Replies: Dealing with the VA for orthotic care, Part I (first post reply to Mr. Simonson)

Following is a compilation of replies to my origin
 Hello again,

Following is a compilation of replies to my original post.  I have removed names, except one.  Mr. Heide stated the factual truth about Veteran choice. 

The first post is my reply to the post by Nathan Simonson, CO, the local VA orthotist that is the main reason for my initial post.  I will also post separately information obtained from Mr. Joe Miller, Phd, CP, National Director of the VA Prosthetics.  I think he is a good man, caught in the middle, and doing the right things to help resolve and diffuse this situation. 

Mr. Simonson’s post to the list:

Just a quick addition to this post….I feel the O&P link is a great tool for sharing information throughout our profession; however, when the goal is to slander organizations and their staff with unfounded incidents and fabricated lies, it certainly takes away from its intended purpose. I suggest this individual seek some obviously much needed education in matters pertaining to orthotic & prosthetics as it pertains to the this and potentially future situations.

Nathan Simonson, CO
Prosthetic Department
(210) 617-5300  ext. 17161

My reply to him, cc’d to his supervisor, Gordon Bosker, CPO and the Chief, Mrs. Nancy Bishop:
 
Hello Nate,
 
I appreciate the not so veiled threat.  When I posted this query I fully expected my referrals from the VA to dry up.  I realize the people I’m dealing with.  I am going to miss taking care of our nation’s best, but I believe this needs to be aired.  
 
You say the incidents are unfounded, but your office refused to investigate.  A simple phone call to the veterans would have yielded answers.  Why would your service leadership refuse a meeting with me?  I believe they knew what I had to say, knew it was true, and simply didn’t want to hear it.  My company has done over 2 1/2 million dollars in business with the VA over the past 5+ years, and I can’t even get a meeting to discuss an issue.  I believe this to be cowardice.  I believe I have a right as a contracted entity, one that has done work for hundreds of veterans without a single complaint, to raise and have addressed policy queries.   
 
You say I fabricated lies.  One thing I have never been it is a liar, and I take offense at that comment.  I challenge you to prove a single lie.  I did make a claim in the post that perhaps veterans were lied to about their options.  Mr. Dale Jones, Assistant Chief of Prosthetics, in a conversation we had on Thursday said veterans have a choice, and if they request a vendor they are allowed that choice.  I know of a few occasions where you personally disallowed that choice.  What I wanted from a meeting was to find out what policy actually is.  Does that make any sense at all to you?  Is there an actual policy?  It appears to change with the wind, or perhaps the provider in question?  Wouldn’t it make more sense to just say veterans no longer have a choice?  Then there would be no question.
 
By the way, regarding my needing education, I was seeking education when I called.  I was lied to.  Please ask Mr. Jones what he told me.  Perhaps you or he are in need of enlightenment.  If you do become so enlightened, would you be so kind as to inform the rest of us what policy is.  Something in writing would be awesome!    

Replies from the list:
 
 Kevin,

Please go to www.naaop.org and look at what we have been fighting for with
the VA Bill of rights….
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We are in the middle of that as well. Our congress person has seemed to be approachable about the whole thing.  Very crazy though that it has to come to this.
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Kevin,
First thanks for the many excellent youtube videos you have taped.
I am currently an Orthotic student at NUPOC, and Chris Robinson recently mentioned that he was in Washington working on legislation to require the VA to clearly publish Veterans rights to see outside vendors including o and p.
I believe Chris will have good insite into this and may be able to provide you names of Congressman that are actively pursuing this topic.
Regards
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Kevin,
You can certainly try your congressman, my only comment is “good luck”. Contact the local offices of the various Veterans Service Offices, DAV,VFW, American Legion and give them the details, along with any testamony from veterans you treat. You will get faster and far better results from most fellow vets employed by these groups. Fellow vet and life member DAV, also a CP.
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We have a case right now where the VA told the pt that they were his only choice… WRONG. The pt is going to have to travel 3 x further to go to them. Funny you bring it up Kevin , but it seems to be happening all over.
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 Call Mo Kenny at Kenny Ortho in ky. He will tell you the story.   (I believe Mr. Kenny successfully sued over this type of practice…If memeory serves.)
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 Kevin,
I don’t know if you are aware that a company in Tennessee or Kentucky sued the government over pretty much the same problems you are experiencing and won. The patients have a choice of the provider they prefer to go to. It is true that the VA has the right to evaluate the patients, but the patient has the right to see their provider of choice.

