I believe that it technically belongs to Visual C++, not the operating system, but it needs to ship with the OS because the user space binaries are compiled with MSVC.
Current versions of the OS ship with functions in MSVCRT.DLL that weren't in the last VC6 version, such as the updated C++ exception handler (__CxxFrameHandler4). AFAIK, there is no redistributable version of it, it's unique to the OS.