 107–135, § 208(e)(6)(A), inserted “services under sections 1782 and 1783 of this title” after “of this title,”.

    Enacted provision · exact public law section
    (A) in paragraph (4), by inserting “services under sections 1782 and 1783 of this title” after “of this title,”; and

23. 2002

    Department of Veterans Affairs Health Care Programs Enhancement Act of 2001

    Pub. L. 107–135 § 208(e)(6)(B) · 115 Stat. 2446

    Substituted · 38 U.S.C. § 8111(g)(5)

    Pub. L. 107–135, § 208(e)(6)(B), substituted “section 1782, 1783, or 1784” for “section 1711(b) or 1713”

    Source evidence

    Code amendment note
    Subsec. (g)(5). Pub. L. 107–135, § 208(e)(6)(B), substituted “section 1782, 1783, or 1784” for “section 1711(b) or 1713”.

    Enacted provision · exact public law section
    (B) in paragraph (5), by striking “section 1711(b) or 1713” and inserting “section 1782, 1783, or 1784”.

24. 2002

    Pub. L. 107–314 div. A title VII § 721(a)(1) · 116 Stat. 2458

    Amended · 38 U.S.C. § 8111

    Pub. L. 107–314 amended section catchline and text generally. Prior to amendment, text related to agreements and contracts for mutual use or exchange of use of hospital and domiciliary facilities and other resources by the Secretary of Veterans Affairs and the Secretary of the Army, the Secretary of the Air Force, and the Secretary of the Navy and provided for establishment of the Department/Department of Defense Health-Care Resources Sharing Committee

    Source evidence

    Code amendment note
    Pub. L. 107–314 amended section catchline and text generally. Prior to amendment, text related to agreements and contracts for mutual use or exchange of use of hospital and domiciliary facilities and other resources by the Secretary of Veterans Affairs and the Secretary of the Army, the Secretary of the Air Force, and the Secretary of the Navy and provided for establishment of the Department/Department of Defense Health-Care Resources Sharing Committee.

