COL Richard Danielson, USA
A Memorandum Of Understanding has been signed between Walter Reed Army Medical Center and the Dept of Veterans Affairs Denver Distribution Center (DDC) on 1 MAY 98, based on the terms of the MEDCOM-VA sharing agreement of Dec 97. Under the terms of this agreement, audiologists and log techs at WRAMC can electronically order hearing aids and hearing aid batteries via the DDC, using the VA’s Remote Order/Entry System (ROES). WRAMC DOIM coordinated access to the DDC database using an authorized proxy access through the VA’s firewall, providing 16 computer IP addresses/users at AASC. AASC uses the VA ROES to order hearing aids and batteries currently on the VA’s contract for active duty patients. Hearing aids NOT listed on the VA contract will still be ordered for active duty patients directly from manufacturers, using IMPAC credit cards. Finally, hearing aids purchased by retirees under provisions of the Retiree At-Cost Hearing Aid Program will not be ordered from DDC via ROES, since the DDC does not accept credit card purchases. Although AMEDD audiology clinics can purchase hearing aids at reduced prices negotiated by the VA, these Army clinics (and retirees using the RACHAP) are being charged an Industrial Funding Fee (IFF) of 7.5% above the price of the instruments. This IFF is ultimately paid to the DDC for “services”. Considerable discussion has occurred re: appropriateness of charging this IFF to retirees who buy their hearing aids via the RACHAP, since these hearing aids are neither ordered nor tracked electronically via ROES. The DDC reports that manufacturers are required (by contract) to charge the IFF whenever they sell a hearing aid based on the VA’s DDC-negotiated price. Consequently, the IFF must be added to the base price. Our patients are charged an IFF for hearing aid models and circuits on VA contract, but the patient is not charged an IFF for circuits or models that are not on VA contract. Once per month, the VA’s Financial Services Center (FSC) in Austin will transmit an on-line payment and accounting program to DFAS in Indianapolis, triggering electronic payment by DFAS to FSC Austin.
In addition, a report is submitted by DDC to AASC for review and certification that the hearing aids have been received. Upon certification, AASC will recommend that DFAS make payment for goods received. The funds are extracted from an APC designated by AASC. In addition to ROES’ logistical advantages, audiologists at AASC will be able to use their connectivity to the VA database to place remote inquiries re: their retired patients’ eligibility for hearing aid services through the VA system. Clinicians can now access the DDC database to perform a remote inquiry, determining if (and when) a patient has had hearing aids issued by the VA previously. This process has major implications for assisting retired (and active duty patients) in our environment of limited resources. COL Danielson, Dir of AASC WRAMC, is coordinating this project for the Army. In June, Brooke Army Medical Center came on board with ROES and other MEDCENs will follow this summer. The Executive Committee should encourage DDC to ultimately accept credit card payments, which could facilitate use of ROES.