A-76170, JULY 25, 1936, 16 COMP. GEN. 67

A-76170: Jul 25, 1936

Additional Materials:

Contact:

Edda Emmanuelli Perez
(202) 512-2853
EmmanuelliPerezE@gao.gov

 

Office of Public Affairs
(202) 512-4800
youngc1@gao.gov

WHO WAS CALLED IN AN EFFORT TO SAVE THE PATIENT'S LIFE RENDERED MEDICAL OR SURGICAL TREATMENT IN GOOD FAITH WITHOUT NOTICE OF ANY ADMINISTRATIVE IRREGULARITY. REIMBURSEMENT IS AUTHORIZED UNDER THE "GOOD FAITH" RULE (3 COMP. IT IS UNNECESSARY TO GIVE CONSIDERATION TO THE CLAIM UNDER THE EQUITABLE STATUTE OF APRIL 10. LAMMONDS WAS DISCHARGED FROM THE DRAFT WITHOUT BEING INDUCTED INTO THE SERVICE. THERE IS NO SHOWING THAT THE DISABILITY FOR WHICH HOSPITALIZATION WAS NECESSARY WAS THE RESULT OF REPORTING FOR SERVICE. HE WAS ADMITTED TO THE HOSPITAL IN AN EMERGENCY WITHOUT HIS ELIGIBILITY TO RECEIVE HOSPITALIZATION HAVING BEEN ESTABLISHED. AFTER HIS ADMISSION THE TREATMENTS COVERED BY THIS VOUCHER WERE FOUND TO BE NECESSARY.

A-76170, JULY 25, 1936, 16 COMP. GEN. 67

VETERANS' ADMINISTRATION - REIMBURSEMENT FOR EMERGENCY MEDICAL TREATMENT - GOOD FAITH RULE WHERE THE VETERANS' ADMINISTRATION ORDERED HOSPITALIZATION FOR EMERGENCY TREATMENT WITHOUT FIRST DETERMINING THE PATIENT'S ELIGIBILITY TO RECEIVE TREATMENT AT PUBLIC EXPENSE, AND A PRIVATE PHYSICIAN, WHO WAS CALLED IN AN EFFORT TO SAVE THE PATIENT'S LIFE RENDERED MEDICAL OR SURGICAL TREATMENT IN GOOD FAITH WITHOUT NOTICE OF ANY ADMINISTRATIVE IRREGULARITY, REIMBURSEMENT IS AUTHORIZED UNDER THE "GOOD FAITH" RULE (3 COMP. GEN. 248), AND IT IS UNNECESSARY TO GIVE CONSIDERATION TO THE CLAIM UNDER THE EQUITABLE STATUTE OF APRIL 10, 1928, 45 STAT. 413.

ACTING COMPTROLLER GENERAL ELLIOTT TO THE ADMINISTRATOR OF VETERANS' AFFAIRS, JULY 25, 1936:

CONSIDERATION HAS BEEN GIVEN TO YOUR COMMUNICATION OF APRIL 14, 1936, FORWARDING THE ADMINISTRATIVELY APPROVED CLAIM OF DR. GEORGE BENET IN THE AMOUNT OF $40 WITH THE FOLLOWING ENDORSEMENT.

THE ATTACHED CLAIM COVERS MEDICAL SERVICES RENDERED DANIEL E. LAMMONDS IN CONNECTION WITH HOSPITAL TREATMENT. MR. LAMMONDS WAS DISCHARGED FROM THE DRAFT WITHOUT BEING INDUCTED INTO THE SERVICE, AND THERE IS NO SHOWING THAT THE DISABILITY FOR WHICH HOSPITALIZATION WAS NECESSARY WAS THE RESULT OF REPORTING FOR SERVICE. HE WAS ADMITTED TO THE HOSPITAL IN AN EMERGENCY WITHOUT HIS ELIGIBILITY TO RECEIVE HOSPITALIZATION HAVING BEEN ESTABLISHED. AFTER HIS ADMISSION THE TREATMENTS COVERED BY THIS VOUCHER WERE FOUND TO BE NECESSARY, DR. BENET WAS AUTHORIZED TO RENDER THE SERVICES. SINCE THE SERVICES WERE RENDERED IN GOOD FAITH IN RELIANCE UPON AN APPARENTLY PROPER AUTHORIZATION ISSUED BY AN OFFICER OF THIS ADMINISTRATION EMPOWERED TO INCUR SUCH EXPENSES, THE VOUCHER IS SUBMITTED WITH A RECOMMENDATION THAT SETTLEMENT BE MADE AS A CLAIM INVOLVING ELEMENTS OF EQUITY PURSUANT TO THE PROVISIONS OF THE ACT OF APRIL 10, 1928 (PUBLIC, NO. 247, 70TH CONGRESS).

