VA Says It Loud and Clear, Patients Will Get Prosthetics Ordered By Their Physicians

By Sandra Basu

WASHINGTON — It should always be what the doctor orders.

 That was the message that VA delivered to a House subcommittee concerned about procuring the best prosthetics for patients who need them.

“We understand the critical value these devices offer, and the independent clinical judgment of our providers will and must remain fully intact,” Robert Petzel, MD, VHA undersecretary for health, told the Committee on Veterans’ Affairs Subcommittee on Health.

Petzel testified at a recent hearing where lawmakers wanted an update on VA’s planned prosthetic procurement reforms.

Orthotist Scott Gray adjusts the prosthetic leg of Tristan Wyatt during a fitting at the VA San Diego Healthcare System. Wyatt, who was wounded in Fallujah, Iraq, in 2003, is now assistant chief of prosthetics at VASDHS. VA photo by Christopher Menzie

The new policy requires prosthetic items that cost more than $3,000 to be purchased by a contracting officer, rather than the prosthetics service purchasing officers who usually handle these purchases.

The changes are designed to save money and provide better oversight for purchasing prosthetics. Some veterans’ groups complained at a hearing earlier this year, however, that the new process might cause unneeded delays in delivering prosthetics and could even mean the contracting officer’s judgment would override clinical judgment, if price is an issue.

Petzel told the subcommittee that the VA expects 100% compliance from contracting officers when it comes to the physician’s order.

“The contracting officer’s responsibility is to see that we get a fair price for it. He or she will not buy something different because it is less costly. We look at what is the physician’s order, and that is what we buy.”

Subcommittee chairwoman Rep. Ann Marie Buerkle (R-NY) opened the hearing by stating her concerns “that the reforms were developed without careful and thorough consideration” had not been quelled by a recent review of information provided by the VA.

Petzel explained, however, that the procurement reforms are a “systemwide effort” to ensure that VA has professional, certified contractors doing procurement. Prosthetics is “the last area” of procurement within VA that has not had certified warranted procurement officers handling items that cost more than $3,000, he said.

“We have been criticized in the past by organizations such as the [Inspector General] for not having a professional procurement force and for not following, in all instances, the federal regulations or VA’s acquisition regulations,” he said. “The effort is in no way directed specifically at prosthetics.”

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  1. Arthur Angaran says:

    Mr. Petzel is lying. Prosthetics did have professional warranted purchasing agents and warranted procurement officers doing procurement. Therefore the statement that the non-certified warranted officers handeling items that cost more than $3,000 is totally false.

    Another lie is that the warranted officers did not, “in all instances” follow the FAR and the VAR. Because of timeliness issues the FAR allows for orders over $3,000 to be made without a bidding process. Before the when an order came in to prosthetics from a clinician, the purchasing agent could override the bidding process because time was of the essence, (ie.surgical implants needed for a surgery scheduled the next day.) Now the order goes through a bidding process and sometimes surgeries have been canceled because the contracting officer must follow a rule not designed for a hospital, but for the military.

    ” The contracting officer sees that we get a fair price… We look at what is the physician’s order, and that is what we buy.” If it is over $3,000 then the order must be sent out for bid and the lowest price oftem times is what is purchased and it may or may not be medically appropriate for the patient. this is what is happening in the real world and not the Lies being told us by governmentr officials.

    Arthur Angaran
    Procurement Tech/ Prosthetic and Sensory Aids Service, VA AnnArbor Health Care System

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