B-127791, MAY 25, 1956

B-127791: May 25, 1956

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ELIZABETHS HOSPITAL: WE HAVE RECEIVED A CONGRESSIONAL INQUIRY CONCERNING THE CASE OF DR. IN THE COURSE OF EVENTS HE WAS REQUESTED TO TAKE A PRE-EMPLOYMENT PHYSICAL EXAMINATION. FOR THIS PHYSICAL EXAMINATION WAS PRECEDED BY A COMMUNICATION FROM ST. WILKINS WAS BILLED $44 BY THE VETERANS HOSPITAL. ARE THE FOLLOWING STATEMENTS: "IT IS UNFORTUNATE THAT THE TRANSACTION HAS DEVELOPED IN THIS MANNER BUT THE FISCAL REGULATIONS UNDER WHICH WE OPERATE WILL NOT PERMIT US TO PAY THE BILL. AT THE TIME YOUR PHYSICAL EXAMINATION WAS ARRANGED. IT WAS ASSUMED THERE WOULD BE NO CHARGE. NOR WERE WE INFORMED THERE WOULD BE A CHARGE UNTIL AFTER THE SERVICES HAD BEEN FURNISHED. I REGRET TO SAY THERE IS NOTHING WE CAN DO TO ASSIST YOU IN THIS MATTER EXCEPT TO STATE THAT IT WAS OUR BELIEF THERE WOULD BE NO CHARGE TO US OR YOU FOR THE PHYSICAL EXAMINATION AND LABORATORY TESTS.'.

B-127791, MAY 25, 1956

TO JAY L. HOFFMAN, M. D., ACTING SUPERINTENDENT, ST. ELIZABETHS HOSPITAL:

WE HAVE RECEIVED A CONGRESSIONAL INQUIRY CONCERNING THE CASE OF DR. JAMES ALEXANDER WILKINS OF LYNCHBURG, VIRGINIA, AND HIS PROTEST AGAINST THE PAYMENT OF A MEDICAL EXAMINATION FEE TO THE VETERANS ADMINISTRATION HOSPITAL AT ROANOKE, VIRGINIA.

FROM THE INFORMATION FORWARDED TO OUR OFFICE AND FROM AN INFORMAL CONVERSATION WITH MR. MADDEN OF YOUR HOSPITAL, IT APPEARS THAT DR. WILKINS APPLIED FOR A POSITION AS PATHOLOGIST AT ST. ELIZABETHS. IN THE COURSE OF EVENTS HE WAS REQUESTED TO TAKE A PRE-EMPLOYMENT PHYSICAL EXAMINATION. DR. WILKINS' ARRIVAL AT ROANOKE ON JUNE 16, 1955, FOR THIS PHYSICAL EXAMINATION WAS PRECEDED BY A COMMUNICATION FROM ST. ELIZABETHS HOSPITAL TO THE VETERANS HOSPITAL INFORMING THE LATTER OF HIS IMPENDING VISIT AND REQUESTING THAT CERTAIN TESTS BE PERFORMED. ON OR ABOUT JUNE 29, 1955, THE VETERANS HOSPITAL BILLED YOU $22 FOR THE EXAMINATION OF DR. WILKINS, BUT ST. ELIZABETHS, RELYING UPON SECTION 1311 OF THE SUPPLEMENTAL APPROPRIATION ACT, 1955, 68 STAT. 830, WHICH REQUIRES DOCUMENTARY EVIDENCE TO SUPPORT AN OBLIGATION OF THE GOVERNMENT, DECLINED TO PAY FOR THE EXAMINATION. SUBSEQUENTLY, ON APRIL 19, 1956, DR. WILKINS WAS BILLED $44 BY THE VETERANS HOSPITAL. IN YOUR LETTER TO DR. WILKINS, DATED APRIL 27, 1956, ARE THE FOLLOWING STATEMENTS:

"IT IS UNFORTUNATE THAT THE TRANSACTION HAS DEVELOPED IN THIS MANNER BUT THE FISCAL REGULATIONS UNDER WHICH WE OPERATE WILL NOT PERMIT US TO PAY THE BILL. AT THE TIME YOUR PHYSICAL EXAMINATION WAS ARRANGED, IT WAS ASSUMED THERE WOULD BE NO CHARGE, NOR WERE WE INFORMED THERE WOULD BE A CHARGE UNTIL AFTER THE SERVICES HAD BEEN FURNISHED.

"UNDER THE CIRCUMSTANCES, I REGRET TO SAY THERE IS NOTHING WE CAN DO TO ASSIST YOU IN THIS MATTER EXCEPT TO STATE THAT IT WAS OUR BELIEF THERE WOULD BE NO CHARGE TO US OR YOU FOR THE PHYSICAL EXAMINATION AND LABORATORY TESTS.'

WHILE THE RECORD FAILS TO REVEAL WHETHER DR. WILKINS HAD BEEN INFORMED, PRIOR TO THE EXAMINATION, THAT HE WOULD BEAR THE COST THEREOF, THE INFERENCE IS REASONABLY STRONG THAT HE WAS LED TO BELIEVE THE EXAMINATION FEE WOULD NOT BE ASSESSED AGAINST HIM.

