AP46-Supplemental Notice of Proposed Rulemaking-Prosthetic and Rehabilitative Items and Services
2017-10-19 2017-11-02 2017-11-02 2017-11-03 2017-11-03 2017-11-09 2017-11-14 2017-11-16 2017-11-16 2017-12-11
VA-2017-VHA-0023-0005 VA-2017-VHA-0023-0068 VA-2017-VHA-0023-0094 VA-2017-VHA-0023-0126 VA-2017-VHA-0023-0130 VA-2017-VHA-0023-0163 VA-2017-VHA-0023-0174 VA-2017-VHA-0023-0191 VA-2017-VHA-0023-0192 VA-2017-VHA-0023-0269
04:00:00 04:00:00 04:00:00 04:00:00 04:00:00 05:00:00 05:00:00 05:00:00 05:00:00 05:00:00
https://api.regulations.gov/v4/comments/VA-2017-VHA-0023-0005 https://api.regulations.gov/v4/comments/VA-2017-VHA-0023-0068 https://api.regulations.gov/v4/comments/VA-2017-VHA-0023-0094 https://api.regulations.gov/v4/comments/VA-2017-VHA-0023-0126 https://api.regulations.gov/v4/comments/VA-2017-VHA-0023-0130 https://api.regulations.gov/v4/comments/VA-2017-VHA-0023-0163 https://api.regulations.gov/v4/comments/VA-2017-VHA-0023-0174 https://api.regulations.gov/v4/comments/VA-2017-VHA-0023-0191 https://api.regulations.gov/v4/comments/VA-2017-VHA-0023-0192 https://api.regulations.gov/v4/comments/VA-2017-VHA-0023-0269
Roland Anonymous Anonymous Anonymous Anonymous Anonymous Anonymous Anonymous Anonymous Melissa
Roberts Anonymous Anonymous Anonymous Anonymous Anonymous Anonymous Anonymous Anonymous Stockwell
See Uploaded File. I am writing today in order to offer comments on the proposed rule entitled, Prosthetic and Rehabilitative Items and Services that was published in the Federal Register on October 16, 2017.  The stated purpose of the proposed rule is to, revise its medical regulations related to providing prosthetic and rehabilitative items, primarily to clarify eligibility for prosthetic and other rehabilitative items and services, and to define the types of items and services available to eligible veterans.While I understand the need of the Department of Veterans Affairs (VA) to establish formal regulations in order to ensure continued coverage for medically necessary prosthetic services, I am deeply concerned regarding the provisions of the proposed rule contained in section 17.3240 entitled, Furnishing authorized items and services.  This section, in part, states that solely the VA will determine whether VA or a VA-authorized vendor will furnish authorized items and services to veterans.  The proposed section goes on to state that the VA would clarify in regulation that, this administrative business decision is made solely by the VA to eliminate any possible confusion as to whether a veteran has a right to request items or services generally, or to request specific items or services from a provider other than the VA, and to clarify for the benefit of VA-authorized vendors that VA retains this discretion as part of our duty to administer this program in a legally sufficient, fiscally responsible manner.  The proposed regulations at  17.3240 appear to directly contradict the longstanding policy of the VA regarding a veterans right to receive prosthetic services through the VA directly or through a VA contracted provider as well as the provisions of the Veterans Access, Choice and Accountability Act of 2014.Since the creation of the Veterans Administration in 1930, providers of artificial limbs and braces have worked closely with the VA to ensure that veterans have complete access to high quality, clinically appropriate, prosthetic and orthotic care.  Whether services were provided directly by the VA within their own facilities or by private companies through a contractual arrangement, the needs of the individual veteran has always been paramount in how care is delivered.  The proposed rule completely disregards: (1) respect for the Veterans right, like other Americans, to participate in the choice of who they entrust with delivering key components of their health care; and (2) the long history of cooperation between the VA and its contracted prosthetic and orthotic providers, as well as the clinical needs of the individual veteran, by proposing regulations that authorizes the VA to exercise sole discretion as to how prosthetic and orthotic care is delivered to veterans.  The proposed rule goes so far as to state that the decision regarding how care is delivered is an administrative decision.  I could not disagree more.  The delivery of appropriate prosthetic and orthotic care is not an administrative issue, it is a clinical issue; one that should be made based on the clinical needs of the individual veteran, not the administrative needs of a government agency.I am truly perplexed by the proposal to completely remove the veterans right to choose to receive service from a VA contracted provider as it is in direct conflict with testimony from top VA officials who have repeatedly reinforced the right and opportunity of Veterans to work with providers of their choice who can best meet their clinical needs.  On October 24, 2017, in testimony before the House Veterans Affairs Committee, Secretary Shulkin stated the following: Veterans should get more choice in the say of their care.  