    Enacted provision · exact public law section
    (1) Section 8111 of title 38, United States Code, is amended to read as follows: “§8111. Sharing of Department of Veterans Affairs and Department of Defense health care resources “(a) Required Coordination and Sharing of Health Care Resources.— The Secretary of Veterans Affairs and the Secretary of Defense shall enter into agreements and contracts for the mutually beneficial coordination, use, or exchange of use of the health care resources of the Department of Veterans Affairs and the Department of Defense with the goal of improving the access to, and quality and cost effectiveness of, the health care provided by the Veterans Health Administration and the Military Health System to the beneficiaries of both Departments. “(b) Joint Requirements for Secretaries of Veterans Affairs and Defense.— To facilitate the mutually beneficial coordination, use, or exchange of use of the health care resources of the two Departments, the two Secretaries shall carry out the following functions: “(1) Develop and publish a joint strategic vision statement and a joint strategic plan to shape, focus, and prioritize the coordination and sharing efforts among appropriate elements of the two Departments and incorporate the goals and requirements of the joint sharing plan into the strategic and performance plan of each Department under the Government Performance and Results Act. “(2) Jointly fund the interagency committee provided for under subsection (c). “(3) Continue to facilitate and improve sharing between individual Department of Veterans Affairs and Department of Defense health care facilities, but giving priority of effort to initiatives (A) that improve sharing and coordination of health resources at the intraregional and nationwide levels, and (B) that improve the ability of both Departments to provide coordinated health care. “(4) Establish a joint incentive program under subsection (d). “(c) DOD–VA Health Executive Committee.— (1) There is established an interagency committee to be known as the Department of Veterans Affairs-Department of Defense Health Executive Committee (hereinafter in this section referred to as the ‘Committee’). The Committee is composed of— “(A) the Deputy Secretary of Veterans Affairs and such other officers and employees of the Department of Veterans Affairs as the Secretary of Veterans Affairs may designate; and “(B) the Under Secretary of Defense for Personnel and Readiness and such other officers and employees of the Department of Defense as the Secretary of Defense may designate. “(2) (A) During odd-numbered fiscal years, the Deputy Secretary of Veterans Affairs shall chair the Committee. During even-numbered fiscal years, the Under Secretary of Defense shall chair the Committee. “(B) The Deputy Secretary and the Under Secretary shall determine the size and structure of the Committee, as well as the administrative and procedural guidelines for the operation of the Committee. The two Departments shall share equally the Committee’s cost of personnel and administrative support and services. Support for such purposes shall be provided at a level sufficient for the efficient operation of the Committee, including a permanent staff and, as required, other temporary working groups of appropriate departmental staff and outside experts. “(3) The Committee shall recommend to the Secretaries strategic direction for the joint coordination and sharing efforts between and within the two Departments under this section and shall oversee implementation of those efforts. “(4) Reports. The Committee shall submit to the two Secretaries and to Congress an annual report containing such recommendations as the Committee considers appropriate. “(5) In order to enable the Committee to make recommendations in its annual report under paragraph (4), the Committee shall do the following: “(A) Review existing policies, procedures, and practices relating to the coordination and sharing of health care resources between the two Departments. “(B) Identify changes in policies, procedures, and practices that, in the judgment of the Committee, would promote mutually beneficial coordination, use, or exchange of use of the health care resources of the two Departments, with the goal of improving the access to, and quality and cost effectiveness of, the health care provided by the Veterans Health Administration and the Military Health System to the beneficiaries of both Departments. “(C) Identify and assess further opportunities for the coordination and sharing of health care resources between the Departments that, in the judgment of the Committee, would not adversely affect the range of services, the quality of care, or the established priorities for care provided by either Department. “(D) Review the plans of both Departments for the acquisition of additional health care resources, especially new facilities and major equipment and technology, in order to assess the potential effect of such plans on further opportunities for the coordination and sharing of health care resources. “(E) Review the implementation of activities designed to promote the coordination and sharing of health care resources between the Departments. “(6) The Committee chairman, under procedures jointly developed by the two Secretaries, may require the Inspector General of either or both Departments to assist in activities under paragraph (5)(E). “(d) Joint Incentives Program.— (1) Pursuant to subsection (b)(4), the two Secretaries shall carry out a program to identify, provide incentives to, implement, fund, and evaluate creative coordination and sharing initiatives at the facility, intraregional, and nationwide levels. The program shall be administered by the Committee established in subsection (c), under procedures jointly prescribed by the two Secretaries. “(2) To facilitate the incentive program, effective October 1, Effective date. 2003, there is established in the Treasury a fund to be known as the ‘DOD–VA Health Care Sharing Incentive Fund’. Each Secretary shall annually contribute to the fund a minimum of $15,000,000 from the funds appropriated to that Secretary’s Department. Such funds shall remain available until expended. “(3) (A) For each fiscal year during which the program under this subsection is in effect, the Comptroller General shall conduct a review of the implementation and effectiveness of the incentives program under this subsection. Upon completion of each such Reports. annual review, the Comptroller General shall submit to the Committees on Armed Services and Veterans’ Affairs of the Senate and House of Representatives a report on the results of that review. Each such report shall be submitted not later than February 28 Deadline. Deadline. Reports. of the year following the fiscal year covered by the report. In addition, the Comptroller General shall conduct such a review during the first five months of fiscal year 2004 and, not later than February 28, 2004, shall submit to those committees a report on the implementation and effectiveness of the incentives program under this subsection to that date. “(B) Each report under this paragraph shall describe activities carried out under the program under this subsection during the preceding fiscal year (or, in the case of the first such report, to the date of the submission of the report). Each report shall include at least the following: “(i) An analysis of the initiatives funded by the Committee, and the funds so expended by such initiatives, from the DOD–VA Health Care Sharing Incentive Fund, including the purposes and effects of those initiatives on improving access to care by beneficiaries, improvements in the quality of care received by those beneficiaries, and efficiencies gained in delivering services to those beneficiaries. “(ii) Other matters of interest, including recommendations from the Comptroller General for legislative improvements to the program. “(4) Termination date. The program under this subsection shall terminate on September 30, 2007. “(e) Guidelines and Policies for Implementation of Coordination and Sharing Recommendations, Contracts, and Agreements.