On August 2, the National Association for the Advancement of Orthotics and Prosthetics (NAAOP) released a statement regarding the U.S. Department of Veterans Affairs (VA) and prosthetic procurement. The statement appears in edited form below:
On July 31, the House VA Subcommittee on Health held its third hearing in three months on the changes the VA plans to implement on procurement of prosthetic devices, particularly limb prostheses. Two hearings were held in May on this subject where significant concerns were raised by amputee veterans regarding choice of practitioner, access to new technology, and the overall system of VA prosthetic care. In fact, John Register, an amputee veteran and NAAOP board member, and Michael Oros, CPO, FAAOP, an American Orthotic & Prosthetic Association (AOPA) board member, testified before the House VA Subcommittee on Health regarding these concerns, but the subcommittee leaders were simply unsatisfied with the level of the VA’s response to the subcommittee’s questions.
VA Undersecretary Robert Petzel, MD, a high-ranking VA official, was the only witness asked to testify at the hearing and was joined by three other VA officials involved with prosthetics procurement. The criticism of the VA for its response to the subcommittee was bipartisan. In response, Undersecretary Petzel made several key points, which included the following
- The VA has submitted a written narrative of the changes it intends to implement on prosthetic procurement that has been submitted to the subcommittee. The transition to warranted purchasing officers from VA prosthetic staff in purchasing prosthetics has been delayed until September 30 and may be delayed again if the VA leadership does not believe it is ready to implement the changes without causing any problems in access or other accurate provision of VA care.
- The changes in procurement are intended to be “absolutely transparent” and veterans should not even know these changes are put into effect. The new procurement rules are intended to change how the VA purchases prosthetic devices, not what they purchase. The physician’s prescription is supposed to dictate all procurement decisions.
- Section 8123 of the VA statute, 38 U.S. Code, will continue to allow private prosthetic practitioners to be contractors of the VA without going through the VA’s competitive process that other “vendors” need to follow.
- “Cutting-edge technology” will continue to be available to any amputee veteran who wants and needs these devices. This suggests that veterans will have choice in selection of prosthetic componentry.
- A list of prosthetic contractors must be made available to each veteran and the VA must explain that veterans have a choice of practitioner. If there is an existing relationship between the veteran and a private prosthetist, the practitioner will be invited to attend the VA O&P clinic.
Many of these statements made by senior VA staff to the House subcommittee are very encouraging but seem to contradict experiences by prosthetists across the country. These statements are embodied in House Resolution (H.R.) 805, the Injured and Amputee Veterans Bill of Rights.
NAAOP said it will continue to work with the VA and the VA Congressional committees to codify these statements into law. For more information, visit www.naaop.org or e-mail info@naaop.org