Nobody should feel trapped in the VA system.This is just one example of repeated testimony by VA officials that support the right of the veteran to receive care from their chosen provider.I urge you to revise the language contained in section 17.3240 of the proposed rule to bring it in line with the VAs longstanding position, with the intent of the Choice Act,  and with the public statements before Congress by the Secretary and others assuring Veteran choice of where and from who they receive their orthotic/prosthetic care.  The elimination of the veterans right to choose to receive prosthetic and orthotic services directly through the VA or through a relationship with a contracted provider is in nobodys best interest and it is certainly not an administrative decision.  It is a deeply personal decision that must involve input from all involved parties but especially from the veteran.  Publication of a final rule without affirming the rights of the veteran would be a true disservice to those who have dedicated their lives to serving their country. I am writing today in order to offer comments on the proposed rule entitled, Prosthetic and Rehabilitative Items and Services that was published in the Federal Register on October 16, 2017.  The stated purpose of the proposed rule is to, revise its medical regulations related to providing prosthetic and rehabilitative items, primarily to clarify eligibility for prosthetic and other rehabilitative items and services, and to define the types of items and services available to eligible veterans.While I understand the need of the Department of Veterans Affairs (VA) to establish formal regulations in order to ensure continued coverage for medically necessary prosthetic services, I am deeply concerned regarding the provisions of the proposed rule contained in section 17.3240 entitled, Furnishing authorized items and services.  This section, in part, states that solely the VA will determine whether VA or a VA-authorized vendor will furnish authorized items and services to veterans.  The proposed section goes on to state that the VA would clarify in regulation that, this administrative business decision is made solely by the VA to eliminate any possible confusion as to whether a veteran has a right to request items or services generally, or to request specific items or services from a provider other than the VA, and to clarify for the benefit of VA-authorized vendors that VA retains this discretion as part of our duty to administer this program in a legally sufficient, fiscally responsible manner.  The proposed regulations at  17.3240 appear to directly contradict the longstanding policy of the VA regarding a veterans right to receive prosthetic services through the VA directly or through a VA contracted provider as well as the provisions of the Veterans Access, Choice and Accountability Act of 2014.Since the creation of the Veterans Administration in 1930, providers of artificial limbs and braces have worked closely with the VA to ensure that veterans have complete access to high quality, clinically appropriate, prosthetic and orthotic care.  Whether services were provided directly by the VA within their own facilities or by private companies through a contractual arrangement, the needs of the individual veteran has always been paramount in how care is delivered.  The proposed rule completely disregards: (1) respect for the Veterans right, like other Americans, to participate in the choice of who they entrust with delivering key components of their health care; and (2) the long history of cooperation between the VA and its contracted prosthetic and orthotic providers, as well as the clinical needs of the individual veteran, by proposing regulations that authorizes the VA to exercise sole discretion as to how prosthetic and orthotic care is delivered to veterans.  The proposed rule goes so far as to state that the decision regarding how care is delivered is an administrative decision.  I could not disagree more.  The delivery of appropriate prosthetic and orthotic care is not an administrative issue, it is a clinical issue; one that should be made based on the clinical needs of the individual veteran, not the administrative needs of a government agency.I am truly perplexed by the proposal to completely remove the veterans right to choose to receive service from a VA contracted provider as it is in direct conflict with testimony from top VA officials who have repeatedly reinforced the right and opportunity of Veterans to work with providers of their choice who can best meet their clinical needs.  On October 24, 2017, in testimony before the House Veterans Affairs Committee, Secretary Shulkin stated the following: Veterans should get more choice in the say of their care.  Nobody should feel trapped in the VA system.This is just one example of repeated testimony by VA officials that support the right of the veteran to receive care from their chosen provider.I urge you to revise the language contained in section 17.3240 of the proposed rule to bring it in line with the VAs longstanding position, with the intent of the Choice Act,  and with the public statements before Congress by the Secretary and others assuring Veteran choice of where and from who they receive their orthotic/prosthetic care.  