— (1) To implement the recommendations made by the Committee under subsection (c)(2), as well as to carry out other health care contracts and agreements for coordination and sharing initiatives as they consider appropriate, the two Secretaries shall jointly issue guidelines and policy directives. Such guidelines and policies shall provide for coordination and sharing that— “(A) is consistent with the health care responsibilities of the Department of Veterans Affairs under this title and with the health care responsibilities of the Department of Defense under chapter 55 of title 10; “(B) will not adversely affect the range of services, the quality of care, or the established priorities for care provided by either Department; and “(C) will not reduce capacities in certain specialized programs of the Department of Veterans Affairs that the Secretary is required to maintain in accordance with section 1706(b) of this title. “(2) To facilitate the sharing and coordination of health care services between the two Departments, the two Secretaries shall jointly develop and implement guidelines for a standardized, uniform payment and reimbursement schedule for those services. Such schedule shall be implemented no later than October 1, 2003, and shall be revised periodically as necessary. The two Secretaries, following implementation of the schedule, may on a case-by-case basis waive elements of the schedule if they jointly agree that such a waiver is in the best interests of both Departments. “(3) (A) The guidelines established under paragraph (1) shall authorize the heads of individual Department of Defense and Department of Veterans Affairs medical facilities and service regions to enter into health care resources coordination and sharing agreements. “(B) Under any such agreement, an individual who is a primary beneficiary of one Department may be provided health care, as provided in the agreement, at a facility or in the service region of the other Department that is a party to the sharing agreement. “(C) Each such agreement shall identify the health care resources to be shared. “(D) Each such agreement shall provide, and shall specify procedures designed to ensure, that the availability of direct health care to individuals who are not primary beneficiaries of the providing Department is (i) on a referral basis from the facility or service region of the other Department, and (ii) does not (as determined by the head of the providing facility or region) adversely affect the range of services, the quality of care, or the established priorities for care provided to the primary beneficiaries of the providing Department. “(E) Each such agreement shall provide that a providing Department or service region shall be reimbursed for the cost of the health care resources provided under the agreement and that the rate of such reimbursement shall be as determined in accordance with paragraph (2). “(F) Each proposal for an agreement under this paragraph shall be effective (i) on the 46th day after the receipt of such proposal by the Committee, unless earlier disapproved, or (ii) if earlier approved by the Committee, on the date of such approval. “(G) Any funds received through such a uniform payment and reimbursement schedule shall be credited to funds that have been allotted to the facility of either Department that provided the care or services, or is due the funds from, any such agreement. “(f) Annual Joint Report.— (1) At the time the President’s budget is transmitted to Congress in any year pursuant to section 1105 of title 31, the two Secretaries shall submit to Congress a joint report on health care coordination and sharing activities under this section during the fiscal year that ended during the previous calendar year. “(2) Each report under this section shall include the following: “(A) The guidelines prescribed under subsection (e) (and any revision of such guidelines). “(B) The assessment of further opportunities identified under subparagraph (C) of subsection (c)(5) for the sharing of health-care resources between the two Departments. “(C) Any recommendation made under subsection (c)(4) during such fiscal year. “(D) A review of the sharing agreements entered into under subsection (e) and a summary of activities under such agreements during such fiscal year and a description of the results of such agreements in improving access to, and the quality and cost effectiveness of, the health care provided by the Veterans Health Administration and the Military Health System to the beneficiaries of both Departments. “(E) A summary of other planning and activities involving either Department in connection with promoting the coordination and sharing of Federal health-care resources during the preceding fiscal year. “(F) Such recommendations for legislation as the two Secretaries consider appropriate to facilitate the sharing of healthcare resources between the two Departments. “(3) In addition to the matters specified in paragraph (2), the two Secretaries shall include in the annual report under this subsection an overall status report of the progress of health resources sharing between the two Departments as a consequence of subtitle C of title VII of the Bob Stump National Defense Authorization Act for Fiscal Year 2003 and of other sharing initiatives taken during the period covered by the report. Such status report shall indicate the status of such sharing and shall include appropriate data as well as analyses of that data. The annual report shall include the following: “(A) Enumerations and explanations of major policy decisions reached by the two Secretaries during the period covered by the report period with respect to sharing between the two Departments. “(B) A description of progress made in new ventures or particular areas of sharing and coordination that would be of policy interest to Congress consistent with the intent of such subtitle. “(C) A description of enhancements of access to care of beneficiaries of both Departments that came about as a result of new sharing approaches brought about by such subtitle. “(D) A description of proposals for which funds are provided through the joint incentives program under subsection (d), together with a description of their results or status at the time of the report, including access improvements, savings, and quality-of-care enhancements they brought about, and a description of any additional use of funds made available under subsection (d). “(4) In addition to the matters specified in paragraphs (2) and (3), the two Secretaries shall include in the annual report under this subsection for each year through 2008 the following: “(A) A description of the measures taken, or planned to be taken, to implement the health resources sharing project under section 722 of the Bob Stump National Defense Authorization Act for Fiscal Year 2003 and any cost savings anticipated, or cost sharing achieved, at facilities participating in the project, including information on improvements in access to care, quality, and timeliness, as well as impediments encountered and legislative recommendations to ameliorate such impediments. “(B) A description of the use of the waiver authority provided by section 722(d)(1) of the Bob Stump National Defense Authorization Act for Fiscal Year 2003, including— “(i) a statement of the numbers and types of requests for waivers under that section of administrative policies that have been made during the period covered by the report and, for each such request, an explanation of the content of each request, the intended purpose or result of the requested waiver, and the disposition of each request; and “(ii) descriptions of any new administrative policies that enhance the success of the project. “(5) In addition to the matters specified in paragraphs (2), (3), and (4), the two Secretaries shall include in the annual report under this subsection for each year through 2009 a report on the pilot program for graduate medical education under section 725 of the Bob Stump National Defense Authorization Act for Fiscal Year 2003, including activities under the program during the preceding year and each Secretary’s assessment of the efficacy of providing education and training under that program. “(g) Definitions.— For the purposes of this section: “(1) The term ‘beneficiary’ means a person who is a primary beneficiary of the Department of Veterans Affairs or of the Department of Defense. “(2) The term ‘direct health care’ means health care provided to a beneficiary in a medical facility operated by the Department of Veterans Affairs or the Department of Defense. “(3) The term ‘head of a medical facility’ (A) with respect to a medical facility of the Department of Veterans Affairs, means the director of the facility, and (B) with respect to a medical facility of the Department of Defense, means the medical or dental officer in charge or the contract surgeon in charge. “(4) The term ‘health-care resource’ includes hospital care, medical services, and rehabilitative services, as those terms are defined in paragraphs (5), (6), and (8), respectively, of section 1701 of this title, services under sections 1782 and 1783 of this title, any other health-care service, and any healthcare support or administrative resource. “(5) The term ‘primary beneficiary’ (A) with respect to the Department means a person who is eligible under this title (other than under section 1782, 1783, or 1784 or subsection (d) of this section) or any other provision of law for care or services in Department medical facilities, and (B) with respect to the Department of Defense, means a member or former member of the Armed Forces who is eligible for care under section 1074 of title 10. “(6) The term ‘providing Department’ means the Department of Veterans Affairs, in the case of care or services furnished by a facility of the Department of Veterans Affairs, and the Department of Defense, in the case of care or services furnished by a facility of the Department of Defense. “(7) The term ‘service region’ means a geographic service area of the Veterans Health Administration, in the case of the Department of Veterans Affairs, and a service region, in the case of the Department of Defense.”.

