US (United States) Code. Title 42. Chapter 32: Third party liability for hospital and medical care

Codificación normativa de EEUU (Estados Unidos) Legislación Federal estadounidense # The Public Health and Welfare

  • Enviado por: El remitente no desea revelar su nombre
  • Idioma: inglés
  • País: Estados Unidos Estados Unidos
  • 9 páginas
publicidad

-CITE-

42 USC CHAPTER 32 - THIRD PARTY LIABILITY FOR HOSPITAL

AND MEDICAL CARE 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 32 - THIRD PARTY LIABILITY FOR HOSPITAL AND MEDICAL CARE

-HEAD-

CHAPTER 32 - THIRD PARTY LIABILITY FOR HOSPITAL AND MEDICAL CARE

-MISC1-

Sec.

2651. Recovery by United States.

(a) Conditions, exceptions; persons liable; amount

of recovery; subrogation; assignment.

(b) Recovery of cost of pay for member of uniformed

services unable to perform duties.

(c) United States deemed third party beneficiary

under alternative system of compensation.

(d) Enforcement procedure; intervention; joinder of

parties; State or Federal court proceedings.

(e) Veterans' exception.

(f) Crediting of amounts recovered.

(g) Definitions.

2652. Regulations.

(a) Determination and establishment of reasonable

value of care and treatment.

(b) Settlement, release and waiver of claims.

(c) Damages recoverable for personal injury

unaffected.

2653. Limitation or repeal of other provisions for recovery

of hospital and medical care costs.

-SECREF-

CHAPTER REFERRED TO IN OTHER SECTIONS

This chapter is referred to in title 10 section 1095; title 25

sections 1621g, 1683; title 38 section 1729A.

-End-

-CITE-

42 USC Sec. 2651 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 32 - THIRD PARTY LIABILITY FOR HOSPITAL AND MEDICAL CARE

-HEAD-

Sec. 2651. Recovery by United States

-STATUTE-

(a) Conditions; exceptions; persons liable; amount of recovery;

subrogation; assignment

In any case in which the United States is authorized or required

by law to furnish or pay for hospital, medical, surgical, or dental

care and treatment (including prostheses and medical appliances) to

a person who is injured or suffers a disease, after the effective

date of this Act, under circumstances creating a tort liability

upon some third person (other than or in addition to the United

States and except employers of seamen treated under the provisions

of section 249 of this title) to pay damages therefor, the United

States shall have a right to recover (independent of the rights of

the injured or diseased person) from said third person, or that

person's insurer, the reasonable value of the care and treatment so

furnished, to be furnished, paid for, or to be paid for and shall,

as to this right be subrogated to any right or claim that the

injured or diseased person, his guardian, personal representative,

estate, dependents, or survivors has against such third person to

the extent of the reasonable value of the care and treatment so

furnished, to be furnished, paid for, or to be paid for. The head

of the department or agency of the United States furnishing such

care or treatment may also require the injured or diseased person,

his guardian, personal representative, estate, dependents, or

survivors, as appropriate, to assign his claim or cause of action

against the third person to the extent of that right or claim.

(b) Recovery of cost of pay for member of uniformed services unable

to perform duties

If a member of the uniformed services is injured, or contracts a

disease, under circumstances creating a tort liability upon a third

person (other than or in addition to the United States and except

employers of seamen referred to in subsection (a) of this section)

for damages for such injury or disease and the member is unable to

perform the member's regular military duties as a result of the

injury or disease, the United States shall have a right

(independent of the rights of the member) to recover from the third

person or an insurer of the third person, or both, the amount equal

to the total amount of the pay that accrues and is to accrue to the

member for the period for which the member is unable to perform

such duties as a result of the injury or disease and is not

assigned to perform other military duties.

(c) United States deemed third party beneficiary under alternative

system of compensation

(1) If, pursuant to the laws of a State that are applicable in a

case of a member of the uniformed services who is injured or

contracts a disease as a result of tortious conduct of a third

person, there is in effect for such a case (as a substitute or

alternative for compensation for damages through tort liability) a

system of compensation or reimbursement for expenses of hospital,

medical, surgical, or dental care and treatment or for lost pay

pursuant to a policy of insurance, contract, medical or hospital

service agreement, or similar arrangement, the United States shall

be deemed to be a third-party beneficiary of such a policy,

contract, agreement, or arrangement.

(2) For the purposes of paragraph (1) -

(A) the expenses incurred or to be incurred by the United

States for care and treatment for an injured or diseased member

as described in subsection (a) of this section shall be deemed to

have been incurred by the member;

(B) the cost to the United States of the pay of the member as

described in subsection (b) of this section shall be deemed to

have been pay lost by the member as a result of the injury or

disease; and

(C) the United States shall be subrogated to any right or claim

that the injured or diseased member or the member's guardian,

personal representative, estate, dependents, or survivors have

under a policy, contract, agreement, or arrangement referred to

in paragraph (1) to the extent of the reasonable value of the

care and treatment and the total amount of the pay deemed lost

under subparagraph (B).