The elimination of the veterans right to choose to receive prosthetic and orthotic services directly through the VA or through a relationship with a contracted provider is in nobodys best interest and it is certainly not an administrative decision.  It is a deeply personal decision that must involve input from all involved parties but especially from the veteran.  Publication of a final rule without affirming the rights of the veteran would be a true disservice to those who have dedicated their lives to serving their country. I am writing today in order to offer comments on the proposed rule entitled, Prosthetic and Rehabilitative Items and Services that was published in the Federal Register on October 16, 2017.  The stated purpose of the proposed rule is to, revise its medical regulations related to providing prosthetic and rehabilitative items, primarily to clarify eligibility for prosthetic and other rehabilitative items and services, and to define the types of items and services available to eligible veterans.While I understand the need of the Department of Veterans Affairs (VA) to establish formal regulations in order to ensure continued coverage for medically necessary prosthetic services, I am deeply concerned regarding the provisions of the proposed rule contained in section 17.3240 entitled, Furnishing authorized items and services.  This section, in part, states that solely the VA will determine whether VA or a VA-authorized vendor will furnish authorized items and services to veterans.  The proposed section goes on to state that the VA would clarify in regulation that, this administrative business decision is made solely by the VA to eliminate any possible confusion as to whether a veteran has a right to request items or services generally, or to request specific items or services from a provider other than the VA, and to clarify for the benefit of VA-authorized vendors that VA retains this discretion as part of our duty to administer this program in a legally sufficient, fiscally responsible manner.  The proposed regulations at  17.3240 appear to directly contradict the longstanding policy of the VA regarding a veterans right to receive prosthetic services through the VA directly or through a VA contracted provider as well as the provisions of the Veterans Access, Choice and Accountability Act of 2014.Since the creation of the Veterans Administration in 1930, providers of artificial limbs and braces have worked closely with the VA to ensure that veterans have complete access to high quality, clinically appropriate, prosthetic and orthotic care.  Whether services were provided directly by the VA within their own facilities or by private companies through a contractual arrangement, the needs of the individual veteran has always been paramount in how care is delivered.  The proposed rule completely disregards: (1) respect for the Veterans right, like other Americans, to participate in the choice of who they entrust with delivering key components of their health care; and (2) the long history of cooperation between the VA and its contracted prosthetic and orthotic providers, as well as the clinical needs of the individual veteran, by proposing regulations that authorizes the VA to exercise sole discretion as to how prosthetic and orthotic care is delivered to veterans.  The proposed rule goes so far as to state that the decision regarding how care is delivered is an administrative decision.  I could not disagree more.  The delivery of appropriate prosthetic and orthotic care is not an administrative issue, it is a clinical issue; one that should be made based on the clinical needs of the individual veteran, not the administrative needs of a government agency.I am truly perplexed by the proposal to completely remove the veterans right to choose to receive service from a VA contracted provider as it is in direct conflict with testimony from top VA officials who have repeatedly reinforced the right and opportunity of Veterans to work with providers of their choice who can best meet their clinical needs.  On October 24, 2017, in testimony before the House Veterans Affairs Committee, Secretary Shulkin stated the following: Veterans should get more choice in the say of their care.  Nobody should feel trapped in the VA system.This is just one example of repeated testimony by VA officials that support the right of the veteran to receive care from their chosen provider.I urge you to revise the language contained in section 17.3240 of the proposed rule to bring it in line with the VAs longstanding position, with the intent of the Choice Act,  and with the public statements before Congress by the Secretary and others assuring Veteran choice of where and from who they receive their orthotic/prosthetic care.  The elimination of the veterans right to choose to receive prosthetic and orthotic services directly through the VA or through a relationship with a contracted provider is in nobodys best interest and it is certainly not an administrative decision.  