Ineffective Use and Oversight of Medical Surgical Prime Vendor Program Led to Increased Spending

The Veterans Health Administration (VHA) requires its medical facilities to use the Medical/Surgical Prime Vendor (MSPV) program’s distribution contracts for cost effective ordering and distribution of healthcare supplies. The VA Office of Inspector General (OIG) conducted this audit to assess the extent to which VHA medical facilities use the MSPV program. The OIG found that medical facilities did not always purchase through the program because items were often unavailable on the MSPV product list. Sometimes staff did not use the program before ordering from the open market, often from their own prime vendor, because the ordering system defaults to the previous supplier rather than the MSPV product list. Staff do not always report issues with the prime vendor or unavailable or back-ordered products, which some attribute to an ineffective reporting tool and quicker results through local workarounds. The OIG also found the program office and medical center leaders have not provided effective oversight, which may affect training and local leaders’ motivation to enforce the program’s use. In 2022, facilities spent about $865 million on supplies available through the MSPV program, but $353 million went for open market purchases instead of through MSPV. Had facilities purchased these through MSPV, VHA could have saved approximately $35.5 million. Finally, the MSPV product list did not include the majority of medical and surgical supplies facilities purchase; the OIG determined that medical facilities spent about $1.5 billion on items not available through MSPV. The OIG made nine recommendations to the under secretary for health, including to identify a VA owned system where staff can check product availability and price, review open market purchases, improve training on MSPV usage and tools, ensure staff report unavailable items, and increase items available through the program.