B-84816, MAY 23, 1949, 28 COMP. GEN. 673

B-84816: May 23, 1949

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APPROPRIATIONS - AVAILABILITY - PRIVATE MEDICAL SERVICES FOR RETIRED AND INACTIVE NAVAL PERSONNEL IN NAVAL HOSPITALS IN THOSE CASES WHERE ADVANCE AUTHORIZATION WAS OBTAINED FOR THE PROCUREMENT OF THE SERVICES OF A CIVILIAN MEDICAL CONSULTANT IN CONNECTION WITH THE DIAGNOSIS AND TREATMENT OF INACTIVE RETIRED NAVAL PERSONNEL. 1949: REFERENCE IS MADE TO YOUR LETTER OF MARCH 23. DECISION IS REQUESTED AS TO WHETHER THE NAVY DEPARTMENT MAY LAWFULLY PROVIDE BY REGULATION FOR THE PROCUREMENT BY NAVAL HOSPITALS OF CONSULTANTS. IT APPEARS FROM THE INFORMATION PRESENTED THAT ALL OF THE PATIENTS INVOLVED WERE LAWFULLY ADMITTED TO THE UNITED STATES NAVAL HOSPITAL. THAT NO MEDICAL OFFICER SO QUALIFIED WAS ATTACHED TO OR AVAILABLE AT THE HOSPITAL.

B-84816, MAY 23, 1949, 28 COMP. GEN. 673

APPROPRIATIONS - AVAILABILITY - PRIVATE MEDICAL SERVICES FOR RETIRED AND INACTIVE NAVAL PERSONNEL IN NAVAL HOSPITALS IN THOSE CASES WHERE ADVANCE AUTHORIZATION WAS OBTAINED FOR THE PROCUREMENT OF THE SERVICES OF A CIVILIAN MEDICAL CONSULTANT IN CONNECTION WITH THE DIAGNOSIS AND TREATMENT OF INACTIVE RETIRED NAVAL PERSONNEL, AND INACTIVE MEMBERS OF THE FLEET RESERVE, LAWFULLY ADMITTED TO NAVAL HOSPITALS UNDER REGULATIONS PROMULGATED BY THE SECRETARY OF THE NAVY, PAYMENT FOR SUCH SERVICES MAY BE MADE FROM THE CURRENT APPROPRIATION FOR THE MEDICAL DEPARTMENT, BUREAU OF MEDICINE AND SURGERY, NAVY, WHICH MAKES FUNDS AVAILABLE FOR THE CARE, MAINTENANCE, AND TREATMENT OF PATIENTS IN NAVAL AND OTHER HOSPITALS AS PROVIDED BY REGULATION.

ASSISTANT COMPTROLLER GENERAL YATES TO THE SECRETARY OF THE NAVY, MAY 23, 1949:

REFERENCE IS MADE TO YOUR LETTER OF MARCH 23, 1949, REQUESTING THE APPROVAL OF THIS OFFICE FOR THE PAYMENT OF VARIOUS BILLS OF DR. JOHN C. HART, M.D., FOR SERVICES RENDERED AT THE UNITED STATES NAVAL HOSPITAL, CORONA, CALIFORNIA, IN CONNECTION WITH THE DIAGNOSIS AND TREATMENT OF CERTAIN RETIRED PERSONNEL OF THE NAVY AND MARINE CORPS NOT ON ACTIVE DUTY, AND INACTIVE MEMBERS OF THE FLEET RESERVE, UNDER THE FACTS AND CIRCUMSTANCES HEREINAFTER SET FORTH. IN THE EVENT IT BE DETERMINED THAT PAYMENT OF SUCH BILLS CANNOT BE APPROVED, DECISION IS REQUESTED AS TO WHETHER THE NAVY DEPARTMENT MAY LAWFULLY PROVIDE BY REGULATION FOR THE PROCUREMENT BY NAVAL HOSPITALS OF CONSULTANTS, TO BE PAID FROM THE CURRENT APPROPRIATION " MEDICAL DEPARTMENT, NAVY," IN ACCORDANCE WITH PARAGRAPH 3111.1 OF THE MANUAL OF THE MEDICAL DEPARTMENT, UNITED STATES NAVY (1945), EVEN THOUGH SOME OR PART OF THEIR SERVICES MAY BE RENDERED IN THE COURSE OF MAJOR OPERATIONS ON INACTIVE RETIRED PATIENTS LAWFULLY ADMITTED.

IT APPEARS FROM THE INFORMATION PRESENTED THAT ALL OF THE PATIENTS INVOLVED WERE LAWFULLY ADMITTED TO THE UNITED STATES NAVAL HOSPITAL, CORONA, IN ACCORDANCE WITH PART IV OF THE MANUAL OF THE MEDICAL DEPARTMENT, UNITED STATES NAVY; THAT THE TREATMENT IN THEIR CASES REQUIRED THE SERVICES OF A QUALIFIED CHEST SURGEON; AND THAT NO MEDICAL OFFICER SO QUALIFIED WAS ATTACHED TO OR AVAILABLE AT THE HOSPITAL. IN THE MAJORITY OF THE CASES, IT APPEARS THAT ADVANCE AUTHORIZATION FOR THE PROCUREMENT OF THE SERVICES OF DR. HART WAS OBTAINED FROM THE BUREAU OF MEDICINE AND SURGERY, WHICH AUTHORIZATION WAS MADE CONTINGENT UPON THE RECEIPT OF AN AFFIRMATIVE DECISION FROM THIS OFFICE AS TO THE LEGALITY OF PAYMENT FOR THE SERVICES RENDERED BY DR. HART. HOWEVER, IN THE CASE OF WILLIAM C. MORGAN, MM1, USN, RETIRED, INACTIVE, DR. HART'S SERVICES WERE PROCURED BY THE MEDICAL OFFICER IN COMMAND OF THE HOSPITAL WITHOUT FIRST OBTAINING ADVANCE AUTHORITY FROM THE BUREAU OF MEDICINE AND SURGERY AS REQUIRED BY PARAGRAPH 3111.1 OF THE SAID MANUAL.

