((a)) ** .—** Pay of physicians, podiatrists, optometrists, and dentists in the Veterans Health Administration shall consist of three elements as follows:
((1)) Base pay as provided for under subsection (b).
((2)) Market pay as provided for under subsection (c).
((3)) Performance pay as provided under subsection (d).
((b)) ** .—** One element of pay for physicians, podiatrists, optometrists, and dentists shall be base pay. Base pay shall meet the following requirements:
((1)) Each physician, podiatrist, optometrist and dentist is entitled to base pay determined under the Physician, Podiatrist, and Dentist Base and Longevity Pay Schedule.
((2)) The Physician, Podiatrist, and Dentist Base and Longevity Pay Schedule is composed of 15 rates of base pay designated, from the lowest rate of pay to the highest rate of pay, as base pay steps 1 through 15.
((3)) The rate of base pay payable to a physician, podiatrist, optometrist or dentist is based on the total number of the years of the service of the physician, podiatrist, optometrist or dentist in the Veterans Health Administration as follows:
((4)) At the same time as rates of basic pay are increased for a year under , the Secretary shall increase the amount of base pay payable under this subsection for that year by a percentage equal to the percentage by which rates of basic pay are increased under such section for that year.
((5)) The non-foreign cost of living adjustment allowance authorized under for physicians, podiatrists, optometrists, and dentists whose pay is set under this section shall be determined as a percentage of base pay only.
((c)) ** .—** One element of pay for physicians, podiatrists, optometrists, and dentists shall be market pay. Market pay shall meet the following requirements:
((1)) Each physician, podiatrist, optometrist and dentist is eligible for market pay.
((2)) Market pay shall consist of pay intended to reflect the recruitment and retention needs for the specialty or assignment (as defined by the Secretary) of a particular physician, podiatrist, optometrist or dentist in a facility of the Department of Veterans Affairs.
((3)) The annual amount of the market pay payable to a physician, podiatrist, optometrist or dentist shall be determined by the Secretary on a case-by-case basis.
((4)) The determination of the amount of market pay of a physician, podiatrist, optometrist or dentist shall take into account—
((A)) the level of experience of the physician, podiatrist, optometrist or dentist in the specialty or assignment of the physician, podiatrist, optometrist or dentist;
((B)) the need for the specialty or assignment of the physician, podiatrist, optometrist or dentist at the medical facility of the Department concerned;
((C)) the health care labor market for the specialty or assignment of the physician, podiatrist, optometrist or dentist, which may cover any geographic area the Secretary considers appropriate for the specialty or assignment;
((D)) the board certifications, if any, of the physician, podiatrist, optometrist or dentist;
((E)) the prior experience, if any, of the physician, podiatrist, optometrist or dentist as an employee of the Veterans Health Administration; and
((F)) such other considerations as the Secretary considers appropriate.
((5)) The amount of market pay of a physician, podiatrist, optometrist or dentist shall be evaluated by the Secretary not less often than once every 24 months. The amount of market pay may be adjusted as the result of an evaluation under this paragraph. A physician, podiatrist, optometrist or dentist whose market pay is evaluated under this paragraph shall receive written notice of the results of such evaluation in accordance with procedures prescribed under . Such a notice shall include a statement of whether the market pay will increase, decrease, or remain unchanged following such evaluation.
((6)) No adjustment of the amount of market pay of a physician, podiatrist, optometrist or dentist under paragraph (5) may result in a reduction of the amount of market pay of the physician, podiatrist, optometrist or dentist while in the same position or assignment at the medical facility of the Department concerned, unless there is a change in board certification or reduction of privileges.
((7)) The Secretary shall ensure that each physician, podiatrist, optometrist, and dentist in the Veterans Health Administration is—
((A)) advised, on an annual basis, of the criteria described in subparagraph (F) of paragraph (4);
((B)) evaluated in accordance with such criteria; and
((C)) compensated in accordance with—
((i)) applicable assignment and pay levels, subject to relevant pay limitations; and
((ii)) the extent to which such criteria are met.
