3.7. Commercial Sources
The local Artificial Limb Contract must be used as the primary source for commercial procurement of limbs purchased for VA beneficiaries. Prosthetics Representatives are responsible for compliance with the terms and conditions of this contract, and they must perform inspections of contractor facilities. Any changes in qualified personnel, i.e., regarding certified prosthetists or VA qualified prosthetists, which occur during the contract year, must be reported to the contracting officer at the local facility.
a. Eligible veterans will be permitted to obtain authorized artificial limbs and/or terminal devices from any commercial artificial limb dealer who is under a current local contract to the VA or the veteran's preferred prosthetist who agrees to accept the preferred provider rate. Such procurements are subject to the following restrictions and limitations:
(1) The physician's prescription must be specific as to the type of limb recommended and must include specific instructions as to the components to be used; e.g., type of knee joints, type of foot, etc. Any changes to the prescription deemed necessary by the prosthetist, must be presented to Prosthetics and the prescribing physician for approval.
(2) If an outpatient, the veteran's choice of an approved contractor is normally limited to those in the veteran's residential geographical area.
(a) If the prescribed limb is not available from any of the local contractors, the Chief, P&SAS, must seek another Prosthetic and/or Orthotic Laboratory that can provide the veteran with the appropriate prosthesis.
(b) If a veteran selects an approved contractor, other than a contractor in the local geographical area, any travel costs incurred must be at the veteran's own expense. NOTE: Exceptions are only made in those instances when it is clearly indicated that it is in the best interest of both the veteran and VA.
b. To assist all eligible veterans authorized permanent artificial limbs using a commercial contractor, a current list of approved contractors in the immediate geographical area must be provided to each. Included in this list will be the VA Prosthetic-Orthotic Laboratories, when applicable. Except in those rare instances where a physician determines it to be necessary for the proper medical treatment of the veteran, VA personnel are not allowed to direct, guide, or prompt a veteran to go to a specific contractor. NOTE: A rotating contractor schedule will not be used as a method of selecting a contractor for the fabrication of a limb.
(1) A list of VA contractors (in alphabetical order) must be developed locally and must include all contractors who are located in the facility's area of prosthetic jurisdiction and have a current VA contract.
(2) Each list must contain the following statement in bold face type:
YOU HAVE THE RIGHT TO SELECT THE ARTIFICIAL LIMB CONTRACTOR OF YOUR CHOICE FROM ANY OF THE FOLLOWING LISTED VA-APPROVED CONTRACTORS. ANY ATTEMPT TO INFLUENCE YOUR DECISION, OR TO DIRECT YOU TO ANY PARTICULAR CONTRACTOR, SHOULD BE REPORTED TO THE DIRECTOR OF THIS FACILITY.
c. When the designated physician of the Amputee Clinic Team prescribes a limb or componetry that cannot be provided by a VA prosthetist or contract vender:
(1) A qualified non-contract vender may be offered the fabrication of the limb, or
(2) A veteran who has a long standing relation with a qualified vendor not currently under contract, may request that vender to fabricate the limb, provided charges do not exceed the average discount price of preferred vendors.
NOTE: Appropriate non-contract components (which are commercially available) may be added to a contract limb and approved locally by the Prosthetic representative, provided the cost of the component does not exceed the dollar limitation stated in the current Centers for Medicare and Medicaid Services (CMS) L-Code schedule plus the discount.