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NAAOP Alert: VA Victory on Private Contracting of O&P Care

The National Association for the Advancement of Orthotics & Prosthetics (NAAOP) has issued the following legislative alert:

Congress is poised to pass-and the President is expected to sign-major legislation impacting the Veterans Health Administration. NAAOP is proud to announce that one of the key provisions in House Resolution (H.R.) 3408, the Injured and Amputee Veterans Bill of Rights, involving private contracting, is included in this bill.

The private contracting provision in the soon-to-become-law H.R. 3230, titled the Veterans Access to Care Act of 2014, is far broader than the provision in H.R. 3408 and applies to more than just O&P practitioners. But the concept is the same. The provision is designed to address the long waiting times for care that led to numerous deaths of veterans in the recent past. The private contracting provision applies to physicians, hospitals, and other providers, including orthotists and prosthetists. The new law requires the U.S. Department of Veterans Affairs (VA) to permit access to private practitioners when veterans cannot receive an appointment within 30 days or if they live more than 40 miles away from the nearest VA facility, in this case, the nearest VA O&P clinic. There are also specific provisions for those in highly rural areas.

The Injured and Amputee Veterans Bill of Rights states that veterans have a right to access the private O&P practitioner of the veteran’s choice, whether or not the practitioner has a contract with the VA. The soon-to-be-enacted law essentially implements this right, at least for certain veterans. In order for a veteran to gain access to a private O&P practitioner, the practitioner must participate in the Medicare program, must agree to accept Medicare rates, and must retain all the licenses and credentials that Medicare requires.

How this new form of access for veterans interacts with the current system is not yet clear. Currently, over 80 percent of O&P care for veterans is provided by private practitioners under contract with the VA. Many of those contracts are at discounted rates off the Medicare fee schedule. The number of contracts totaled 600 in the past, but more recently, that number has been reduced as the VA strengthened its internal capacity to provide O&P care.

NAAOP said it will be working with its O&P Alliance partners to clarify these new provisions and will alert its members as soon as more information is available. NAAOP will also continue to work in a bipartisan manner to pass other important aspects of the VA Bill of Rights in future VA legislation.