Page:United States Statutes at Large Volume 100 Part 1.djvu/419

 PUBLIC LAW 99-272—APR. 7, 1986

100 STAT. 383

"(C) that is incurred as the result of a crime of personal violence that occurred in a State, or a political subdivision of a State, in which a person injured as the result of such a crime is entitled to receive health care and services at such State's or subdivision's expense for personal injuries suffered as the result of such crime; or "(D) that is incurred by a veteran— "(i) who does not have a service-connected disability; and "(ii) who is entitled to care (or payment of the expenses of care) under a health-plan contract. "(3) In the case of a health-plan contract that contains a requirement for payment of a deductible or copayment by the veteran— "(A) the veteran's not having paid such deductible or copayment with respect to care or services furnished under this chapter shall not preclude recovery or collection under this section; and "(B) the amount that the United States may collect or recover under this section shall be reduced by the appropriate deductible or copayment amount, or both. "(b)(1) As to the right provided in subsection (a) of this section, the United States shall be subrogated to any right or claim that the veteran (or the veteran's personal representative, successor, dependents, or survivors) may have against a third party. "(2)(A) In order to enforce any right or claim to which the United States is subrogated under paragraph (1) of this subsection, the United States may intervene or join in any action or proceeding brought by the veteran (or the veteran's personal representative, successor, dependents, or survivors) against a third party. "(B) The United States may institute and prosecute legal proceedings against the third party if— "(i) an action or proceeding described in subparagraph (A) of this paragraph is not begun within 180 days after the first day on which care or services for which recovery is sought are furnished to the veteran by the Administrator under this chapter; "(ii) the United States has sent written notice by certified mail to the veteran at the veteran's last-known address (or to the veteran's personal representative or successor) of the intention of the United States to institute such legal proceedings; and "(iii) a period of 60 days has passed following the mailing of such notice. "(c)(1) The Administrator may compromise, settle, or waive any claim which the United States has under this section. "(2)(A) The Administrator, after consultation with the Comptroller General of the United States, shall prescribe regulations for the purpose of determining the reasonable cost of care or services under subsection (a)(1) of this section. Any determination of such cost shall be made in accordance with such regulations. "(B) Such regulations shall provide that the reasonable cost of care or services sought to be recovered or collected from a thirdparty liable under a health-plan contract may not exceed the amount that such third party demonstrates to the satisfaction of the Administrator it would pay for the care or services in accordance with the prevailing rates at which the third party makes payments under comparable health-plan contracts with facilities (other than

Contracts,

Claims.

Claims, Regulations.

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