38 CFR 17.1003 – Emergency transportation
Notwithstanding the provisions of § 17.1002, payment or reimbursement under 38 U.S.C. § 1725 for ambulance services, including air ambulance services, may be made for transporting a veteran to a facility only if the following conditions are met:
Terms Used In 38 CFR 17.1003
- Contract: A legal written agreement that becomes binding when signed.
- Recourse: An arrangement in which a bank retains, in form or in substance, any credit risk directly or indirectly associated with an asset it has sold (in accordance with generally accepted accounting principles) that exceeds a pro rata share of the bank's claim on the asset. If a bank has no claim on an asset it has sold, then the retention of any credit risk is recourse. Source: FDIC
(a) Payment or reimbursement is authorized under 38 U.S.C. § 1725 for emergency treatment provided at a non-VA facility, or payment or reimbursement would have been authorized under 38 U.S.C. § 1725 for emergency treatment had:
(1) The veteran’s personal liability for the emergency treatment not been fully extinguished by payment by a third party, including under a health-plan contract, or by VA; or
(2) Death had not occurred before emergency treatment could be provided;
(b) The veteran is financially liable to the provider of the emergency transportation;
(c) The veteran does not have coverage under a health-plan contract that would fully extinguish the medical liability for the emergency transportation (this condition is not met if the veteran has coverage under a health-plan contract but payment is barred because of a failure by the veteran or the provider to comply with the provisions of that health-plan contract);
(d) If the condition for which the emergency transportation was furnished was caused by an accident or work-related injury, the claimant has exhausted without success all claims and remedies reasonably available to the veteran or provider against a third party for payment of such transportation; and the veteran has no contractual or legal recourse against a third party that could reasonably be pursued for the purpose of fully extinguishing the veteran’s liability to the provider; and
(e) If the veteran is not eligible for reimbursement for any emergency treatment expenses under 38 U.S.C. § 1728.