Veterans Health Administration (VHA) Purchased Long Term Services and Support (PLTSS) Department of Veterans Affairs (VA)

The PLTSS Program is organizationally aligned under the VHA Geriatrics and Extended Care (GEC) Office that strives to empower Veterans and the Nation to rise above the challenges of aging, disability or serious illness. The mission of GEC is to honor Veterans’ preferences of health, independence, and well-being by advancing expertise, programs, and partnerships. GEC programs are for Veterans of all ages, including older, frail, chronically ill patients, their families and their caregivers. Further, because the course of chronic illness varies and health care needs of chronically ill patients change, it is possible that services of one, some, or all GEC long term services and support will be required over time.

Agency Accountable Official: Mr. John Rychalski , Assistant Secretary for Management and Chief Financial Officer

Program Accountable Official: Richard M. Allman, MD, Acting Executive Director for Geriatrics and Extended Care

Total Payments
$2.1B
Improper Payments
$2.1B
Improper Payment Rate
100%

Supplemental Measures

Current Measure: 100 percent

Target: 95 percent (PLTSS may make the target more aggressive as more is learned about the impact it may have to accessibility.)

Description: By September 30, 2018, decrease percent of improper proper payments utilizing FAR compliant contracts for PLTSS’s CNH and Inpatient Hospice Care with authorized ordering officers. Due to the widespread systemic issue (revision of over 1,200 contracts required) without impact to Veteran’s access to care, the target for the first year of this measure is set at a 5 percent improvement (reduction to 95 percent improper). While VA determined through statistically compliant testing that valid contracts were in place and the correct price was paid, the payments are still technically improper because the individuals authorizing the care were not formally delegated ordering officer authority, in accordance with FAR requirements.

Update Frequency: Quarterly

Data Current as of: March 2018


Program Comments

To determine payment accuracy, VHA samples its PLTSS program to make certain medical care payments to providers in the community are correct. VHA uses a statistically valid sample to determine the program payment accuracy rates. In FY 2015, VA classified payments that did not follow Federal Acquisition Regulations and where VA exceeded its regulatory authority as improper. This is a departure from how VA had traditionally reported improper payments related to community care programs. Historically, VA only reported instances of community care as improper payments where the wrong party was paid, the wrong amount was paid, a duplicate payment was made, or services were not received. However, to ensure every effort to report in compliance with the statute and promote transparency, the Department included transactions that did not follow acquisition regulations as improper. As a result, this decision significantly increased both percentage and amount of improper payments made in the PLTSS program. Additional information on the program and detail on the progress of corrective actions can be found in VA’s Agency Financial Report.