[Federal Register Volume 88, Number 217 (Monday, November 13, 2023)]
[Notices]
[Pages 77671-77673]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2023-24893]


=======================================================================
-----------------------------------------------------------------------

DEPARTMENT OF VETERANS AFFAIRS


Annual Pay Ranges for Physicians, Dentists and Podiatrists of the 
Veterans Health Administration

AGENCY: Department of Veterans Affairs.

ACTION: Notice.

-----------------------------------------------------------------------

SUMMARY: VA is hereby giving notice of annual pay ranges, which is the 
sum of the base pay rate and market pay for VHA physicians, dentists 
and podiatrists as prescribed by the Secretary for Department-wide 
applicability. These annual pay ranges are intended to enhance the 
flexibility of the Department to recruit, develop and retain the most 
highly qualified providers to serve the Nation's Veterans and maintain 
a standard of excellence in the VA health care system.

DATES: Annual pay ranges are applicable on January 14, 2024.

FOR FURTHER INFORMATION CONTACT: Leah Brady, Supervisory Human 
Resources (HR) Specialist, Human Resources Center of Expertise, VHA 
Workforce Management and Consulting (10A2A), Department of Veterans 
Affairs, 810 Vermont Avenue NW, Washington, DC 20420, 842-288-7894. 
This is not a toll-free number.

SUPPLEMENTARY INFORMATION: Under 38 U.S.C. 7431(e)(1)(A), not less 
often than once every 2 years, the Secretary must prescribe for 
Department-wide applicability the minimum and maximum amounts of annual 
pay that may be paid to VHA physicians, dentists and podiatrists. 38 
U.S.C. 7431(e)(1)(B) allows the Secretary to prescribe separate minimum 
and maximum amounts of annual pay for a specialty or assignment. 
Pursuant to 38 U.S.C. 7431(e)(1)(C), amounts prescribed under section 
7431(e) shall be published in the Federal Register and shall not take 
effect until at least 60 days after the date of publication.
    In addition, under 38 U.S.C. 7431(e)(4), the total amount of 
compensation paid to a physician, dentist or podiatrist under title 38 
of the United States Code cannot exceed, in any year, the amount of 
annual compensation (excluding expenses) of the President. For the 
purposes of section 7431(e)(4), ``the total amount of compensation'' 
includes base pay, market pay, performance pay, and fee basis earnings, 
but excludes recruitment, relocation, retention incentives,\1\ awards 
for performance and special contributions from total compensation 
calculations.
---------------------------------------------------------------------------

    \1\ In accordance with title IX, section 906 of the ``Sergeant 
First Class Heath Robinson Honoring our Promise to Address 
Comprehensive Toxics (PACT) Act of 2022'' (Pub. L. 117-168, dated 
August 10, 2022), recruitment, relocation and retention incentives, 
along with performance awards, shall not be considered in 
calculating the limitation under 38 U.S.C. 7431(e)(4).
---------------------------------------------------------------------------

Background

    The ``Department of Veterans Affairs Health Care Personnel 
Enhancement Act of 2004'' (Pub. L. 108-445) was signed by the President 
on December 3, 2004.

[[Page 77672]]

The law's major provisions established a new pay system for VHA 
physicians and dentists consisting of base pay, market pay and 
performance pay. These three components create a system of pay that is 
driven by both market indicators and employee performance, while 
recognizing employee tenure in VHA. While the base pay component is set 
by statute, market pay is intended to reflect the recruitment and 
retention needs for the specialty or assignment of a particular 
physician or dentist at a facility. Further, performance pay is 
intended to recognize the achievement of specific goals and performance 
objectives prescribed annually.
    On April 8, 2019, the President signed Public Law 116-12, which 
amended 38 U.S.C. 7431 to include podiatrists within the physician and 
dentist pay system, authorizing podiatrists to receive base pay, market 
pay and performance pay. With the amendment, podiatrists are also 
subject to the same limitations and requirements as physicians and 
dentists under section 7431.
    VA will consolidate pay table 1 and 2, resulting in the elimination 
of a pay table. Changes to the minimum and maximum amounts for the 
revised pay tables 1 and 2 have been made. The maximum amount for the 
former pay table 3 (now pay table 2) remains unchanged since the 2016 
publication in the Federal Register. Pay tables 1 and 2 will cover the 
clinical specialties, with pay tables 3 and 4 covering the executive 
assignments.