It is a deeply personal decision that must involve input from all involved parties but especially from the veteran.  Publication of a final rule without affirming the rights of the veteran would be a true disservice to those who have dedicated their lives to serving their country. I am writing today in order to offer comments on the proposed rule entitled, Prosthetic and Rehabilitative Items and Services that was published in the Federal Register on October 16, 2017.  The stated purpose of the proposed rule is to, revise its medical regulations related to providing prosthetic and rehabilitative items, primarily to clarify eligibility for prosthetic and other rehabilitative items and services, and to define the types of items and services available to eligible veterans.While I understand the need of the Department of Veterans Affairs (VA) to establish formal regulations in order to ensure continued coverage for medically necessary prosthetic services, I am deeply concerned regarding the provisions of the proposed rule contained in section 17.3240 entitled, Furnishing authorized items and services.  This section, in part, states that solely the VA will determine whether VA or a VA-authorized vendor will furnish authorized items and services to veterans.  The proposed section goes on to state that the VA would clarify in regulation that, this administrative business decision is made solely by the VA to eliminate any possible confusion as to whether a veteran has a right to request items or services generally, or to request specific items or services from a provider other than the VA, and to clarify for the benefit of VA-authorized vendors that VA retains this discretion as part of our duty to administer this program in a legally sufficient, fiscally responsible manner.  The proposed regulations at  17.3240 appear to directly contradict the longstanding policy of the VA regarding a veterans right to receive prosthetic services through the VA directly or through a VA contracted provider as well as the provisions of the Veterans Access, Choice and Accountability Act of 2014.Since the creation of the Veterans Administration in 1930, providers of artificial limbs and braces have worked closely with the VA to ensure that veterans have complete access to high quality, clinically appropriate, prosthetic and orthotic care.  Whether services were provided directly by the VA within their own facilities or by private companies through a contractual arrangement, the needs of the individual veteran has always been paramount in how care is delivered.  The proposed rule completely disregards: (1) respect for the Veterans right, like other Americans, to participate in the choice of who they entrust with delivering key components of their health care; and (2) the long history of cooperation between the VA and its contracted prosthetic and orthotic providers, as well as the clinical needs of the individual veteran, by proposing regulations that authorizes the VA to exercise sole discretion as to how prosthetic and orthotic care is delivered to veterans.  The proposed rule goes so far as to state that the decision regarding how care is delivered is an administrative decision.  I could not disagree more.  The delivery of appropriate prosthetic and orthotic care is not an administrative issue, it is a clinical issue; one that should be made based on the clinical needs of the individual veteran, not the administrative needs of a government agency.I am truly perplexed by the proposal to completely remove the veterans right to choose to receive service from a VA contracted provider as it is in direct conflict with testimony from top VA officials who have repeatedly reinforced the right and opportunity of Veterans to work with providers of their choice who can best meet their clinical needs.  On October 24, 2017, in testimony before the House Veterans Affairs Committee, Secretary Shulkin stated the following: Veterans should get more choice in the say of their care.  Nobody should feel trapped in the VA system.This is just one example of repeated testimony by VA officials that support the right of the veteran to receive care from their chosen provider.I urge you to revise the language contained in section 17.3240 of the proposed rule to bring it in line with the VAs longstanding position, with the intent of the Choice Act,  and with the public statements before Congress by the Secretary and others assuring Veteran choice of where and from who they receive their orthotic/prosthetic care.  The elimination of the veterans right to choose to receive prosthetic and orthotic services directly through the VA or through a relationship with a contracted provider is in nobodys best interest and it is certainly not an administrative decision.  It is a deeply personal decision that must involve input from all involved parties but especially from the veteran.  