WHILE THERE IS NO SPECIFIC STATUTE GRANTING TO RETIRED PERSONNEL AND OTHER INACTIVE PERSONNEL OF THE NAVY THE RIGHT TO HOSPITALIZATION AND TREATMENT IN NAVAL HOSPITALS, THE AUTHORITY OF THE SECRETARY OF THE NAVY TO PROVIDE SUCH HOSPITALIZATION AND TREATMENT HAS LONG BEEN RECOGNIZED. IN A DECISION DATED JULY 22, 1926, TO THE DIRECTOR, UNITED STATES VETERANS' BUREAU, 6 COMP. GEN. 62, IT WAS STATED (PAGE 64) AS FOLLOWS:

* * * WHILE MEDICAL AND HOSPITAL CARE AND TREATMENT OF RETIRED OFFICERS AND ENLISTED MEN OF THE ARMY AND NAVY HAS NOT BEEN SPECIFICALLY PROVIDED BY STATUTE, UNDER THE REGULATIONS AND THE LONG ESTABLISHED PRACTICE OF THE SERVICES, THEY ARE GRANTED THE PRIVILEGE OF OBTAINING MEDICAL AND HOSPITAL TREATMENT FROM ARMY AND NAVY MEDICAL OFFICERS AND HOSPITALS. THE PRESENT REGULATIONS RELATIVE TO THE ADMISSION TO NAVAL HOSPITALS OF RETIRED AND INACTIVE PERSONNEL OF THE NAVY AND THE MARINE CORPS ARE CONTAINED IN PART IV, MANUAL OF THE MEDICAL DEPARTMENT, UNITED STATES NAVY, PARAGRAPH 4132 OF WHICH PROVIDES FOR THE ADMISSION OF RETIRED OFFICERS, NURSES, OR ENLISTED PERSONNEL OF THE REGULAR NAVY OR MARINE CORPS TO ANY NAVAL HOSPITAL UPON THE APPLICATION AND SATISFACTORY IDENTIFICATION OF THE INDIVIDUAL CONCERNED, AND SIMILAR AUTHORITY FOR THE ADMISSION OF MEMBERS OF THE FLEET RESERVE AND THE FLEET MARINE CORPS RESERVE IS CONTAINED IN PARAGRAPH 4134 OF PART IV. AS POINTED OUT IN YOUR LETTER, PARAGRAPH 3111.1 OF PART III OF THE SAID MANUAL CONTAINS THE AUTHORITY FOR AND THE CONDITIONS UNDER WHICH CIVILIAN SPECIALISTS MAY BE EMPLOYED TO TREAT PATIENTS LAWFULLY ADMITTED TO NAVAL HOSPITALS, AND NO DISTINCTION IS MADE THEREIN AMONG ACTIVE, INACTIVE, AND RETIRED PERSONNEL. THE APPROPRIATION FOR THE MEDICAL DEPARTMENT, BUREAU OF MEDICINE AND SURGERY, NAVY, FOR THE FISCAL YEARS 1948 AND 1949 MAKES FUNDS AVAILABLE FOR "OTHER NECESSARY EXPENSES, INCLUDING CARE, MAINTENANCE AND TREATMENT OF PATIENTS IN NAVAL AND OTHER HOSPITALS AS PROVIDED BY REGULATION" ( ITALICS SUPPLIED) AND SEEMS TO BE A RECOGNITION BY THE CONGRESS OF THE AUTHORITY OF THE SECRETARY OF THE NAVY TO DESIGNATE BY REGULATION THE CLASSES OF PERSONS WHO MAY BE ADMITTED TO NAVAL HOSPITALS AND THE EXPENSES WHICH MAY BE PAID INCIDENT TO THE TREATMENT OF SUCH PERSONS LAWFULLY ADMITTED THERETO.

IN VIEW OF THE FOREGOING, IT REASONABLY MAY BE CONCLUDED THAT UNDER EXISTING REGULATIONS PAYMENT TO DR. HART FOR SERVICES RENDERED BY HIM IS AUTHORIZED, IF OTHERWISE CORRECT, IN THOSE CASES WHERE ADVANCE AUTHORIZATION WAS OBTAINED FROM THE BUREAU OF MEDICINE AND SURGERY, IN ACCORDANCE WITH THE MANUAL OF THE MEDICAL DEPARTMENT, NAVY (1945), PRIOR TO THE PROCUREMENT OF HIS SERVICES. HOWEVER, IN THE CASE OF WILLIAM C. MORGAN, MM1, USN, RETIRED, INACTIVE, AS WELL AS ANY OTHER CASE WHERE THE OBTAINING OF THE SERVICES OF A CIVILIAN SPECIALIST HAS NEITHER BEEN AUTHORIZED IN ADVANCE, NOR SUBSEQUENTLY APPROVED BY THE BUREAU OF MEDICINE AND SURGERY, IN ACCORDANCE WITH PARAGRAPH 3111.1 OR 316.3, RESPECTIVELY, OF THE SAID MANUAL, THERE APPEARS TO BE NO LEGAL BASIS FOR PAYMENT.