    Effective date note
    Pub. L. 107–314, div. A, title VII, § 721(c), Dec. 2, 2002, 116 Stat. 2595, provided that: “The amendments made by this section [amending this section and section 1104 of Title 10, Armed Forces] shall take effect on October 1, 2003.”

25. 2003

    National Defense Authorization Act for Fiscal Year 2004

    Pub. L. 108–136 § 583(b)(2)(A) · 117 Stat. 1392

    Substituted · 38 U.S.C. § 8111(b)(2)

    Pub. L. 108–136, § 583(b)(2)(A), substituted “the Department of Veterans Affairs-Department of Defense Joint Executive Committee under section 320 of this title” for “the interagency committee provided for under subsection (c)”

    Source evidence

    Code amendment note
    Subsec. (b)(2). Pub. L. 108–136, § 583(b)(2)(A), substituted “the Department of Veterans Affairs-Department of Defense Joint Executive Committee under section 320 of this title” for “the interagency committee provided for under subsection (c)”.

    Enacted provision · exact public law section
    (A) in subsection (b)(2), by striking “the interagency committee provided for under subsection (c)” and inserting “the Department of Veterans Affairs-Department of Defense Joint Executive Committee under section 320 of this title”;

26. 2003

    National Defense Authorization Act for Fiscal Year 2004

    Pub. L. 108–136 § 583(b)(1) · 117 Stat. 1392

    Struck · 38 U.S.C. § 8111(c)

    Pub. L. 108–136, § 583(b)(1), struck out subsec. (c) which related to establishment of Department of Veterans Affairs-Department of Defense Health Executive Committee

    Source evidence

    Code amendment note
    Subsec. (c). Pub. L. 108–136, § 583(b)(1), struck out subsec. (c) which related to establishment of Department of Veterans Affairs-Department of Defense Health Executive Committee.

    Enacted provision · exact public law section
    (1) Subsection (c) of section 8111 of such title is repealed.

27. 2003

    National Defense Authorization Act for Fiscal Year 2004

    Pub. L. 108–136 § 583(b)(2)(B) · 117 Stat. 1392

    Substituted · 38 U.S.C. § 8111(d)(1)

    Pub. L. 108–136, § 583(b)(2)(B), substituted “Department of Veterans Affairs-Department of Defense Joint Executive Committee” for “Committee established in subsection (c)”

    Source evidence

    Code amendment note
    Subsec. (d)(1). Pub. L. 108–136, § 583(b)(2)(B), substituted “Department of Veterans Affairs-Department of Defense Joint Executive Committee” for “Committee established in subsection (c)”.

    Enacted provision · exact public law section
    (B) in subsection (d)(1), by striking “Committee established in subsection (c)” and inserting “Department of Veterans Affairs-Department of Defense Joint Executive Committee”;

28. 2003

    National Defense Authorization Act for Fiscal Year 2004

    Pub. L. 108–136 § 583(b)(2)(C) · 117 Stat. 1392

    Substituted · 38 U.S.C. § 8111(e)(1)

    Pub. L. 108–136, § 583(b)(2)(C), substituted “Department of Veterans Affairs-Department of Defense Joint Executive Committee with respect to health care resources” for “Committee under subsection (c)(2)” in introductory provisions

    Source evidence

    Code amendment note
    Subsec. (e)(1). Pub. L. 108–136, § 583(b)(2)(C), substituted “Department of Veterans Affairs-Department of Defense Joint Executive Committee with respect to health care resources” for “Committee under subsection (c)(2)” in introductory provisions.