Discussion

    VA identified and utilized salary survey data sources which most 
closely represent VA comparability in the areas of practice setting, 
employment environment and hospital/health care systems. The 
Association of American Medical Colleges, Sullivan Cotter and 
Associates, Medical Group Management Association, Korn Ferry Healthcare 
National and Executive Report, Mercer Integrated Health Networks and 
the Survey of Dental Practice published by the American Dental 
Association were collectively utilized as benchmarks to prescribe 
annual pay ranges across the scope of assignments/specialties within 
the Department. While aggregating the data, a preponderance of weight 
was given to those surveys which most directly resembled the 
environment of the Department.
    VA continued the practice of grouping specialties into consolidated 
pay ranges to accommodate the more than 40 specialties that currently 
exist in the VA system. This allows VA to use multiple salary survey 
data sources to minimize disparities and aberrations that may surface 
from data involving smaller samples that change from year to year. 
Aggregating multiple survey sources into like groupings results in 
greater confidence that the average compensation reported is truly 
representative. The aggregation of data provides for a large enough 
sample size to provide maximum flexibility for pay setting for VHA 
physicians, dentists and podiatrists.
    In developing the annual pay ranges, distinctive principles were 
factored into the compensation analysis of the data. The first 
principle is to ensure that the minimum and maximum salaries are at a 
level that accommodates special employment situations from fellowships 
and medical research career development awards to Nobel Laureates; 
high-cost areas; and internationally renowned clinicians. The second 
principle provides ranges large enough to accommodate career 
progression, geographic differences, sub-specialization and other 
special factors.
    Clinical specialties were reviewed against available, relevant 
private sector data. The specialties are grouped into two (formerly 
three) clinical pay ranges that reflect comparable complexity in 
salary, recruitment and retention considerations. The Steering 
Committee recommendations included consolidating the former pay tables 
1 and 2, designating two clinical pay ranges (pay tables 1 and 2) for 
the varying clinical specialties and designating pay tables 3 and 4 for 
executive assignments. The Steering Committee also made recommendations 
to add new and realign existing specialties to different clinical pay 
ranges, as well as changes to the minimum and maximum pay ranges.

------------------------------------------------------------------------
                    Tier level                       Minimum    Maximum
------------------------------------------------------------------------
                     Pay Table 1--Clinical Specialty
------------------------------------------------------------------------
Tier 1............................................   $115,587   $300,000
Tier 2............................................    145,000    320,000
Tier 3............................................    165,000    336,000
------------------------------------------------------------------------
                Pay Table 1--Covered Clinical Specialties
------------------------------------------------------------------------
Allergy and Immunology, Endocrinology, Endodontics, Family Medicine,
 General Practice--Dentistry, Geriatrics, Health Informatics,
 Hospitalist, Infectious Diseases, Internal Medicine, Neurology,
 Nocturnist, Palliative Care, Periodontics, Physical Medicine &
 Rehabilitation/Spinal Cord Injury, Podiatry (General), Preventive
 Medicine, Primary Care, Prosthodontics, Psychiatry, Rheumatology, Sleep
 Medicine, All other specialties or assignments.........................
------------------------------------------------------------------------