Publication of a final rule without affirming the rights of the veteran would be a true disservice to those who have dedicated their lives to serving their country. I am writing today in order to offer comments on the proposed rule entitled, Prosthetic and Rehabilitative Items and Services that was published in the Federal Register on October 16, 2017.  The stated purpose of the proposed rule is to, revise its medical regulations related to providing prosthetic and rehabilitative items, primarily to clarify eligibility for prosthetic and other rehabilitative items and services, and to define the types of items and services available to eligible veterans.While I understand the need of the Department of Veterans Affairs (VA) to establish formal regulations in order to ensure continued coverage for medically necessary prosthetic services, I am deeply concerned regarding the provisions of the proposed rule contained in section 17.3240 entitled, Furnishing authorized items and services.  This section, in part, states that solely the VA will determine whether VA or a VA-authorized vendor will furnish authorized items and services to veterans.  The proposed section goes on to state that the VA would clarify in regulation that, this administrative business decision is made solely by the VA to eliminate any possible confusion as to whether a veteran has a right to request items or services generally, or to request specific items or services from a provider other than the VA, and to clarify for the benefit of VA-authorized vendors that VA retains this discretion as part of our duty to administer this program in a legally sufficient, fiscally responsible manner.  The proposed regulations at  17.3240 appear to directly contradict the longstanding policy of the VA regarding a veterans right to receive prosthetic services through the VA directly or through a VA contracted provider as well as the provisions of the Veterans Access, Choice and Accountability Act of 2014.Since the creation of the Veterans Administration in 1930, providers of artificial limbs and braces have worked closely with the VA to ensure that veterans have complete access to high quality, clinically appropriate, prosthetic and orthotic care.  Whether services were provided directly by the VA within their own facilities or by private companies through a contractual arrangement, the needs of the individual veteran has always been paramount in how care is delivered.  The proposed rule completely disregards: (1) respect for the Veterans right, like other Americans, to participate in the choice of who they entrust with delivering key components of their health care; and (2) the long history of cooperation between the VA and its contracted prosthetic and orthotic providers, as well as the clinical needs of the individual veteran, by proposing regulations that authorizes the VA to exercise sole discretion as to how prosthetic and orthotic care is delivered to veterans.  The proposed rule goes so far as to state that the decision regarding how care is delivered is an administrative decision.  I could not disagree more.  The delivery of appropriate prosthetic and orthotic care is not an administrative issue, it is a clinical issue; one that should be made based on the clinical needs of the individual veteran, not the administrative needs of a government agency.I am truly perplexed by the proposal to completely remove the veterans right to choose to receive service from a VA contracted provider as it is in direct conflict with testimony from top VA officials who have repeatedly reinforced the right and opportunity of Veterans to work with providers of their choice who can best meet their clinical needs.  On October 24, 2017, in testimony before the House Veterans Affairs Committee, Secretary Shulkin stated the following: Veterans should get more choice in the say of their care.  Nobody should feel trapped in the VA system.This is just one example of repeated testimony by VA officials that support the right of the veteran to receive care from their chosen provider.I urge you to revise the language contained in section 17.3240 of the proposed rule to bring it in line with the VAs longstanding position, with the intent of the Choice Act,  and with the public statements before Congress by the Secretary and others assuring Veteran choice of where and from who they receive their orthotic/prosthetic care.  The elimination of the veterans right to choose to receive prosthetic and orthotic services directly through the VA or through a relationship with a contracted provider is in nobodys best interest and it is certainly not an administrative decision.  It is a deeply personal decision that must involve input from all involved parties but especially from the veteran.  Publication of a final rule without affirming the rights of the veteran would be a true disservice to those who have dedicated their lives to serving their country. I am writing today in order to offer comments on the proposed rule entitled, Prosthetic and Rehabilitative Items and Services that was published in the Federal Register on October 16, 2017.  