VA contract
Michael Pack
Description
Collection
Title:
VA contract
Creator:
Michael Pack
Date:
4/30/2003
Text:
Hello List,
I am the owner of a small prosthetic facility and would like to know if anyone has researched the VA policy on payment for services for non-contracted providers. We are being told that we have to accept the average discount from Medicare pricing of the current 5 contracted providers. For example, (20%+19%+16%+15%+12% = 82/5 = 16.4% off Medicare). It would seem to me that we should be able to receive Medicare reimbursement if we are not contracted with the VA. Are there any other options? Is it possible for a service connected veteran to go to a non-contracted provider without having a prior relationship with that provider? We are being told Experienced service-connected and non-service connected amputees with continuing eligibility who have been in the VA system and have established ties with a prosthetist they like to use will continue to be allowed their choice of artificial limbs providers. I thought they had a choice.
Also, has anyone looked into the fact that awards for contracts (50% of the weight) are based on the best percentage discount that you offer against the L-Code pricing baseline. L-Code pricing shall be referenced as published by the Centers for Medicare & Medicaid Services' (CMS) Healthcare Common Procedure Coding System (HCPCS)? It seems odd that a government entity is asking (read demanding) for a discount off of a government established fee schedule!
How about in-house fabrication at the VA?
Any and all feedback is greatly appreciated.
Michael Pack, C.P.
<Email Address Redacted>
I am the owner of a small prosthetic facility and would like to know if anyone has researched the VA policy on payment for services for non-contracted providers. We are being told that we have to accept the average discount from Medicare pricing of the current 5 contracted providers. For example, (20%+19%+16%+15%+12% = 82/5 = 16.4% off Medicare). It would seem to me that we should be able to receive Medicare reimbursement if we are not contracted with the VA. Are there any other options? Is it possible for a service connected veteran to go to a non-contracted provider without having a prior relationship with that provider? We are being told Experienced service-connected and non-service connected amputees with continuing eligibility who have been in the VA system and have established ties with a prosthetist they like to use will continue to be allowed their choice of artificial limbs providers. I thought they had a choice.
Also, has anyone looked into the fact that awards for contracts (50% of the weight) are based on the best percentage discount that you offer against the L-Code pricing baseline. L-Code pricing shall be referenced as published by the Centers for Medicare & Medicaid Services' (CMS) Healthcare Common Procedure Coding System (HCPCS)? It seems odd that a government entity is asking (read demanding) for a discount off of a government established fee schedule!
How about in-house fabrication at the VA?
Any and all feedback is greatly appreciated.
Michael Pack, C.P.
<Email Address Redacted>
Citation
Michael Pack, “VA contract,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 1, 2024, https://library.drfop.org/items/show/221077.