------------------------------------------------------------------------
 
------------------------------------------------------------------------
                     Pay Table 2--Clinical Specialty
------------------------------------------------------------------------
Tier level                                            Minimum    Maximum
------------------------------------------------------------------------
Tier 1............................................   $115,587   $400,000
Tier 2............................................    200,000    400,000
------------------------------------------------------------------------
                Pay Table 2--Covered Clinical Specialties
------------------------------------------------------------------------
Anatomic Pathology, Anesthesiology, Cardiology (Invasive/Non-
 Interventional), Cardiology (Non-Invasive), Cardio-Thoracic Surgery,
 Critical Care, Dermatology, Dermatology (Mohs), Emergency Medicine,
 Gastroenterology, General Surgery, Gynecology, Hematology--Oncology,
 Interventional Cardiology, Interventional Radiology, Nephrology,
 Neurosurgery, Nuclear Medicine, Ophthalmology, Oral Surgery, Orthopedic
 Surgery, Otolaryngology, Pain Management (Interventional & Non-
 Operating Room Anesthesiology), Pain Management (PM&R), Pathology,
 Plastic Surgery, Podiatry (Surgery-Forefoot, Rearfoot/Ankle, Advanced
 Rearfoot/Ankle), Pulmonary, Radiology (Diagnostic), Radiation Oncology,
 Urology, Vascular Surgery..............................................
------------------------------------------------------------------------


------------------------------------------------------------------------
 
------------------------------------------------------------------------
             Pay Table 3--Chief Medical Officer Assignments
------------------------------------------------------------------------
Tier level                                            Minimum    Maximum
------------------------------------------------------------------------
Tier 1............................................   $150,000   $400,000
Tier 2............................................    147,000    375,000
Tier 3............................................    145,000    350,000
Tier 4............................................    140,000    325,000
------------------------------------------------------------------------
                    Pay Table 3--Covered Assignments
------------------------------------------------------------------------
The recommendation is to decouple VHA Chiefs of Staff and Network Chief
 Medical Officers Tier assignments for Chiefs of Staff from their
 complexity levels to address recruitment and retention issues. By
 decoupling the provider from their facility, this allows individual
 qualifications to be acknowledged......................................
Tier 1--Network Chief Medical Officer...................................
Tier 2--Chief of Staff..................................................
Tier 3--Deputy Network Chief Medical Officer and Deputy Chief of Staff..
Tier 4--Associate Chief of Staff........................................
------------------------------------------------------------------------


------------------------------------------------------------------------
 
------------------------------------------------------------------------
                   Pay Table 4--Executive Assignments
------------------------------------------------------------------------
No discussions took place regarding pay table 4 (formerly pay table 5)
 other than the pay table number changing due to combining of other pay
 tables.................................................................
------------------------------------------------------------------------
Tier level                                            Minimum    Maximum
------------------------------------------------------------------------
Tier 1............................................   $145,000   $310,000
Tier 2............................................    145,000    295,000
Tier 3............................................    145,000    285,000
------------------------------------------------------------------------

[[Page 77673]]

 
                    Pay Table 4--Covered Assignments
------------------------------------------------------------------------
Deputy Under Secretary for Health; Assistant Under Secretaries for
 Health; Associate Deputy Under Secretary for Health; Assistant Deputy
 Under Secretary for Health; Chief Officers (VHA Central Office (CO));
 Network Directors; Medical Center Directors; Executive Directors (VHA
 CO); Deputy to the Assistant Under Secretaries for Health; Chief
 Consultants (VHA CO); Deputy Chief Officers (VHA CO); Deputy Network
 Directors; Deputy Medical Center Directors; Deputy Chief Consultants
 (VHA CO); Deputy to the Executive Directors (VHA CO); VHA CO
 physicians, dentists or podiatrists (non-Senior Executive Service
 equivalents) with an administrative/executive role for more than 50% of
 their full-time equivalent.............................................
------------------------------------------------------------------------

Signing Authority

    Denis McDonough, Secretary of Veterans Affairs, approved and signed 
this document on October 24, 2023, and authorized the undersigned to 
sign and submit the document to the Office of the Federal Register for 
publication electronically as an official document of the Department of 
Veterans Affairs.

Luvenia Potts,
Regulation Development Coordinator, Office of Regulation Policy & 
Management, Office of General Counsel, Department of Veterans Affairs.
[FR Doc. 2023-24893 Filed 11-9-23; 8:45 am]
BILLING CODE 8320-01-P