IT IS NOT THE FUNCTION NOR THE POLICY OF OUR OFFICE TO INTERFERE WITH THE ADMINISTRATIVE DUTIES OF ANY EXECUTIVE AGENCY OR GOVERNMENT CORPORATION. AT THE SAME TIME, HOWEVER, IT IS OUR PRACTICE TO COOPERATE WITH ALL ADMINISTRATIVE AGENCIES OF THE GOVERNMENT BY RENDERING DECISIONS TO THEM, UPON PROPER REQUEST, CONCERNING THE LEGALITY OF ANY PROPOSED TRANSACTION WHICH WOULD BE SUBJECT TO AUDIT. SEE 27 COMP. GEN. 429. IN THAT CONNECTION THE STATEMENT IN YOUR LETTER, SUPRA, THAT THE "FISCAL REGULATIONS UNDER WHICH WE OPERATE WILL NOT PERMIT US TO PAY THE BILL" TOUCHES UPON THE LEGALITY OF PAYMENTS FOR PRE-EMPLOYMENT EXAMINATIONS.

CONGRESS HAS PROVIDES, 5 U.S.C. 150, THAT THE EXPENSE OF PRE EMPLOYMENT EXAMINATIONS MAY BE CHARGEABLE TO THE GOVERNMENT. IN OTHER WORDS, THE STATUTE ALLOWS GOVERNMENT AGENCIES DISCRETIONARY AUTHORITY TO ABSORB EXPENSES OF PRE-EMPLOYMENT PHYSICAL EXAMINATIONS. THIS CONCEPT HAS BEEN MENTIONED BY THE CIVIL SERVICE COMMISSION IN PART M1 3, TS 482, OF THE FEDERAL PERSONNEL MANUAL, WHICH PROVIDES THAT "PHYSICAL EXAMINATIONS ARE TO BE CONDUCTED IN SO FAR AS PRACTICABLE BY FEDERAL MEDICAL OFFICERS WITHOUT EXPENSE TO THE APPOINTEE.' ASIDE FROM YOUR OWN ADMINISTRATIVE POLICY, IF ANY, THERE IS NO "FISCAL REGULATION" WHICH PROHIBITS REIMBURSEMENT TO A VETERANS HOSPITAL FOR CONDUCTING A PRE-EMPLOYMENT PHYSICAL EXAMINATION.

SECTION 1311 OF THE SUPPLEMENTAL APPROPRIATION ACT, 1955, SUPRA, PROVIDES IN PART, AS FOLLOWS:

"SEC. 1311. (A) AFTER THE DATE OF ENACTMENT HEREOF NOAMOUNT SHALL BE RECORDED AS AN OBLIGATION OF THE GOVERNMENT OF THE UNITED STATES UNLESS IT IS SUPPORTED BY DOCUMENTARY EVIDENCE OF---

"/1) A BINDING AGREEMENT IN WRITING BETWEEN THE PARTIES THERETO, INCLUDING GOVERNMENT AGENCIES, IN A MANNER AND FORM AND FOR A PURPOSE AUTHORIZED BY LAW, EXECUTED BEFORE THE EXPIRATION OF THE PERIOD OF AVAILABILITY FOR OBLIGATION OF THE APPROPRIATION OR FUND CONCERNED FOR SPECIFIC GOODS TO BE DELIVERED, REAL PROPERTY TO BE PURCHASED OR LEASED, OR WORK OR SERVICES TO BE PERFORMED; OR" AS INDICATED BY THE UNDERLINED WORDS, THE SENSE OF THIS STATUTE IS THAT GOVERNMENT APPROPRIATIONS SHALL NOT BE OBLIGATED, AMONG OTHER THINGS, FOR SERVICES TO BE PERFORMED IN THE FUTURE UNLESS SUPPORTED BY THE REQUISITE DOCUMENTARY EVIDENCE. THAT ACT RESTRICTS ONLY THE OBLIGATION OF FUNDS FOR SERVICES NOT YET PERFORMED AND DOES NOT PROHIBIT PAYMENT FOR SERVICES ALREADY RENDERED. WHEN THE VETERANS HOSPITAL BILLED ST. ELIZABETHS HOSPITAL THE EXAMINATION HAD BEEN PERFORMED; THEREFORE, SECTION 1311 IS NOT A BAR TO PAYMENT OF THE BILL. THUS, IN THE ABSENCE OF ANY ADMINISTRATIVE POLICY TO THE CONTRARY, OUR OFFICE WOULD INTERPOSE NO OBJECTION, BASED ON THE FACTS STATED ABOVE, TO YOUR PAYMENT OF DR. WILKINS' EXAMINATION FEE TO THE VETERANS HOSPITAL.

BEARING IN MIND THAT THE PAYMENT OF PRE-EMPLOYMENT EXAMINATION FEES BY A GOVERNMENT AGENCY IS NOT MANDATORY AND IS AT THE DISCRETION OF THE AGENCY CONCERNED--- ACCORDING TO ITS ESTABLISHED POLICY--- YOUR RECONSIDERATION, IN LIGHT OF THE ABOVE DISCUSSION, OF DR. WILKINS' CASE IS REQUESTED.

IN VIEW OF THE CONGRESSIONAL INTEREST WE SHOULD APPRECIATE YOUR GIVING THIS MATTER EXPEDITIOUS TREATMENT.