    Enacted provision · exact public law section
    (C) in subsection (e)(1), by striking “Committee under subsection (c)(2)” and inserting “Department of Veterans Affairs-Department of Defense Joint Executive Committee with respect to health care resources”; and

29. 2003

    National Defense Authorization Act for Fiscal Year 2004

    Pub. L. 108–136 § 583(b)(2)(D) · 117 Stat. 1392

    1. Added · 38 U.S.C. § 8111(f)(2)(B); 38 U.S.C. § 8111(f)(2)(C)

       Pub. L. 108–136, § 583(b)(2)(D), added subpars. (B) and (C)

    2. Struck · 38 U.S.C. § 8111(f)(2)(B); 38 U.S.C. § 8111(f)(2)(C)

       Pub. L. 108–136, § 583(b)(2)(D), struck out former subpars. (B) and (C) which read as follows:

    Source evidence

    Code amendment note
    Subsec. (f)(2)(B), (C). Pub. L. 108–136, § 583(b)(2)(D), added subpars. (B) and (C) and struck out former subpars. (B) and (C) which read as follows:

    “(B) The assessment of further opportunities identified under subparagraph (C) of subsection (c)(5) for the sharing of health-care resources between the two Departments. “(C) Any recommendation made under subsection (c)(4) during such fiscal year.”

    Enacted provision · exact public law section
    (D) in subsection (f)(2), by striking subparagraphs (B) and (C) and inserting the following: “(B) The assessment of further opportunities identified by the Department of Veterans Affairs-Department of Defense Joint Executive Committee under subsection (d)(3) of section 320 of this title for the sharing of health-care resources between the two Departments. “(C) Any recommendation made by that committee under subsection (c)(2) of that section during that fiscal year.” .

30. 2003

    National Defense Authorization Act for Fiscal Year 2004

    Pub. L. 108–136 § 583(c) · 117 Stat. 1392

    Inserted · 38 U.S.C. § 8111(f)(3); 38 U.S.C. § 8111(4)(A); 38 U.S.C. § 8111(f)(B); 38 U.S.C. § 8111(f)(5)

    Pub. L. 108–136, § 583(c), inserted “(Public Law 107–314)” after “for Fiscal Year 2003”

    Source evidence

    Code amendment note
    Subsec. (f)(3), (4)(A), (B), (5). Pub. L. 108–136, § 583(c), inserted “(Public Law 107–314)” after “for Fiscal Year 2003”.

    Enacted provision · exact public law section
    (c) Technical Amendments.— Subsection (f) of such section is further amended by inserting “(Public Law 107–314)” in paragraphs (3), (4)(A), (4)(B), and (5) after “for Fiscal Year 2003”.

31. 2004

    Veterans Health Programs Improvement Act of 2004

    Pub. L. 108–422 title VI § 605 · 118 Stat. 2379

    Inserted · 38 U.S.C. § 8111(d)(2)

    Pub. L. 108–422 inserted “and shall be available for any purpose authorized by this section” before period at end

    Source evidence

    Code amendment note
    Subsec. (d)(2). Pub. L. 108–422 inserted “and shall be available for any purpose authorized by this section” before period at end.

    Enacted provision · exact public law section
    SEC. 605. TECHNICAL CLARIFICATION.   Section 8111(d)(2) is amended by inserting before the period at the end of the last sentence the following: “and shall be available for any purpose authorized by this section”.

32. 2006

    National Defense Authorization Act for Fiscal Year 2006

    Pub. L. 109–163 § 1056(g) · 119 Stat. 3136

    Inserted · 38 U.S.C. § 8111(b)(1)

    Pub. L. 109–163, § 1056(g), inserted “of 1993” after “Government Performance and Results Act”

    Target inherited from the preceding amendment note.

    Source evidence

    Code amendment note
    Pub. L. 109–163, § 1056(g), inserted “of 1993” after “Government Performance and Results Act”.

    Enacted provision · exact public law section
    (g) Title 38, United States Code.— Section 8111(b)(1) of title 38, United States Code, is amended by inserting “of 1993” after “the Government Performance and Results Act”.