(d) Enforcement procedure; intervention; joinder of parties; State

or Federal court proceedings

The United States may, to enforce a right under subsections (a),

(b), and (c) of this section (1) intervene or join in any action or

proceeding brought by the injured or diseased person, his guardian,

personal representative, estate, dependents, or survivors, against

the third person who is liable for the injury or disease or the

insurance carrier or other entity responsible for the payment or

reimbursement of medical expenses or lost pay; or (2) if such

action or proceeding is not commenced within six months after the

first day in which care and treatment is furnished or paid for by

the United States in connection with the injury or disease

involved, institute and prosecute legal proceedings against the

third person who is liable for the injury or disease or the

insurance carrier or other entity responsible for the payment or

reimbursement of medical expenses or lost pay, in a State or

Federal court, either alone (in its own name or in the name of the

injured person, his guardian, personal representative, estate,

dependents, or survivors) or in conjunction with the injured or

diseased person, his guardian, personal representative, estate,

dependents, or survivors.

(e) Veterans' exception

The provisions of this section shall not apply with respect to

hospital, medical, surgical, or dental care and treatment

(including prostheses and medical appliances) furnished by the

Department of Veterans Affairs to an eligible veteran for a

service-connected disability under the provisions of chapter 17 of

title 38.

(f) Crediting of amounts recovered

(1) Any amount recovered under this section for medical care and

related services furnished by a military medical treatment facility

or similar military activity shall be credited to the appropriation

or appropriations supporting the operation of that facility or

activity, as determined under regulations prescribed by the

Secretary of Defense.

(2) Any amount recovered under this section for the cost to the

United States of pay of an injured or diseased member of the

uniformed services shall be credited to the appropriation that

supports the operation of the command, activity, or other unit to

which the member was assigned at the time of the injury or illness,

as determined under regulations prescribed by the Secretary

concerned.

(g) Definitions

For the purposes of this section:

(1) The term "uniformed services" has the meaning given such

term in section 101 of title 10.

(2) The term "tortious conduct" includes any tortiousomission.

(3) The term "pay", with respect to a member of the uniformed

services, means basic pay, special pay, and incentive pay that

the member is authorized to receive under title 37 or any other

law providing pay for service in the uniformed services.

(4) The term "Secretary concerned" means -

(A) the Secretary of Defense, with respect to the Army, the

Navy, the Air Force, the Marine Corps, and the Coast Guard

(when it is operating as a service in the Navy);

(B) the Secretary of Transportation, with respect to the

Coast Guard when it is not operating as a service in the Navy;

(C) the Secretary of Health and Human Services, with respect

to the commissioned corps of the Public Health Service; and

(D) the Secretary of Commerce, with respect to the

commissioned corps of the National Oceanic and Atmospheric

Administration.

-SOURCE-

(Pub. L. 87-693, Sec. 1, Sept. 25, 1962, 76 Stat. 593; Pub. L.

102-54, Sec. 13(q)(8), June 13, 1991, 105 Stat. 281; Pub. L.

104-201, div. A, title X, Sec. 1075(a), (b), Sept. 23, 1996, 110

Stat. 2661, 2663.)

-REFTEXT-

REFERENCES IN TEXT

Effective date of this Act, referred to in subsec. (a), is the

first day of the fourth month following September 1962, see section

4 of Pub. L. 87-693 set out as an Effective Date note below.

-MISC1-

AMENDMENTS

1996 - Subsec. (a). Pub. L. 104-201, Sec. 1075(b)(1), inserted

"(independent of the rights of the injured or diseased person)"

after "a right to recover" and ", or that person's insurer," after

"from said third person".

Pub. L. 104-201, Sec. 1075(a)(1), (2), inserted "or pay for"

after "required by law to furnish" and substituted ", to be

furnished, paid for, or to be paid for" for "or to be furnished" in

two places.

Subsecs. (b), (c). Pub. L. 104-201, Sec. 1075(a)(3), added

subsecs. (b) and (c). Former subsecs. (b) and (c) redesignated (d)

and (e), respectively.

Subsec. (d). Pub. L. 104-201, Sec. 1075(a)(4), (b)(2),

substituted "a right under subsections (a), (b), and (c) of this

section" for "such right," in introductory provisions, inserted "or

paid for" after "treatment is furnished" in par. (2), and inserted

"or the insurance carrier or other entity responsible for the

payment or reimbursement of medical expenses or lost pay" after

"the third person who is liable for the injury or disease" in pars.