The stated purpose of the proposed rule is to, revise its medical regulations related to providing prosthetic and rehabilitative items, primarily to clarify eligibility for prosthetic and other rehabilitative items and services, and to define the types of items and services available to eligible veterans.While I understand the need of the Department of Veterans Affairs (VA) to establish formal regulations in order to ensure continued coverage for medically necessary prosthetic services, I am deeply concerned regarding the provisions of the proposed rule contained in section 17.3240 entitled, Furnishing authorized items and services.  This section, in part, states that solely the VA will determine whether VA or a VA-authorized vendor will furnish authorized items and services to veterans.  The proposed section goes on to state that the VA would clarify in regulation that, this administrative business decision is made solely by the VA to eliminate any possible confusion as to whether a veteran has a right to request items or services generally, or to request specific items or services from a provider other than the VA, and to clarify for the benefit of VA-authorized vendors that VA retains this discretion as part of our duty to administer this program in a legally sufficient, fiscally responsible manner.  The proposed regulations at  17.3240 appear to directly contradict the longstanding policy of the VA regarding a veterans right to receive prosthetic services through the VA directly or through a VA contracted provider as well as the provisions of the Veterans Access, Choice and Accountability Act of 2014.Since the creation of the Veterans Administration in 1930, providers of artificial limbs and braces have worked closely with the VA to ensure that veterans have complete access to high quality, clinically appropriate, prosthetic and orthotic care.  Whether services were provided directly by the VA within their own facilities or by private companies through a contractual arrangement, the needs of the individual veteran has always been paramount in how care is delivered.  The proposed rule completely disregards: (1) respect for the Veterans right, like other Americans, to participate in the choice of who they entrust with delivering key components of their health care; and (2) the long history of cooperation between the VA and its contracted prosthetic and orthotic providers, as well as the clinical needs of the individual veteran, by proposing regulations that authorizes the VA to exercise sole discretion as to how prosthetic and orthotic care is delivered to veterans.  The proposed rule goes so far as to state that the decision regarding how care is delivered is an administrative decision.  I could not disagree more.  The delivery of appropriate prosthetic and orthotic care is not an administrative issue, it is a clinical issue; one that should be made based on the clinical needs of the individual veteran, not the administrative needs of a government agency.I am truly perplexed by the proposal to completely remove the veterans right to choose to receive service from a VA contracted provider as it is in direct conflict with testimony from top VA officials who have repeatedly reinforced the right and opportunity of Veterans to work with providers of their choice who can best meet their clinical needs.  On October 24, 2017, in testimony before the House Veterans Affairs Committee, Secretary Shulkin stated the following: Veterans should get more choice in the say of their care.  Nobody should feel trapped in the VA system.This is just one example of repeated testimony by VA officials that support the right of the veteran to receive care from their chosen provider.I urge you to revise the language contained in section 17.3240 of the proposed rule to bring it in line with the VAs longstanding position, with the intent of the Choice Act,  and with the public statements before Congress by the Secretary and others assuring Veteran choice of where and from who they receive their orthotic/prosthetic care.  The elimination of the veterans right to choose to receive prosthetic and orthotic services directly through the VA or through a relationship with a contracted provider is in nobodys best interest and it is certainly not an administrative decision.  It is a deeply personal decision that must involve input from all involved parties but especially from the veteran.  Publication of a final rule without affirming the rights of the veteran would be a true disservice to those who have dedicated their lives to serving their country. I am writing today in order to offer comments on the proposed rule entitled, Prosthetic and Rehabilitative Items and Services that was published in the Federal Register on October 16, 2017.  The stated purpose of the proposed rule is to, revise its medical regulations related to providing prosthetic and rehabilitative items, primarily to clarify eligibility for prosthetic and other rehabilitative items and services, and to define the types of items and services available to eligible veterans.While I understand the need of the Department of Veterans Affairs (VA) to establish formal regulations in order to ensure continued coverage for medically necessary prosthetic services, I am deeply concerned regarding the provisions of the proposed rule contained in section 17.3240 entitled, Furnishing authorized items and services.  