2401 Overview

This chapter establishes the Department of Veterans Affairs’ (VA) financial policies for payments to individuals, other governmental organizations, and tribal organizations for Graduate Medical Education (GME) and residency under Section 403 of the MISSION Act.

Key points covered in this chapter:

• In accordance with 38 U.S.C. § 7302, VA may place medical and dental residents in underserved areas in VA, Indian Health Service (IHS), Indian tribe, tribal organization, Department of Defense (DoD), or other organization healthcare facilities as part of a training rotation;
• In accordance with VA authority under 38 U.S.C. § 8153, this program is not subject to the Federal Acquisition Regulation (FAR)-based competitive bid process; and
• Use of a miscellaneous vendor code is not permitted for this program; recipients must be individually vendorized.

2402 Revisions

Section	Revision	Office	Reason for Change	Effective Date
Various	New policy	OFP	Reorganized chapter layout	April 2026

2403 Definitions

Obligation – A legally binding agreement that will result in outlays, immediately or in the future. An obligation is a legal liability of the Government against an available appropriation.

Non-Contractual Obligation – Obligations with special statutory authority or other regulatory authority to exempt the obligation from Federal Acquisition Regulations (FAR). There are instances where these obligations may be generally defined as a contract (agreement between two parties), but these obligations do not follow FAR-based procedures.

2404 Roles and Responsibilities

Office of Academic Affiliations (OAA) in the Veterans Health Administration (VHA) is responsible for overseeing VA health profession training programs.

Local Finance Offices are responsible for ensuring the proper processing of GME obligations.

2405 Policies

240501 General Policies

1. In accordance with 38 U.S.C. § 7302, VA may assign medical and dental residents to facilities in underserved areas as part of a training rotation. The facilities can be under the jurisdiction of VA, Indian Health Service, an Indian tribal organization, Department of Defense, or such other public or nonprofit agencies, institutions, or organizations as the Secretary considers appropriate.
2. In accordance with 38 U.S.C. § 7302, may reimburse:
   • Direct salary and benefit costs for GME residents rotating to approved non-VA covered facilities, and
   • Start-up costs including staffing and supplying new education programs at sites identified in the pilot program legislation.
3. Rate schedules for payments of GME residents’ salary and benefit costs at non-VA sites are approved by the Office of Academic Affiliations (OAA) in Veterans Health Administration (VHA).
4. GME transactions processed by VA’s Financial Services Center will be recorded in VA’s accounting system.
5. VA’s Local Finance Offices will reimburse other Federal agencies including DoD and the Department of Health and Human Services’ IHS for approved GME expenses.
6. The amount to be recorded for Graduate Medical Education (GME) obligations is the amount on the signed Fiscal Service (FS) Form 7600B, Inter-Agency Agreement (IAA) (G-Invoicing), or the approved reimbursement amount on the agreement for non-Federal agencies. For additional information on transactions using FS Form 7600B, see Volume IX, Chapter 7 – Buy/Sell Transactions (G-Invoicing).
   1. GME agreement obligations to Federal agencies are recorded when both the requesting agency (buyer) and servicing agency (seller) sign the Treasury FS Form 7600B, IAA (G-Invoicing).
   2. GME agreement obligations to non-Federal agencies, including Indian tribes are recorded on the date the VA official approves the reimbursement request (administrative approval of payment transaction).
7. In accordance with 31 U.S.C. § 1501, documentation required for GME obligations are the FS Forms 7600B, IAA (G-Invoicing), or the documentation from the approved reimbursement requests for non-Federal recipients.
8. Recipients of payments or reimbursements of GME obligations must be individually vendorized; use of “Miscellaneous Vendor” is not permitted.
9. GME obligations must follow the requirements for all Government obligations, established for VA in Volume III, Chapter 2 – Obligations.

240502 Integrated Financial and Acquisition Management System (iFAMS)

1. GME reimbursement obligations will vary based on recipient:
   • Federal trading partners that have not implemented G-invoicing will use External Obligation (OEE);
   • Federal trading partners utilizing G-invoicing will use GINV External Obligation (OEG); and
   • Non-Federal payments utilize Administrative Approval of Payment, therefore no obligation document will be used.
2. Payment document codes for GME reimbursements will vary based on whether the recipient is a Federal or non-Federal entity:
   • Reimbursements to Federal agencies will use Payment – GINV Inbound (PIG) for Federal partners that utilize G-invoicing; Payment – Intra-Governmental Payment and Collection (IPAC) Inbound (PIE) for Federal partners that do not utilize G-invoicing; and
   • Reimbursements to non-Federal agencies will utilize the Invoice Payment Processing System (IPPS) Obligate & Pay Payment Type (PBI) referencing a Funding Reservation Request (FRR) for recipients that utilize IPPS for payment; and Payment Authorization – Obligate and Pay (PBE) for recipients not utilizing IPPS.

240503 Financial Management System (FMS)

1. Obligations for GME expenses use VA Form 1358 approved use #7.
2. Payment processes will vary based on whether the recipient is a Federal or non-Federal entity:
   • Payments to Federal agencies will use G-invoicing for Federal partners that utilize G-invoicing or Intra-Governmental Payment and Collection (IPAC) for Federal partners that do not utilize G-invoicing; and
   • Payments to non-Federal agencies will be through standard invoicing procedures for recipients that utilize IPPS for payment or standard procedures for payment by electronic funds transfer for recipients not utilizing IPPS.

2406 Authorities and References

• United States Code (U.S.C.)
  • 31 U.S.C. § 1501, Documentary evidence requirement for Government obligations
  • 38 U.S.C. § 7302, Functions of Veterans Health Administration: health-care personnel education and training programs (See statutory notes: Pilot Program on Graduate Medical Education and Residency)
  • 38 U.S.C. § 8153, Sharing of health-care resources
• P.L. 115-182, MISSION Act (Maintaining Internal Systems and Strengthening Integrated Outside Networks Act of 2018)
• P.L. 116-159, Continuing Appropriations Act, 2021 and Other Extensions Act
• VA Financial Policy
  • Volume II, Chapter 2 – Obligations
  • Volume IX, Chapter 7 – Buy/Sell Transactions (G-Invoicing)

2407 Rescissions

None.

Appendix A: Previous Policy Revisions

None.