33. 2006

    National Defense Authorization Act for Fiscal Year 2006

    Pub. L. 109–163 § 747(a) · 119 Stat. 3136

    1. Redesignated · 38 U.S.C. § 8111(d)(3)

       Pub. L. 109–163, § 747(a), redesignated par. (4) as (3)

    2. Struck · 38 U.S.C. § 8111(d)(3)

       Pub. L. 109–163, § 747(a), struck out former par. (3) which provided for an annual review and report by the Comptroller General of the implementation and effectiveness of the incentives program under this subsection

    Target inherited from the preceding amendment note.

    Source evidence

    Code amendment note
    Pub. L. 109–163, § 747(a), redesignated par. (4) as (3) and struck out former par. (3) which provided for an annual review and report by the Comptroller General of the implementation and effectiveness of the incentives program under this subsection.

    Enacted provision · exact public law section
    (a) Joint Incentives Program.— Section 8111(d) of title 38, United States Code, is amended— (1) by striking paragraph (3); and (2) by redesignating paragraph (4) as paragraph (3).

34. 2006

    National Defense Authorization Act for Fiscal Year 2006

    Pub. L. 109–163 § 747(a)(2) · 119 Stat. 3136

    Redesignated · 38 U.S.C. § 8111(d)(4)

    Pub. L. 109–163, § 747(a)(2), redesignated par. (4) as (3)

    Source evidence

    Code amendment note
    Subsec. (d)(4). Pub. L. 109–163, § 747(a)(2), redesignated par. (4) as (3).

    Enacted provision · exact public law section
    (2) by redesignating paragraph (4) as paragraph (3).

35. 2006

    John Warner National Defense Authorization Act for Fiscal Year 2007

    Pub. L. 109–364 div. A title VII § 743 · 120 Stat. 2083

    Substituted · 38 U.S.C. § 8111(d)(3)

    Pub. L. 109–364 substituted “September 30, 2010” for “September 30, 2007”

    Source evidence

    Code amendment note
    Subsec. (d)(3). Pub. L. 109–364 substituted “September 30, 2010” for “September 30, 2007”.

    Enacted provision · exact public law section
    SEC. 743. THREE-YEAR EXTENSION OF JOINT INCENTIVES PROGRAM ON SHARING OF HEALTH CARE RESOURCES BY THE DEPARTMENT OF DEFENSE AND DEPARTMENT OF VETERANS AFFAIRS.   Section 8111(d)(3) of title 38, United States Code, is amended by striking “September 30, 2007” and inserting “September 30, 2010”.

36. 2006

    Pub. L. 109–444 § 8(a)(6) · 120 Stat. 3304

    Substituted · 38 U.S.C. § 8111(b)(1)

    Pub. L. 109–444, § 8(a)(6), which substituted “into the strategic plan of each Department under section 306 of title 5 and the performance plan of each Department under section 1115 of title 31” for “into the strategic and performance plan of each Department under the Government Performance and Results Act of 1993”, was terminated by Pub. L. 109–461, § 1006(b). See Amendment notes above

    Target inherited from the preceding amendment note.

    Source evidence

    Code amendment note
    Pub. L. 109–444, § 8(a)(6), which substituted “into the strategic plan of each Department under section 306 of title 5 and the performance plan of each Department under section 1115 of title 31” for “into the strategic and performance plan of each Department under the Government Performance and Results Act of 1993”, was terminated by Pub. L. 109–461, § 1006(b). See Amendment notes above.

    Enacted provision · exact public law section
    (6) Citation correction.— Section 8111(b)(1) is amended by striking “into the strategic” and all that follows through “and Results Act of 1993” and inserting “into the strategic plan of each Department under section 306 of title 5 and the performance plan of each Department under section 1115 of title 31”.

37. 2006

    Pub. L. 109–444 § 8(a)(7)(A) · 120 Stat. 3304

    Struck · 38 U.S.C. § 8111(d)(2)

    Pub. L. 109–444, § 8(a)(7)(A), which struck out “effective October 1, 2003,” after “the incentive program,”, was terminated by Pub. L. 109–461, § 1006(b). See Amendment notes above

    Target inherited from the preceding amendment note.

    Source evidence

    Code amendment note
    Pub. L. 109–444, § 8(a)(7)(A), which struck out “effective October 1, 2003,” after “the incentive program,”, was terminated by Pub. L. 109–461, § 1006(b). See Amendment notes above.

    Enacted provision · exact public law section
    (A) in subsection (d)(2), by striking “effective October 1, 2003,”; and

38. 2006

    Pub. L. 109–444 § 8(a)(7)(B) · 120 Stat. 3304

    Struck · 38 U.S.C. § 8111(e)(2)

    Pub. L. 109–444, § 8(a)(7)(B), which struck out “shall be implemented no later than October 1, 2003, and” after “Such schedule” in second sentence and “, following implementation of the schedule,” after “The two Secretaries” in third sentence, was terminated by Pub. L. 109–461, § 1006(b). See Amendment notes above

    Target inherited from the preceding amendment note.

