Veterans Prosthetics Advancement and Reform Act
This bill, titled the Veterans Prosthetics Advancement and Reform Act, would create a formal Prosthetic and Rehabilitative Items and Services Formulary for the Department of Veterans Affairs (VA). The Formulary is a vetted list of prosthetic and rehabilitative items and services that VA clinics can furnish under existing authorities. Key features include public and veteran input, nationwide accessibility of formulary items at all VA facilities, publication and regular updates of the Formulary online, and processes for clinicians to request non-formulary items when medically necessary. The act also requires training for VA staff, contracts to support item availability, monitoring of non-formulary use, and consideration of PBM-style formulary management to help run the Formulary efficiently. The reform aims to standardize what VA provides, improve transparency in what is covered, and ensure consistent access across facilities. It emphasizes ongoing evaluation of which items should be on the Formulary, with a mechanism to add non-formulary items if consistently needed or to adjust the Formulary based on evidence and usage. A short title is included, and a clerical amendment adds a new section to the VA code. Overall, the bill seeks to modernize and streamline how prosthetic and rehabilitative care is selected, approved, and delivered within VA.
Key Points
- 1Establishment of a Prosthetic and Rehabilitative Items and Services Formulary (Formulary) as a formal list used for furnishing prosthetic and rehabilitative items and services.
- 2Requirement to solicit input from veterans and the public in developing the Formulary; ensure items are available at all VA facilities; and base inclusions on best available evidence.
- 3Public publication and ongoing updates of the Formulary on the VA website, plus clear communication to veterans about contents and how to appeal Formulary decisions.
- 4Authority for VA to contract as needed to support item availability and to provide training on the Formulary for clinicians and staff.
- 5Exceptions process allowing clinicians to request non-formulary items when medically necessary; monitoring of these non-formulary requests to ensure consistency and to determine whether items should be added to the Formulary.
- 6Consideration of PBM-style formulary management and medication safety approaches to support the Formulary’s administration.
- 7Administrative change adding the new 1709D section to the VA code (clerkly, for organizational purposes).