I forget what the statute is but their is a statute in the Veterans Bill of Rights that says just that. Get you a copy of the Veterans Bill of Rights and read it their is a clause that says the Veterans has freedom of choice.

Here at my company we had plastic cards made much like a credit card that they show to the Veterans Administration which spells out that the Veteran has freedom of choice and we have very little problem.

I hope this has been very helpful for you.
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 Hi Kevin,

What you describe has been the subject of recent congressional testimony.  I’d suggest you share your story with Peter Thomas, at [email protected]  He is the general counsel for the O&P Alliance and may be able to advise.  Regardless, he would be interested in the problems your Veteran has experienced.
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Kevin,

This has been occurring in the Southern California for years. The VA does not encourage nor educate veterans that they have a choice. The VA in increasing their staff  of orthotists and prosthetists, and encouraging patients to stay within the VA.

For years I have thought it was wrong and unfair to the patients. However, the VA calls all the shots. We are at their mercy to grant us contracts or approve services. Many veterans don’t want to rock the boat because all they want is their products,  even if means changing providers and going to the VA  instead.
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Hi Kevin,
So far here we have not had that problem, knock on wood.  I suspect the
only remedy is to turn up the heat on them via congress and play party
politics.  This should be a grim reminder of how we really don’t want more
gov’t bureaucracy in the insurance and healthcare.  Private companies are
bad enough, but at least we can vote them out of office with our dollars,
gov’t really doesn’t respond to our vote.  They have convoluted the system
so much it is impossible to unravel the status quo.  Case in point, instead
of Medicare fixing its own claim problems, they hire more outside companies
to retrieve it.

Thank you for bringing up good topics and situations occurring in our field.
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We need to keep the pressure on them, keep it in the public eye, and get the individual VA locations to cut the crap.  It’s amazing that they can openly do what they do.  It’s as if they just don’t care about the rules and they are snubbing the profession.  Makes me sick, and then the same government, different branch, starts the RAC audit program and calls us all crooks.  Go figure.
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Please keep me in your email loop. Someone who has the time ( and guts) needs to organize. I wonder what ABC, AOPA not to mention all of the state agency ( ie COPA in California) are doing?   I live in Los Angeles, near two VA hosptials (Los Angeles and Long Beach) …perhaps the media would be interested in how veterans are being denied their freedoms?
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There is no language, requirement, or federal statute that give the Veteran a choice to go anywhere outside the VA for medical care. You and I as veterans, signed a contract with the government and that care will be supplied by the government. However, if the VA does not offer a particular service, the VA can send you to a provider of their choosing for that particular service the veteran may need.

I would suggest that you contact Joe Miller, Veterans Administration, National Director of O&P Services, Washington,DC for clarification. Many veterans think they can go anywhere they determine is necessary for medical care, not realizing the contract signed is between the govenment and the service veteran, giving the government final determination.

I know this well as a Reagan Marine, I have a co-pay, I am not service connected disabled, and read my entire government contract. Hope this helps. Semper Fidelis!

 KMHeide
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Are you an NAAOP member?  We need more passionate people involved in the organization…  Please consider becoming a member and joining in on the fight with us-   
    (My company joined the fight in Washington, we joined NAAOP.  I know money is tight, but this our future, please consider joining.  Mine is a family practice and I want to do my part to help ensure my family’s  and my future in this profession)
************************************Kevin,
Good lu ck, let me know how it all works out for you. Also we are having some problems with vendors selling direct to the VA and bypassing us in the industry. We have told those vendors that we will no longer buy from them.
Hopefully others will follow suit. This could stop those vendors from contracting with the VA. Our industry buys more from them than the VA..
Good Luck
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Kevin C. Matthews, CO/LO
Advanced Orthopedic Designs
12315 Judson Rd. #206
San Antonio, Texas 78233
210-657-8100
210-657-8105 fax
www.AdvancedOrthopedicDesigns.com
[email protected]