A federal agency’s plan to rein in rising prosthetic costs treats purchases of artificial limbs the same as buying cinder blocks or "mass-produced" widgets, a military veteran told U.S. lawmakers.
The Department of Veterans Affairs is shifting responsibility for ordering some prosthetics, including artificial limbs, from medical personnel to contracting staff. It’s also requiring more documentation on the spending.
Listening to veterans
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The changes are designed to reduce prosthetic costs, which have jumped 80 percent in the past four years, according to the VA inspector general. They also may delay the delivery of devices to wounded veterans, said Jonathan Pruden, a retired Army captain who has a prosthetic leg after being injured in Iraq.
"This system may be great for buying cinder blocks and light bulbs, but it’s certainly not appropriate for medical care," Pruden said May 16 at a hearing of a House of Representatives Veterans Affairs subcommittee. "A prosthetic limb is not a mass-produced widget."
John Register, who also testified, said he and some other veterans are worried that the VA may begin consolidating the number of vendors, giving them fewer options and forcing them to travel long distances.
"Having that care and not having to travel so far to get it is paramount," said Register, who served in the Army in the Gulf War and has a prosthetic leg.
Prosthetics spending. » VA spending on prosthetics rose to $1.8 billion in the fiscal year that ended Sept. 30, from $1 billion in fiscal 2007, according to the inspector general’s March report.
The agency overpaid on 23 percent of prosthetic limb transactions made during fiscal 2010, spending about $2.2 million more than necessary that year on those items, according to a separate inspector general report the same month.
"The department realized it was weak in certain areas of contract administration and awarding of contracts," Norbert Doyle, chief procurement officer of the VA’s Veterans Health Administration, said at the hearing. "This will bring it in-house and ensure the best use of taxpayer dollars."
If a clinician says a specific product is necessary for a veteran, that item will be purchased, Doyle said.
"I do not want my contract officers making a decision about what goes into a veteran’s body," he said. "That is clearly a clinician decision."
Companies affected. » Companies including Minneapolis-based Medtronic Inc. and Natick, Massachusetts-based Boston Scientific Corp. may be affected by the changes.
The VA paid Medtronic about $5 million and Boston Scientific about $3 million for prosthetic products or services in fiscal 2010, according to federal procurement data compiled by Bloomberg.
The agency’s policy changes affect all prosthetics, a broad category that also includes hearing aids and wheelchairs, that cost more than $3,000.
Representative Phil Roe, a Tennessee Republican, was one of several members of Congress who expressed concern about the VA’s prosthetic purchasing reform.
"I’m all for saving taxpayer money but we’re not going to balance this budget on the back of people who lost limbs serving their country," Roe said at the hearing.
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