In accordance with paragraph 17.4120 of paragraph 17.4120 of paragraph 17.4120, va may deviate from the parameters of letter 17.4120, point (a) -c), where it is established that it is not feasible to limit payments due to patient needs, market analyses, health care provider qualifications or other factors, as provided for in the application of S. 17.4120 (a)-c). This general exception is consistent with the provision in Section 1703 (i) (1) that allows VA to pay rates that do not exceed the Medicare rate “to the extent that it is feasible.” Paragraph (d) will give the VA the flexibility to ensure that it will reach an agreement with businesses or suppliers on the provision of the necessary services when cost-sustaining factors may move faster than medicare rates. This flexibility will not guarantee payments above current Medicare rates, as the introductory language is in . 17.4120 stipulates that payment rates are finally set under the terms of the agreement under which care and services are provided. These agreements provide for verification procedures and procedures applicable to all payments that could benefit from the section 17.4120 waiver, point (d), to ensure a uniform level of VA control. (paragraph 208), the annual budget presented by the President to Congress requires that certain information be provided on: 1) the costs of making available and the number of veterans receiving medical care through contracts with non-public bodies; and (2) the number of VA employees who received paid administrative leave in the previous fiscal year. Paragraph b) (2) (v) of page 17.4110 establishes a standard of assessment that would allow VA to refuse an application for certification if VA finds that, for programming reasons, VA is unlikely to enter into a veterans maintenance contract with the applicant. We believe that this denial base is appropriate, given that Section 1703A is a generous purchasing authority that allows (but does not require) the conclusion and use of Veterans maintenance agreements. As a result, it is of little or no benefit to a supplier or company or company to continue the certification process for Section 1703A (c), including obtaining and tracking certified status, when VA, in the exercise of its programmatic judgment, finds that it is unlikely to conclude a VCA with the company or supplier. In these circumstances, VA may reject the application in order to avoid unnecessary spending on company or supplier and VA resources.