Why It Matters

The Department of Veterans Affairs obligated over $608 million in fiscal year 2024 for high-tech medical equipment and related services, including maintenance, yet a recent GAO report found that the VA is not always using its most efficient purchasing tools. Some regional contracting officials are duplicating work, paying more than necessary, and struggling to navigate procurement guidance that provides inconsistent information about which contracts are mandatory.

The agency maintains magnetic resonance imaging equipment and radiation therapy equipment across its medical centers.

The Big Picture

The VA has access to agencywide contracts that can streamline purchasing and help the agency obtain competitive prices for maintenance services. Agencywide contracts reduce administrative burdens and help the VA leverage its buying power to obtain equipment and services at the best available prices. Yet not all regional contracting officials use them.

A nongeneralizable sample of eight medical centers and 16 maintenance orders and contracts that GAO examined from fiscal years 2022 through 2024 revealed inconsistent purchasing practices. In some instances, regional contracting officials did not clearly document the services purchased or verify that the prices paid matched the prices offered through agencywide contracts. In one case, regional contracting officials paid a higher price than the agencywide contract offered for the same service. Regional contracting officials said they plan to seek a refund for that overpayment.

VA procurement guidance contained inconsistent information about whether agencywide contracts for high-tech medical equipment are mandatory when purchasing maintenance services. Regional contracting officials also found national contracting office resources for purchasing high-tech medical equipment maintenance services to be unclear.

Some regional contracting officials unknowingly duplicated other officials' work by awarding their own contracts for high-tech medical equipment maintenance services.

Broader Context

GAO conducted site visits and interviewed relevant regional and national contracting officials. Selected medical centers generally reported satisfaction with maintenance services, and equipment was maintained according to policy. Selected medical centers also generally obtained prices similar to those available through the agencywide contracts for selected equipment.

Regional contracting officials attributed instances of inefficient purchasing of maintenance services in part to difficulty using resources for VA's agencywide high-tech medical equipment contracts.

The Bottom Line

GAO made three recommendations to the Department of Veterans Affairs regarding high-tech medical equipment acquisition and maintenance services.

The first calls on the Secretary of Veterans Affairs to ensure the Associate Executive Director of the National Acquisition Center evaluates how best to purchase maintenance services for radiation therapy equipment, including considering whether to modify the high-tech medical equipment base contracts to include these services. The second calls for Veterans Health Administration contracting officials to determine whether the base contracts are mandatory for purchasing maintenance services and reflect that decision across agency procurement guidance. The third directs the Secretary of Veterans Affairs to ensure the Associate Executive Director of the National Acquisition Center provides guidance and training to Veterans Health Administration contracting officials to facilitate effective use of the high-tech medical equipment base contracts, including updating its resources and identifying relevant information that regional officials should use when comparing prices and explaining how to use the center's high-tech medical equipment resources.

All three GAO recommendations have a status of "Open," meaning GAO has not yet confirmed that the agency has taken actions sufficient to address the recommendations. The Department of Veterans Affairs agreed with GAO's recommendations and has plans to review and update its guidance and resources.

Spot something wrong? Report an issue with this article