    Source evidence

    Code amendment note
    Pub. L. 109–444, § 8(a)(7)(B), which struck out “shall be implemented no later than October 1, 2003, and” after “Such schedule” in second sentence and “, following implementation of the schedule,” after “The two Secretaries” in third sentence, was terminated by Pub. L. 109–461, § 1006(b). See Amendment notes above.

    Enacted provision · exact public law section
    (B) in subsection (e)(2)— (i) in the second sentence, by striking “shall be implemented no later than October 1, 2003, and”; and (ii) in the third sentence, by striking “, following implementation of the schedule,”.

39. 2006

    Veterans Benefits, Health Care, and Information Technology Act of 2006

    Pub. L. 109–461 § 1006(b) · 120 Stat. 3403

    Changed · 38 U.S.C. § 8111

    Pub. L. 109–461, § 1006(b), provided that as of the enactment of Pub. L. 109–461, the amendments made by Pub. L. 109–444 were deemed for all purposes not to have taken effect and that Pub. L. 109–444 ceased to be in effect. See Amendment notes below and section 1006(b) of Pub. L. 109–461, set out as a Coordination of Provisions With Pub. L. 109–444 note under section 101 of this title

    Source evidence

    Code amendment note
    Pub. L. 109–461, § 1006(b), provided that as of the enactment of Pub. L. 109–461, the amendments made by Pub. L. 109–444 were deemed for all purposes not to have taken effect and that Pub. L. 109–444 ceased to be in effect. See Amendment notes below and section 1006(b) of Pub. L. 109–461, set out as a Coordination of Provisions With Pub. L. 109–444 note under section 101 of this title.

    Enacted provision · exact public law section
    (b) Earlier Enactment of Veterans Programs Extension Act of 2006.— If this Act is enacted after the enactment of the Veterans Programs Extension Act of 2006, then as of the date of the enactment of this Act, the Veterans Programs Extension Act of 2006 and the amendments made by that Act shall be deemed for all purposes not to have taken effect and the Veterans Programs Extension Act of 2006 and the amendments made by that Act shall cease to be in effect.

40. 2006

    Veterans Benefits, Health Care, and Information Technology Act of 2006

    Pub. L. 109–461 § 1004(a)(6) · 120 Stat. 3403

    Substituted · 38 U.S.C. § 8111(b)(1)

    Pub. L. 109–461, § 1004(a)(6), substituted “into the strategic plan of each Department under section 306 of title 5 and the performance plan of each Department under section 1115 of title 31” for “into the strategic and performance plan of each Department under the Government Performance and Results Act of 1993”

    Source evidence

    Code amendment note
    Subsec. (b)(1). Pub. L. 109–461, § 1004(a)(6), substituted “into the strategic plan of each Department under section 306 of title 5 and the performance plan of each Department under section 1115 of title 31” for “into the strategic and performance plan of each Department under the Government Performance and Results Act of 1993”.

    Enacted provision · exact public law section
    (6) Citation correction.— Section 8111(b)(1) is amended by striking “into the strategic” and all that follows through “and Results Act of 1993” and inserting “into the strategic plan of each Department under section 306 of title 5 and the performance plan of each Department under section 1115 of title 31”.

41. 2006

    Veterans Benefits, Health Care, and Information Technology Act of 2006

    Pub. L. 109–461 § 1004(a)(7)(A) · 120 Stat. 3403

    Struck · 38 U.S.C. § 8111(d)(2)

    Pub. L. 109–461, § 1004(a)(7)(A), struck out “effective October 1, 2003,” after “the incentive program,”

    Source evidence

    Code amendment note
    Subsec. (d)(2). Pub. L. 109–461, § 1004(a)(7)(A), struck out “effective October 1, 2003,” after “the incentive program,”.

    Enacted provision · exact public law section
    (A) in subsection (d)(2), by striking “effective October 1, 2003,”; and

42. 2006

    Veterans Benefits, Health Care, and Information Technology Act of 2006

    Pub. L. 109–461 § 1004(a)(7)(B) · 120 Stat. 3403

    Struck · 38 U.S.C. § 8111(e)(2)

    Pub. L. 109–461, § 1004(a)(7)(B), struck out “shall be implemented no later than October 1, 2003, and” after “Such schedule” in second sentence and “, following implementation of the schedule,” after “The two Secretaries” in third sentence

    Source evidence

    Code amendment note
    Subsec. (e)(2). Pub. L. 109–461, § 1004(a)(7)(B), struck out “shall be implemented no later than October 1, 2003, and” after “Such schedule” in second sentence and “, following implementation of the schedule,” after “The two Secretaries” in third sentence.

