A-29581, DECEMBER 11, 1929, 9 COMP. GEN. 244

A-29581: Dec 11, 1929

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VETERANS' BUREAU - MEDICAL TREATMENT - CONFINEMENT CASES THERE IS NO AUTHORITY UNDER THE PROVISIONS OF THE WORLD WAR VETERANS' ACT. IS NOT TO BE APPLIED WHERE THE FACTS AND CIRCUMSTANCES ARE SUCH AS TO HAVE REASONABLY CAUSED A DOCTOR OR INSTITUTION TO QUESTION THE JURISDICTION OR CONTROL OF THE GOVERNMENT OVER THE CASE OR OTHERWISE TO HAVE PUT THEM ON NOTICE OF SOME IRREGULARITY. THE HOSPITALIZATION WAS AUTHORIZED BY THE REGIONAL MEDICAL OFFICER OF THE VETERANS' BUREAU UNDER THE FOLLOWING PROVISION APPEARING IN SECTION 202 (10) OF THE WORLD WAR VETERANS' ACT. 44 STAT. 796: * * * THE DIRECTOR IS FURTHER AUTHORIZED. OR SUPERINTENDENT OF SAID CORPS IN SAID PERIOD: * * * IT APPEARS FROM THE PAPERS FORWARDED TO THIS OFFICE THAT THIS VOUCHER WAS AT FIRST ADMINISTRATIVELY DISAPPROVED UNDER A RULE OF THE BUREAU AS INDICATED IN THE FOLLOWING QUOTATION FROM A LETTER DATED JANUARY 16.

A-29581, DECEMBER 11, 1929, 9 COMP. GEN. 244

VETERANS' BUREAU - MEDICAL TREATMENT - CONFINEMENT CASES THERE IS NO AUTHORITY UNDER THE PROVISIONS OF THE WORLD WAR VETERANS' ACT, AS AMENDED BY THE ACT OF JULY 2, 1926, 44 STAT. 796, TO REIMBURSE A PRIVATE HOSPITAL FROM GOVERNMENT FUNDS FOR THE CARE AND TREATMENT OF A WOMAN VETERAN OF THE WORLD WAR DURING CONFINEMENT. THE "GOOD FAITH" RULE ANNOUNCED IN DECISION OF OCTOBER 25, 1923, 3 COMP. GEN. 248, WHEREBY A PRIVATE DOCTOR OR INSTITUTION MAY BE REIMBURSED FOR TREATMENT FURNISHED A BENEFICIARY OF THE VETERANS' BUREAU WHEN AUTHORIZED BY THE PROPER OFFICER OF THE BUREAU AND WITHOUT NOTICE OF ANY ADMINISTRATIVE IRREGULARITY, IS NOT TO BE APPLIED WHERE THE FACTS AND CIRCUMSTANCES ARE SUCH AS TO HAVE REASONABLY CAUSED A DOCTOR OR INSTITUTION TO QUESTION THE JURISDICTION OR CONTROL OF THE GOVERNMENT OVER THE CASE OR OTHERWISE TO HAVE PUT THEM ON NOTICE OF SOME IRREGULARITY, AS FOR INSTANCE, CONFINEMENT CASES.

DECISION BY COMPTROLLER GENERAL MCCARL, DECEMBER 11, 1929:

THERE HAS BEEN RECEIVED FOR SETTLEMENT AS A CLAIM ADMINISTRATIVELY APPROVED VOUCHER IN THE AMOUNT OF $75 IN FAVOR OF THE STRONG MEMORIAL HOSPITAL, ROCHESTER, N.Y., A PRIVATE INSTITUTION, REPRESENTING CHARGE FOR USE OF DELIVERY ROOM AND HOSPITALIZATION FROM NOVEMBER 26, TO DECEMBER 9, 1928, DURING CONFINEMENT OF MRS. RUTH THOMAS HEALY, A WORLD WAR VETERAN.

