HomeVA ProstheticsVA Handbook 1173.2 - Furnishing Prosthetic Appliances and ServicesMajor Medical and Special Equipment Committee (MMSEC)

2.11. Major Medical and Special Equipment Committee (MMSEC)

a. Scope

(1) All facilities providing prosthetic equipment and/or appliances should establish a MMSEC. The MMSEC should be comprised of knowledgeable medical, therapy, engineering, and administrative specialists with PSA responsibility for prosthetic services; referrals will be made when the expertise does not exist at the local VA medical center.

(2) The MMSEC may review requests for major items; e.g., environmental control systems, motorized wheelchairs, hospital beds, patient lifts, respiratory equipment, etc., as well as special items of automobile adaptive equipment; i.e., van modifications, sensitized brakes and steering systems. Special equipment may also include experimental appliances and/or devices as well as unusual requests for modalities of care.

(3) The MMSEC will be outlined in a medical center Policy Memorandum, meet on a regularly scheduled basis, and maintain minutes.

b. Responsibility

(1) The MMSEC Chairperson, a physician who is knowledgeable about prosthetic equipment and rehabilitation, will be charged with the direct professional responsibility for all patients referred to the Committee.

(2) The Prosthetic representative will serve as the coordinator and be responsible for the overall administrative management of the Committee. The remaining composition of the MMSEC will be flexible and should include a specialty physician involved in the patient's treatment, a rehabilitation medicine therapist, a nurse, a driver rehabilitation specialist, a social worker, and a biomedical engineer (when indicated).

(3) The MMSEC will review prescriptions written by fee-basis or private physicians to ensure that the requested items are necessary for the treatment or rehabilitation of the veteran.

(4) The MMSEC will arrange for home visits necessary to assess the available space in the veteran's home, power capability, ingress or egress to the home and/or bathroom facilities, and the need for the requested equipment.

(5) The MMSEC will finalize prescriptions for the needed equipment and arrange for training of the veteran and/or care provider in the use and operation of the equipment.

c. Procedure

(1) Upon receipt of a request that requires MMSEC consideration, the beneficiary will be afforded ample opportunity to attend the meeting for presenting information that may not be a part of the medical record. The veteran's personal comments and desires will be solicited before a final decision is made; this participation will be encouraged.

(2) Scheduling of veterans to the Committee will be accomplished through the VISTA appointment menu. Relevant medical records will be obtained for the meeting.

(3) The Committee coordinator will briefly outline the cases to be considered prior to seeing the veteran; the driver training specialist and/or therapist (as applicable) will give a brief verbal summary of each case.

(4) The medical findings and recommendations will be included in the veteran's medical records. Appropriate prescriptions will be written to cover all approved items. The MMSEC chairperson will arrange for:

(a) Any medical consultation, if indicated.

(b) Professional training, if indicated.

(5) The MMSEC Committee coordinator will prepare correspondence to the beneficiary and/or representatives on its decisions; decisions will be communicated to the veteran including the reasons for denial and the veteran will be advised in writing regarding appellate and reconsideration rights.

(6) The MMSEC Committee coordinator will arrange for the provision of the approved items and/or services, and prepare a VA Form 10-2641, for submission to the VISN and VHA Headquarters, if required.


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