    Enacted provision · exact public law section
    (B) in subsection (e)(2)— (i) in the second sentence, by striking “shall be implemented no later than October 1, 2003, and”; and (ii) in the third sentence, by striking “, following implementation of the schedule,”.

43. 2009

    National Defense Authorization Act for Fiscal Year 2010

    Pub. L. 111–84 div. A title XVII § 1706 · 123 Stat. 2190

    Substituted · 38 U.S.C. § 8111(d)(3)

    Pub. L. 111–84 substituted “September 30, 2015” for “September 30, 2010”

    Source evidence

    Code amendment note
    Subsec. (d)(3). Pub. L. 111–84 substituted “September 30, 2015” for “September 30, 2010”.

    Enacted provision · exact public law section
    SEC. 1706. EXTENSION OF DOD–VA HEALTH CARE SHARING INCENTIVE FUND.   Section 8111(d)(3) of title 38, United States Code, is amended by striking “September 30, 2010” and inserting “September 30, 2015”.

44. 2015

    Department of Veterans Affairs Expiring Authorities Act of 2015

    Pub. L. 114–58 title I § 107 · 129 Stat. 530

    Substituted · 38 U.S.C. § 8111(d)(3)

    Pub. L. 114–58 substituted “September 30, 2016” for “September 30, 2015”

    Target inherited from the preceding amendment note.

    Source evidence

    Code amendment note
    Pub. L. 114–58 substituted “September 30, 2016” for “September 30, 2015”.

    Enacted provision · exact public law section
    SEC. 107. EXTENSION OF AUTHORITY FOR DOD–VA HEALTH CARE SHARING INCENTIVE FUND.   Section 8111(d)(3) is amended by striking “September 30, 2015” and inserting “September 30, 2016”.

45. 2015

    National Defense Authorization Act for Fiscal Year 2016

    Pub. L. 114–92 div. A title VII § 722 · 129 Stat. 726

    Substituted · 38 U.S.C. § 8111(d)(3)

    Pub. L. 114–92, which directed substitution of “September 30, 2020” for “September 30, 2015”, was executed by making the substitution for “September 30, 2016” to reflect the probable intent of Congress and the intervening amendment by Pub. L. 114–58. See below

    Source evidence

    Code amendment note
    Subsec. (d)(3). Pub. L. 114–92, which directed substitution of “September 30, 2020” for “September 30, 2015”, was executed by making the substitution for “September 30, 2016” to reflect the probable intent of Congress and the intervening amendment by Pub. L. 114–58. See below.

    Enacted provision · exact public law section
    SEC. 722. EXTENSION OF AUTHORITY FOR DOD–VA HEALTH CARE SHARING INCENTIVE FUND.   Section 8111(d)(3) of title 38, United States Code, is amended by striking “September 30, 2015” and inserting “September 30, 2020”.

46. 2019

    National Defense Authorization Act for Fiscal Year 2020

    Pub. L. 116–92 div. A title VII § 736 · 133 Stat. 1198

    Substituted · 38 U.S.C. § 8111(d)(3)

    Pub. L. 116–92 substituted “September 30, 2023” for “September 30, 2020”

    Source evidence

    Code amendment note
    Subsec. (d)(3). Pub. L. 116–92 substituted “September 30, 2023” for “September 30, 2020”.

    Enacted provision · exact public law section
    SEC. 736. THREE-YEAR EXTENSION OF AUTHORITY TO CONTINUE THE DOD-VA HEALTH CARE SHARING INCENTIVE FUND.   Section 8111(d)(3) of title 38, United States Code, is amended by striking “September 30, 2020” and inserting, “September 30, 2023”.

47. 2022

    Continuing Appropriations Act, 2023

    Pub. L. 117–180 div. E title I § 103 · 136 Stat. 2114

    Substituted · 38 U.S.C. § 8111(d)(3)

    Pub. L. 117–180 substituted “September 30, 2026” for “September 30, 2023”

    Source evidence

    Code amendment note
    Subsec. (d)(3). Pub. L. 117–180 substituted “September 30, 2026” for “September 30, 2023”.

    Enacted provision · exact public law section
    Sec. 103. Appropriations made by section 101 shall be available to the extent and in the manner that would be provided by the pertinent appropriations Act.

48. 2026

    Pub. L. 119–103 div. D title I § 4107 · 140 Stat. 1007

    Substituted · 38 U.S.C. § 8111(d)(3)

    Pub. L. 119–103 substituted “December 11, 2026” for “September 30, 2026”

    Unresolved: Pub. L. 119–103 was not found in the local Statutes at Large index.

    Source evidence

    Code amendment note
    Subsec. (d)(3). Pub. L. 119–103 substituted “December 11, 2026” for “September 30, 2026”.

53 of 54 references resolved to an enrolled provision · 1 unresolved