Hire more private companies to perform disability medical examinations

Research notes

• Who holds the contracts, and when they were awarded. The current vehicle is the MDEO 2025 IDIQ for medical disability examination services in Regions 1–4: four contracts, 36C10X25D0001 to D0004, held by Loyal Source Government Services LLC, OptumServe Health Services, QTC Medical Services and Veterans Evaluation Services, each signed 2024-12-20 with a period of performance from 2025-01-01 to 2026-12-31. So the one genuinely new name in the pool, Loyal Source, was brought in a month before the window opened, under the previous administration. Inside the window the same four vendors received the FY2026 funding orders, effective 2026-01-01 and signed from 2025-12-30 — sixteen orders totalling about $6.75 billion, roughly $1.77 billion each to QTC and Loyal Source, $1.69 billion to OptumServe and $1.52 billion to Veterans Evaluation Services. That is the money behind the FY2027 submission’s “increased contract medical exam estimates”, and it is why this item is partial: more capacity bought from the same four firms, no fifth firm hired. These figures come from api.usaspending.gov’s award search and award endpoints. They are leads rather than Evidence, and the read-queue row that asked for a citable human-readable page is answered in the negative: re-checked 2026-09-03 at every rung including the full Chrome header set, usaspending.gov/award/CONT_IDV_36C10X25D0001_3600 returns a JavaScript shell carrying fifteen characters of prose, the bare host 301s to www. and serves the same shell, and there is no server-rendered variant and no print view. The four base contracts are confirmed directly from https://api.usaspending.gov/api/v2/awards/CONT_IDV_36C10X25D000{1,2,3,4}_3600/ (200, JSON, all four read 2026-09-03): date_signed 2024-12-20 for each, period of performance 2025-01-01 to 2026-12-31, awarding office “SAC FREDERICK (36C10X)”, recipients Loyal Source (D0001), OptumServe (D0002), QTC (D0003) and Veterans Evaluation Services (D0004). Those endpoints are allowlisted and readable, so they satisfy §6’s “loaded” test — but the contracts they describe are dated 2024-12-20, before the window, so the evidence gate would refuse them as Evidence in any event. The in-window half is the FY2026 funding orders, and those come from spending_by_award, a POST endpoint with no GET URL: there is no URL to write. Hence no new Evidence from this read.
• A live false-negative trap on this API, recorded for the next agent. spending_by_award rejects mixed award-type groups — contracts (A–D) and IDVs (IDV_*) must be separate calls — and the awarding subtier on all of these awards is “Department of Veterans Affairs” (3600), not “Veterans Benefits Administration”. Filtering on the VBA subtier returns an empty results array and looks exactly like a clean negative.
• The FY2026 sweep, re-run 2026-09-03: every VA contract with an action date in the window whose description matches “disability examination”, sorted by amount descending, returns sixteen FY2026 funding orders, all with a 2026-01-01 start date, from $754,312,386 down to $260,174,837 and totalling $6.75 billion — and every one of them goes to the same four firms. Eighty-three award rows come back in all; the ten that are not the four incumbents are support suppliers between three and five orders of magnitude smaller, and only two of them have a start date inside the window: The Ross Agency, Inc. ($2,079,375, 2025-12-10, “Medical Disability Examination (MDE) Examiner Credentials and Licensing”) and the Public Health Foundation (~$265,000 a year, 2025-04-18 and 2026-04-18, a learning-management system). The rest — MITRE’s FFRDC services, RB Continuum’s customer-service surveys, Green-Gate Technology and Cathexis’s independent-verification-and-validation work — all start before 2025-01-20. No fifth examination company was hired.
• The predecessor pool also predates the window. VA’s release announcing the earlier medical disability examination contracts — twelve contracts across five firms, $6.8 billion ceiling — is dated 2016-09-19 (https://news.va.gov/press-room/va-awards-6-8-billion-for-medical-disability-examinations/, fetched 2026-09-01). The FY2027 submission says MDE “has completed more than 16 million contract examinations since 2016 and is on target to exceed 20 million by 2027”.
• Congress moved but did not act: H.R. 9237 §109 would expand the temporary-licensure rules for contract health care professionals who perform VA medical disability examinations, and §110 would require a study of examination access in rural areas. Proceedings on the bill were postponed on the House floor on 2026-07-16 with no passage vote, so under §3b it leaves the rung alone.
• The FY2027 submission also names a small “Contract Exam Pilot Program” line ($8.4 million VBA GOE in 2026, $9.1 million requested for 2027) — reimbursement machinery, not new vendors.