THE HOSPITALIZATION WAS AUTHORIZED BY THE REGIONAL MEDICAL OFFICER OF THE VETERANS' BUREAU UNDER THE FOLLOWING PROVISION APPEARING IN SECTION 202 (10) OF THE WORLD WAR VETERANS' ACT, AS AMENDED BY THE ACT OF JULY 2, 1926, 44 STAT. 796:

* * * THE DIRECTOR IS FURTHER AUTHORIZED, SO FAR AS HE SHALL FIND THE EXISTING GOVERNMENT FACILITIES PERMIT, TO FURNISH HOSPITALIZATION AND NECESSARY TRAVELING EXPENSES INCIDENT TO HOSPITALIZATION TO VETERANS OF ANY WAR, MILITARY OCCUPATION, OR MILITARY EXPEDITION, INCLUDING THOSE WOMEN WHO SERVED AS ARMY NURSES UNDER CONTRACTS BETWEEN APRIL 21, 1898, FEBRUARY 2, 1901, NOT DISHONORABLY DISCHARGED, WITHOUT REGARD TO THE NATURE OR ORIGIN OF THEIR DISABILITIES: PROVIDED, THAT ANY AND ALL LAWS APPLICABLE TO WOMEN WHO BELONGED TO THE NURSE CORPS OF THE ARMY AFTER FEBRUARY 2, 1901, SHALL APPLY EQUALLY TO MEMBERS OF THE ARMY NURSE CORPS WHO SERVED UNDER CONTRACT BETWEEN APRIL 21, 1898, AND FEBRUARY 2, 1901, INCLUDING ALL WOMEN WHO SERVED HONORABLY AS NURSES, CHIEF NURSES, OR SUPERINTENDENT OF SAID CORPS IN SAID PERIOD: * * *

IT APPEARS FROM THE PAPERS FORWARDED TO THIS OFFICE THAT THIS VOUCHER WAS AT FIRST ADMINISTRATIVELY DISAPPROVED UNDER A RULE OF THE BUREAU AS INDICATED IN THE FOLLOWING QUOTATION FROM A LETTER DATED JANUARY 16, 1929, SIGNED BY THE MEDICAL DIRECTOR FOR THE BUREAU AND ADDRESSED TO THE REGIONAL MANAGER:

THIS SERVICE IS UNABLE TO UNDERSTAND YOUR ACTION IN HOSPITALIZING THIS BENEFICIARY FOR THE PURPOSE OF CONFINEMENT, AS IT HAS BEEN CONSISTENTLY HELD THAT THERE IS NO AUTHORITY UNDER THE LAW FOR THE HOSPITALIZATION OF A FEMALE VETERAN FOR THE PURPOSE OF PREGNANCY AND CONFINEMENT.

THE QUESTION OF FURNISHING CARE AND TREATMENT TO FORMER SERVICE WOMEN DURING CONFINEMENT HAS BEEN PRESENTED TO THE BUREAU ON SEVERAL OCCASIONS AND HAS BEEN GIVEN CAREFUL CONSIDERATION AS TO WHETHER IT WAS THE INTENT OF THE ACT OF JUNE 7, 1924, SECTION 202 (10), TO PROVIDE THIS TYPE OF TREATMENT FOR THESE WOMEN.

THE PHYSIOLOGICAL PROCESS OF PREGNANCY AND PARTURITION CAN NOT BE CONSIDERED TO LIE WITHIN THE SAME CATEGORY AS THE ORDINARY DISABILITIES TO WHICH THE EX-SERVICE PERSON IS LIABLE. IF THE CARE OF THE PREGNANT EX- SERVICE WOMAN IS TO BE INCLUDED IN THE PROVISIONS OF SECTION 202, PARAGRAPH 10, OF THE ACT OF JUNE 7, 1924, IT WOULD THEN BE NECESSARY TO SET ASIDE SEPARATE WARDS, OPERATING ROOMS, AND IN MANY INSTANCES PRIVATE ROOMS, BESIDES ADDITIONAL PERSONNEL AND EQUIPMENT IN ALL OF OUR GENERAL HOSPITALS. AT THE PRESENT TIME THERE IS NOT PROVISION MADE OR FACILITIES AVAILABLE IN ANY OF OUR HOSPITALS FOR THE CARE AND TREATMENT OFEX-SERVICE WOMEN DURING LABOR.

INASMUCH AS IT HAS BEEN HELD THAT IT WAS NOT THE INTENT OF THE ACT OF JUNE 7, 1924, TO FURNISH CARE AND TREATMENT FOR WOMEN VETERANS FOR THE PURPOSE OF CONFINEMENT, YOUR ACTION IN HOSPITALIZING MRS. HEALY MUST BE, OF NECESSITY, DISAPPROVED.