This section, in part, states that solely the VA will determine whether VA or a VA-authorized vendor will furnish authorized items and services to veterans.  The proposed section goes on to state that the VA would clarify in regulation that, this administrative business decision is made solely by the VA to eliminate any possible confusion as to whether a veteran has a right to request items or services generally, or to request specific items or services from a provider other than the VA, and to clarify for the benefit of VA-authorized vendors that VA retains this discretion as part of our duty to administer this program in a legally sufficient, fiscally responsible manner.  The proposed regulations at  17.3240 appear to directly contradict the longstanding policy of the VA regarding a veterans right to receive prosthetic services through the VA directly or through a VA contracted provider as well as the provisions of the Veterans Access, Choice and Accountability Act of 2014.Since the creation of the Veterans Administration in 1930, providers of artificial limbs and braces have worked closely with the VA to ensure that veterans have complete access to high quality, clinically appropriate, prosthetic and orthotic care.  Whether services were provided directly by the VA within their own facilities or by private companies through a contractual arrangement, the needs of the individual veteran has always been paramount in how care is delivered.  The proposed rule completely disregards: (1) respect for the Veterans right, like other Americans, to participate in the choice of who they entrust with delivering key components of their health care; and (2) the long history of cooperation between the VA and its contracted prosthetic and orthotic providers, as well as the clinical needs of the individual veteran, by proposing regulations that authorizes the VA to exercise sole discretion as to how prosthetic and orthotic care is delivered to veterans.  The proposed rule goes so far as to state that the decision regarding how care is delivered is an administrative decision.  I could not disagree more.  The delivery of appropriate prosthetic and orthotic care is not an administrative issue, it is a clinical issue; one that should be made based on the clinical needs of the individual veteran, not the administrative needs of a government agency.I am truly perplexed by the proposal to completely remove the veterans right to choose to receive service from a VA contracted provider as it is in direct conflict with testimony from top VA officials who have repeatedly reinforced the right and opportunity of Veterans to work with providers of their choice who can best meet their clinical needs.  On October 24, 2017, in testimony before the House Veterans Affairs Committee, Secretary Shulkin stated the following: Veterans should get more choice in the say of their care.  Nobody should feel trapped in the VA system.This is just one example of repeated testimony by VA officials that support the right of the veteran to receive care from their chosen provider.I urge you to revise the language contained in section 17.3240 of the proposed rule to bring it in line with the VAs longstanding position, with the intent of the Choice Act,  and with the public statements before Congress by the Secretary and others assuring Veteran choice of where and from who they receive their orthotic/prosthetic care.  The elimination of the veterans right to choose to receive prosthetic and orthotic services directly through the VA or through a relationship with a contracted provider is in nobodys best interest and it is certainly not an administrative decision.  It is a deeply personal decision that must involve input from all involved parties but especially from the veteran.  Publication of a final rule without affirming the rights of the veteran would be a true disservice to those who have dedicated their lives to serving their country. I am writing today in order to offer comments on the proposed rule entitled, Prosthetic and Rehabilitative Items and Services that was published in the Federal Register on October 16, 2017.  The stated purpose of the proposed rule is to, revise its medical regulations related to providing prosthetic and rehabilitative items, primarily to clarify eligibility for prosthetic and other rehabilitative items and services, and to define the types of items and services available to eligible veterans.While I understand the need of the Department of Veterans Affairs (VA) to establish formal regulations in order to ensure continued coverage for medically necessary prosthetic services, I am deeply concerned regarding the provisions of the proposed rule contained in section 17.3240 entitled, Furnishing authorized items and services.  