The Prosthetic and Rehabilitative Items and Services Final Rule was published in the Federal Register and goes into effect on January 27, 2021. The proposed rule was published in October 2017. AOPA provided comments at that time.
The rule establishes and clarifies eligibility for prosthetic and rehabilitative items and services available to Veterans.
Previously the categories of prosthetic and orthotic services, sensory aids and medical devices the VA is authorized to provide to Veterans as part of their active treatment and ongoing rehabilitation varied across VA medical centers. AOPA has long communicated its concerns regarding such inconsistencies.
Of the rule, VA Secretary Robert Wilkie said, “The rule establishes a uniform approach for VA to deliver prosthetic items and services to Veterans. It ensures Veterans receive the same standard of service for the rehabilitative devices they need to live independently, no matter which medical center they walk into.”
AOPA staff are in the process of creating a page on the Co-OP to help you better understand the policy requirements and documentation responsibilities of this rule so that you can best serve your Veteran patients. Specifically, we will be addressing the following sections of the policy:
- promote, preserve, and restore standard under § 17.38(b)
- direct and active component test in § 17.3230(a)
- medical necessity standards under §§ 17.38(b) and 17.3230(a)
Over the past several years AOPA staff have worked to increase collaboration and build stronger relationships with VA leadership. One product of these relationships is the development of dedicated VA education for AOPA members, which will be rolling out in 2021. This education will not only dive into the various policies and regulations, but will also provide guidance on how to best work with your local VA, specifically between contract providers and VA staff.
If you have questions about this issue please contact Justin Beland at jbeland@AOPAnet.org.