((8)) Not later than 120 days after the end of each fiscal year, the Secretary shall submit to the Committees on Veterans’ Affairs of the Senate and the House of Representatives a report that includes the following:
((A)) A list of each facility and specialty that conducted an evaluation of pay during the period covered by the report.
((B)) For each evaluation described in subparagraph (A)—
((i)) a list of occupations for which pay was evaluated, disaggregated by medical specialty, number of authorized full-time employees, and onsite full-time employees as of the date of the evaluation;
((ii)) the date such evaluation was completed;
((iii)) whether a market pay adjustment was made following the evaluation per each occupation and specialty evaluated;
((iv)) whether applicable employees were notified of such evaluation;
((v)) whether local labor partners were notified of such evaluation; and
((vi)) in the case of an evaluation that resulted in an adjustment of pay—
((I)) the date such adjustment—
((aa)) was implemented; and
((bb)) became effective; and
((II)) the percentage of employees of each occupation and specialty for which pay was adjusted pursuant to such evaluation.
((C)) A list of facilities of the Department that have not conducted an evaluation of market pay, pursuant to paragraph (5), during the 18-month-period that precedes the date of the submission of such report.
((d)) ** .—**
((1)) One element of pay for physicians, podiatrists, optometrists, and dentists shall be performance pay.
((2)) Performance pay shall be paid to a physician, podiatrist, optometrist or dentist on the basis of the physician’s or dentist’s achievement of specific goals and performance objectives prescribed by the Secretary.
((3)) The Secretary shall ensure that each physician, podiatrist, optometrist and dentist of the Department is advised of the specific goals or objectives that are to be measured by the Secretary in determining the eligibility of that physician, podiatrist, optometrist or dentist for performance pay.
((4)) The amount of the performance pay payable to a physician, podiatrist, optometrist or dentist may vary annually on the basis of individual achievement or attainment of the goals or objectives applicable to the physician, podiatrist, optometrist or dentist under paragraph (2).
((5)) The amount of performance pay payable to a physician, podiatrist, optometrist or dentist in a fiscal year shall be determined in accordance with regulations prescribed by the Secretary, but may not exceed the lower of—
((A)) $15,000; or
((B)) the amount equal to 7.5 percent of the sum of the base pay and the market pay payable to such physician, podiatrist, optometrist or dentist in that fiscal year.
((6)) A failure to meet goals or objectives applicable to a physician, podiatrist, optometrist or dentist under paragraph (2) may not be the sole basis for an adverse personnel action against that physician, podiatrist, optometrist or dentist.
((e)) ** .—**
((1))
((A)) Not less often than once every two years, the Secretary shall prescribe for Department-wide applicability the minimum and maximum amounts of annual pay that may be paid under this section to physicians and the minimum and maximum amounts of annual pay that may be paid under this section to podiatrists and dentists.
((B)) The Secretary may prescribe for Department-wide applicability under this paragraph separate minimum and maximum amounts of pay for a specialty or assignment. If the Secretary prescribes separate minimum and maximum amounts for a specialty or assignment, the Secretary may establish up to four tiers of minimum and maximum amounts for such specialty or assignment and prescribe for each tier a minimum amount and a maximum amount that the Secretary determines appropriate for the professional responsibilities, professional achievements, and administrative duties of the physicians, podiatrists, optometrists, or dentists (as the case may be) whose pay is set within that tier.
((C)) Amounts prescribed under this paragraph shall be published in the Federal Register, and shall not take effect until at least 60 days after the date of publication.
((2)) Except as provided in paragraph (3) and subject to paragraph (4), the sum of the total amount of the annual rate of base pay payable to a physician, podiatrist, optometrist or dentist under subsection (b) and the market pay determined for the physician, podiatrist, optometrist or dentist under subsection (c) may not be less than the minimum amount, nor more than the maximum amount, applicable to specialty or assignment of the physician, podiatrist, optometrist or dentist under paragraph (1).