THIS OFFICE IS IN AGREEMENT WITH THE CONCLUSION THUS REACHED. ASIDE FROM THE NATURE OF THE OCCASION FOR HOSPITALIZATION IN THIS CASE, ATTENTION IS FURTHER DIRECTED TO THE PRINCIPLES STATED IN DECISION OF THIS OFFICE DATED NOVEMBER 2, 1927, 7 COMP. GEN. 308, 311, WHEREIN WERE SET FORTH THE THREE GENERAL CLASSES OF MEDICAL AND HOSPITAL TREATMENT, INCLUDING CLASS (3) "VETERANS OF ANY WAR, ETC., FOR ANY DISEASE OR DISABILITY, WITHOUT REGARD TO THE NATURE OR ORIGIN THEREOF," WITH REGARD TO WHICH IT WAS HELD THAT "THE THIRD CLASS IS, GENERALLY SPEAKING, A SERVICE AUTHORIZED TO BE FURNISHED ONLY IN KIND THROUGH GOVERNMENTAL FACILITIES.' THE LAW PROVIDES FOR TREATMENT OF THE THIRD CLASS IN OTHER THAN GOVERNMENT HOSPITALS ONLY IN THE INSULAR POSSESSIONS OR TERRITORIES OF THE UNITED STATES.

THE VOUCHER IN THE INSTANT CASE WAS ADMINISTRATIVELY APPROVED FOR THE PAYMENT AND FORWARDED TO THIS OFFICE FOR SETTLEMENT AS A CLAIM WITH THE FOLLOWING STATEMENT:

THE STRONG MEMORIAL HOSPITAL RENDERED SERVICES TO MRS. RUTH THOMAS HEALY, W.O.E., IN GOOD FAITH IN ACCORDANCE WITH THE AUTHORITY ISSUED BY THE REGIONAL MEDICAL OFFICER, BUFFALO, NEW YORK, ALTHOUGH THERE APPEARS TO BE NO AUTHORITY IN THE ACT OF JUNE 7, 1924, TO PROVIDE THIS TYPE OF TREATMENT TO WOMEN BENEFICIARIES.

THE "GOOD FAITH" RULE, AS IT HAS BEEN TERMED, WAS FIRST ANNOUNCED IN DECISION OF THIS OFFICE DATED OCTOBER 25, 1923, 3 COMP. GEN. 248, 250, HOLDING AS FOLLOWS:

UNDER THESE STATUTES THE TREATMENT IN THE PRESENT CASE WAS AUTHORIZED BEFORE THE STATUS OF THE APPLICANT FOR TREATMENT WAS DETERMINED ADMINISTRATIVELY WITH RESPECT TO HIS RIGHT TO RECEIVE THE TREATMENT AT GOVERNMENT EXPENSE. THE CIVILIAN DENTIST, HOWEVER, HAD NO KNOWLEDGE OF THE ADMINISTRATIVE IRREGULARITY AND WAS NOT IN A POSITION TO QUESTION THE AUTHORIZATION ISSUED TO HIM FOR THE TREATMENT OF THE PATIENT SENT BY THE PROPER OFFICERS OF THE BUREAU TO HIM. THE DENTIST, RELYING ON THE REGULARITY AND LEGALITY OF THE ORDER ISSUED TO HIM, IS ENTITLED TO PAYMENT FOR SERVICES RENDERED IN GOOD FAITH.

THIS RULE IS FOR APPLICATION WITHIN REASONABLE LIMITS. BUT WHERE THE FACTS AND CIRCUMSTANCES ARE SUCH AS TO HAVE REASONABLY CAUSED A PRIVATE DOCTOR OR INSTITUTION TO QUESTION THE JURISDICTION OR CONTROL OF THE GOVERNMENT OVER THE CASE, OR OTHERWISE TO HAVE PUT IT ON NOTICE OF SOME ADMINISTRATIVE IRREGULARITY, THE "GOOD FAITH" RULE IS NOT APPLICABLE EVEN THOUGH DELAY IN ADMITTING THE PATIENT WAS NOT PRACTICABLE. THERE IS A REASONABLE RESPONSIBILITY ON PRIVATE DOCTORS AND HOSPITALS TO CARE FOR EMERGENCY, PARTICULARLY CONFINEMENT, CASES WHICH MAY NOT BE SHIFTED TO THE GOVERNMENT SIMPLY BECAUSE OF A GOVERNMENT OFFICIAL, ACTING WITHOUT THE SCOPE OF HIS JURISDICTION, PURPORTS TO AUTHORIZE THE TREATMENT. YOU ARE ADVISED, THEREFORE, THAT THE "GOOD FAITH" RULE MAYBE APPLIED IN THE INSTANT CASE, AND THE CLAIM MUST BE AND IS DISALLOWED.