THERE IS WITH THE FILE, ALSO A STATEMENT BY THE MANAGER OF THE VETERANS' ADMINISTRATION FACILITY AS FOLLOWS:

WITH REFERENCE TO YOUR MEMORANDUM OF JANUARY 31, 1936, AND LETTER FROM THE DIRECTOR OF FINANCE, DATED JANUARY 22, 1936, RELATIVE TO VOUCHER IN FAVOR OF DR. GEORGE BENET FOR MEDICAL SERVICES RENDERED IN THE CASE OF THE ABOVE NAMED VETERAN, YOU ARE ADVISED AS FOLLOWS:

MR. LAMMONDS WAS BROUGHT TO THIS HOSPITAL BY AMBULANCE 12:15 P.M. OCTOBER 26, 1935. A CURSORY PHYSICAL EXAMINATION REVEALED THAT HE WAS SUFFERING FROM A VERY SEVERE HEART DISEASE. HIS CONDITION WAS VERY CRITICAL, CONSTITUTING A GENUINE MEDICAL EMERGENCY. HE WAS ADMITTED TO HOSPITAL ON AUTHORIZATION OF THE MANAGER, OCTOBER 26, 1935. ROUTINE EXAMINATIONS OF THE VETERAN AFTER ADMISSION TO WARD REVEALED THAT IN ADDITION TO CARDIAC DISEASE REFERRED TO ABOVE, HE WAS SUFFERING FROM A LARGE ARTERIOVENOUS ANEURISM INVOLVING THE FEMORAL VESSELS. IT APPEARED THAT IN ORDER TO SAVE THE MAN'S LIFE, IT WOULD BE NECESSARY TO SUBJECT HIM TO A HIP-JOINT AMPUTATION. ON ACCOUNT OF THE EXTREME SERIOUSNESS OF THE SITUATION, IT WAS DEEMED ADVISABLE TO CALL DR. BENET IN CONSULTATION. SURGICAL INTERVENTION WAS RECOMMENDED BY DR. BENET, AND OUR CHIEF SURGEON, DR. H. D. COFFEE. SINCE ANY OPERATIVE PROCEDURE INVOLVED DANGER TO THE PATIENT'S LIFE, IT WAS DEEMED ADVISABLE TO AUTHORIZE THE SERVICES OF DR. BENET IN THE PERFORMANCE OF THE OPERATION.

IN MY OPINION, THE UTILIZATION OF DR. BENET'S SERVICES IN THIS CASE WAS ENTIRELY JUSTIFIED.

SINCE ACTION OF THE UNDERSIGNED IN AUTHORIZING SERVICES OF DR. BENET WAS BASED ON THE MANAGER'S APPROVAL OF THE VETERAN'S APPLICATION FOR HOSPITALIZATION, DATED OCTOBER 26, 1935, IT IS SUGGESTED THAT THIS MATTER BE REFERRED TO THE MANAGER FOR A FULL EXPLANATION REGARDING HIS AUTHORIZATION, AND SPECIAL EFFORT BE MADE TO SECURE PAYMENT OF VOUCHER IN FAVOR OF DR. BENET.

THE "GOOD-FAITH" RULE WAS FIRST ANNOUNCED IN THE DECISION OF THIS OFFICE DATED OCTOBER 25, 1923, 3 COMP. GEN. 248, 250, 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.

IN DECISION OF DECEMBER 11, 1929, 9 COMP. GEN. 245, IT WAS STATED, AFTER QUOTING THE ,GOOD-FAITH" RULE, AS FOLLOWS:

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 A GOVERNMENT OFFICIAL, ACTING WITHOUT THE SCOPE OF HIS JURISDICTION, PURPORTS TO AUTHORIZE THE TREATMENT. * * *

THE FACTS REPORTED IN THE INSTANT CASE DISCLOSE NOTHING THAT WOULD HAVE PUT THE PRIVATE PHYSICIAN ON NOTICE OF ANY IRREGULARITY OR ILLEGALITY IN THE ADMINISTRATIVE ORDER OR AUTHORITY FOR HIS SERVICES, WHICH WERE RENDERED IN GOOD FAITH. IT IS THE VIEW OF THIS OFFICE THEREFORE THAT THE CLAIM IS FOR ALLOWANCE UNDER THE "GOOD-FAITH" RULE, SUPRA, AND THAT ITIS UNNECESSARY TO GIVE CONSIDERATION TO THE CLAIM UNDER THE PROVISIONS OF THE ACT OF APRIL 10, 1928, 45 STAT. 413.