((3)) The sum of the total amount of the annual rate of base pay payable to a physician, podiatrist, optometrist or dentist under subsection (b) and the market pay determined for the physician, podiatrist, optometrist or dentist under subsection (c) may exceed the maximum amount applicable to the specialty or assignment of the physician, podiatrist, optometrist or dentist under paragraph (1) as a result of an adjustment under paragraph (3) or (4) of subsection (b).
((4)) Except as provided in sections 7404A(c) and 7410(a)(2) of this title, in no case may the total amount of compensation paid to a physician, podiatrist, optometrist or dentist under this title in any year exceed the amount of annual compensation (excluding expenses) specified in .
((5)) Notwithstanding any compensation or pay limitations under this title or title 5, the Secretary may authorize the Under Secretary for Health to pay physicians, podiatrists, optometrists, and dentists—
((A)) awards authorized under this title;
((B)) advance payments, recruitment or relocation bonuses, and retention allowances authorized under or as otherwise provided by law;
((C)) incentives or bonuses under or as otherwise provided by law; and
((D)) earnings from fee-basis appointments under .
((6))
((A)) The Secretary may waive any pay limitation described in this section (including tier limitations) that the Secretary determines necessary for the recruitment or retention of critical health care personnel whom the Secretary determines would provide direct patient care.
((B)) Priority for such waivers shall be given for positions, locations, and care provided through agreements that are costly to the Department.
((C)) The Chief Human Capital Officer of the Department, the Chief Financial Officer of the Department, and the Office of the General Counsel of the Department shall review any waiver issued under subparagraph (A).
((D)) During the period the authority under subparagraph (A) is effective, the Secretary may not issue more than 300 waivers under such subparagraph.
((E)) The Secretary may prescribe requirements, limitations, and other considerations for waivers under such subparagraph.
((F)) Not later than 180 days after the date of the enactment of the Senator Elizabeth Dole 21st Century Veterans Healthcare and Benefits Improvement Act, and annually thereafter, the Secretary shall submit to the Committees on Veterans’ Affairs of the Senate and the House of Representatives a report that includes—
((i)) any updates to the requirements, limitations, and considerations prescribed under subparagraph (B) during the period covered by the report;
((ii)) a description of the findings of each review, if any, conducted pursuant to subparagraph (C);
((iii)) a description of each waiver under subparagraph (A) in effect as of the date of the submission of the report, including the—
((I)) duty location, position, specialty, market and performance considerations for the waiver; and
((II)) impact, if any, of the waiver on care furnished by the Department pursuant to an agreement regarding the geographic area; and
((iv)) a list of any separation actions during the period covered by the report with respect to a position for which a waiver under subparagraph (A) is in effect.
((G)) The authority of the Secretary under subparagraph (A) shall terminate on the last day of the third full fiscal year following the date of the enactment of the Senator Elizabeth Dole 21st Century Veterans Healthcare and Benefits Improvement Act.
((f)) ** .—** Pay under subsections (b) and (c) of this section shall be considered pay for all purposes, including retirement benefits under chapters 83 and 84 of title 5 and other benefits.
((g)) ** .—**
((1)) A decrease in pay of a physician, podiatrist, optometrist or dentist resulting from an adjustment in the amount of market pay of the physician, podiatrist, optometrist or dentist under subsection (c) shall not be treated as an adverse action.
((2)) If the pay of a physician, podiatrist, optometrist or dentist is reduced under this subchapter as a result of an involuntary reassignment in connection with a disciplinary action taken against the physician, podiatrist, optometrist or dentist, the involuntary reassignment shall be subject to appeal under subchapter V of this chapter.
((h)) ** .—** The Secretary may delegate to an appropriate officer or employee of the Department any responsibility of the Secretary under subsection (c), (d), or (e) except for the responsibilities of the Secretary under subsection (e)(1).