This section, in part, states that solely the VA will determine whether VA or a VA-authorized vendor will furnish authorized items and services to veterans.  The proposed section goes on to state that the VA would clarify in regulation that, this administrative business decision is made solely by the VA to eliminate any possible confusion as to whether a veteran has a right to request items or services generally, or to request specific items or services from a provider other than the VA, and to clarify for the benefit of VA-authorized vendors that VA retains this discretion as part of our duty to administer this program in a legally sufficient, fiscally responsible manner.  The proposed regulations at  17.3240 appear to directly contradict the longstanding policy of the VA regarding a veterans right to receive prosthetic services through the VA directly or through a VA contracted provider as well as the provisions of the Veterans Access, Choice and Accountability Act of 2014.Since the creation of the Veterans Administration in 1930, providers of artificial limbs and braces have worked closely with the VA to ensure that veterans have complete access to high quality, clinically appropriate, prosthetic and orthotic care.  Whether services were provided directly by the VA within their own facilities or by private companies through a contractual arrangement, the needs of the individual veteran has always been paramount in how care is delivered.  The proposed rule completely disregards: (1) respect for the Veterans right, like other Americans, to participate in the choice of who they entrust with delivering key components of their health care; and (2) the long history of cooperation between the VA and its contracted prosthetic and orthotic providers, as well as the clinical needs of the individual veteran, by proposing regulations that authorizes the VA to exercise sole discretion as to how prosthetic and orthotic care is delivered to veterans.  The proposed rule goes so far as to state that the decision regarding how care is delivered is an administrative decision.  I could not disagree more.  The delivery of appropriate prosthetic and orthotic care is not an administrative issue, it is a clinical issue; one that should be made based on the clinical needs of the individual veteran, not the administrative needs of a government agency.I am truly perplexed by the proposal to completely remove the veterans right to choose to receive service from a VA contracted provider as it is in direct conflict with testimony from top VA officials who have repeatedly reinforced the right and opportunity of Veterans to work with providers of their choice who can best meet their clinical needs.  On October 24, 2017, in testimony before the House Veterans Affairs Committee, Secretary Shulkin stated the following: Veterans should get more choice in the say of their care.  Nobody should feel trapped in the VA system.This is just one example of repeated testimony by VA officials that support the right of the veteran to receive care from their chosen provider.I urge you to revise the language contained in section 17.3240 of the proposed rule to bring it in line with the VAs longstanding position, with the intent of the Choice Act,  and with the public statements before Congress by the Secretary and others assuring Veteran choice of where and from who they receive their orthotic/prosthetic care.  The elimination of the veterans right to choose to receive prosthetic and orthotic services directly through the VA or through a relationship with a contracted provider is in nobodys best interest and it is certainly not an administrative decision.  It is a deeply personal decision that must involve input from all involved parties but especially from the veteran.  Publication of a final rule without affirming the rights of the veteran would be a true disservice to those who have dedicated their lives to serving their country. My name is Melissa Stockwell and I am a combat wounded above the knee amputee. I lost my leg in 2004 and in the past 13 years I have thrived as an amputee, competing on the elite level in athletics, become a mom of 2 and truly have done more in my life with one leg than I ever would have done with two. I strongly believe that this is because I have been able to get prosthetic care from the vendor of my choosing and choosing to use a 3rd party instead of the services at the VA. I have been able to get my prosthetic care from someone who specializes in high activity amputees to include those in need of specialized biking and running legs, as I do. This is the case for many of my friends who are also Veterans and receive prosthetic care outside if the VA. While I am grateful for the services that the VA provide and choose to use them for everything except for prosthetics, I urge you to please vote no for this bill. By giving myself and others the choice of where to get prosthetics care, you will help us be able to maintain the quality of life we want to life and continue to thrive in our community. Thank you.Melissa StockwellCombat Wounded, 20042x ParalympianMother 