(1) and (2).

Pub. L. 104-201, Sec. 1075(a)(2), redesignated subsec. (b) as

(d).

Subsec. (e). Pub. L. 104-201, Sec. 1075(a)(2), redesignated

subsec. (c) as (e).

Subsecs. (f), (g). Pub. L. 104-201, Sec. 1075(a)(5), added

subsecs. (f) and (g).

1991 - Subsec. (c). Pub. L. 102-54 substituted "Department of

Veterans Affairs" for "Veterans' Administration".

EFFECTIVE DATE OF 1996 AMENDMENT

Section 1075(c) of Pub. L. 104-201 provided that: "The authority

to collect pursuant to the amendments made by this section

[amending this section] shall apply to expenses described in the

first section of Public Law 87-693 [this section] (as amended by

this section) that are incurred, or are to be incurred, by the

United States on or after the date of the enactment of this Act

[Sept. 23, 1996], whether the event from which the claim arises

occurs before, on, or after that date."

EFFECTIVE DATE

Section 4 of Pub. L. 87-693 provided that: "This Act [enacting

this chapter] becomes effective on the first day of the fourth

month following the month [September 1962] in which enacted."

-TRANS-

TRANSFER OF FUNCTIONS

For transfer of authorities, functions, personnel, and assets of

the Coast Guard, including the authorities and functions of the

Secretary of Transportation relating thereto, to the Department of

Homeland Security, and for treatment of related references, see

sections 468(b), 551(d), 552(d), and 557 of Title 6, Domestic

Security, and the Department of Homeland Security Reorganization

Plan of November 25, 2002, as modified, set out as a note under

section 542 of Title 6.

-SECREF-

SECTION REFERRED TO IN OTHER SECTIONS

This section is referred to in sections 2652, 2653 of this title.

-End-

-CITE-

42 USC Sec. 2652 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 32 - THIRD PARTY LIABILITY FOR HOSPITAL AND MEDICAL CARE

-HEAD-

Sec. 2652. Regulations

-STATUTE-

(a) Determination and establishment of reasonable value of care and

treatment

The President may prescribe regulations to carry out this

chapter, including regulations with respect to the determination

and establishment of the reasonable value of the hospital, medical,

surgical, or dental care and treatment (including prostheses and

medical appliances) furnished or to be furnished.

(b) Settlement, release and waiver of claims

To the extent prescribed by regulations under subsection (a) of

this section, the head of the department or agency of the United

States concerned may (1) compromise, or settle and execute a

release of, any claim which the United States has by virtue of the

right established by section 2651 of this title; or (2) waive any

such claim, in whole or in part, for the convenience of the

Government, or if he determines that collection would result in

undue hardship upon the person who suffered the injury or disease

resulting in care or treatment described in section 2651 of this

title.

(c) Damages recoverable for personal injury unaffected

No action taken by the United States in connection with the

rights afforded under this legislation shall operate to deny to the

injured person the recovery for that portion of his damage not

covered hereunder.

-SOURCE-

(Pub. L. 87-693, Sec. 2, Sept. 25, 1962, 76 Stat. 593.)

-EXEC-

EX. ORD. NO. 11060. DELEGATION OF AUTHORITY TO PRESCRIBE

REGULATIONS

Ex. Ord. No. 11060, Nov. 7, 1962, 27 F.R. 10925, as amended by

Ex. Ord. No. 12608, Sept. 9, 1987, 52 F.R. 34617, provided:

Under and by virtue of the authority vested in me by Title 3 of

the United States Code and by Section 2(a) of the Act of September

25, 1962 (Public Law 87-693) [subsec. (a) of this section], it is

hereby ordered as follows:

Section 1. The Director of the Office of Management and Budget

shall, for the purposes of the Act of September 25, 1962, [this

chapter], from time to time, determine and establish rates that

represent the reasonable value of hospital, medical, surgical, or

dental care and treatment (including prostheses and medical

appliances) furnished or to be furnished.

Sec. 2. Except as provided in Section 1 of this order, the

Attorney General shall prescribe regulations to carry out the

purposes of the Act of September 25, 1962 [this chapter].

-End-

-CITE-

42 USC Sec. 2653 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 32 - THIRD PARTY LIABILITY FOR HOSPITAL AND MEDICAL CARE

-HEAD-

Sec. 2653. Limitation or repeal of other provisions for recovery of

hospital and medical care costs

-STATUTE-

This chapter does not limit or repeal any other provision of law

providing for recovery by the United States of the costs of care

and treatment described in section 2651 of this title.

-SOURCE-

(Pub. L. 87-693, Sec. 3, Sept. 25, 1962, 76 Stat. 594.)

-End-