(c) OBLIGATED SERVICE.—In exchange for a con-
tract buy out under subsection (a), a covered health care 
professional shall agree to be employed for not less than 
four years at a rural or highly rural facility of the Depart-
ment. 
(d) LIABILITY.— 
(1) IN GENERAL.—Except as provided in para-
graph (2), if a covered health care professional fails 
for any reason to complete the period of obligated 
service of the individual under subsection (c), the 
United States shall be entitled to recover from the 
individual an amount equal to— 
(A) the total amount paid under subsection 
(a) to buy out the non-Department service con-
tract of the individual; multiplied by 
(B) a fraction— 
(i) the numerator of which is— 
(I) the total number of months in 
the period of obligated service of the 
individual; minus 
(II) the number of months served 
by the individual; and 
(ii) the denominator of which is the 
total number of months in the period of 
obligated service of the individual. 
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(2) EXCEPTION.—Liability shall not arise under 
paragraph (1) in the case of an individual covered 
by that paragraph if the individual does not obtain, 
or fails to maintain, employment as an employee of 
the Department due to staffing changes approved by 
the Under Secretary for Health. 
(e) NOT A TAXABLE BENEFIT.—A contract buy out 
for a covered health care professional under subsection (a) 
shall not be considered a taxable benefit or event for the 
covered health care professional. 
(f) ANNUAL REPORT.— 
(1) IN GENERAL.—Not later than 18 months 
after the date of the enactment of this Act, and not 
less frequently than annually thereafter, the Sec-
retary of Veterans Affairs shall submit to the Com-
mittee on Veterans’ Affairs of the Senate and the 
Committee on Veterans’ Affairs of the House of 
Representatives a report on the use by the Secretary 
of the authority under this section. 
(2) ELEMENTS.—Each report required by para-
graph (1) shall include the following: 
(A) The number of health care profes-
sionals for whom a service contract buyout pay-
ment was made under subsection (a) in the pre-
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vious fiscal year, disaggregated by occupation 
or specialty. 
(B) The average, highest, and lowest 
amount of the service contract buyout payments 
made under subsection (a) for each occupation 
or specialty in the previous fiscal year. 
(C) Each location where contract buyout 
authority under subsection (a) was utilized and 
the number of covered health care professionals 
who agreed to be employed at such location in 
the previous fiscal year. 
(g) DEFINITIONS.—In this section: 
(1) The term ‘‘covered health care professional’’ 
means a physician, nurse anesthetist, surgical physi-
cian assistant, or nurse practitioner offered employ-
ment with the Department regardless of the author-
ity under which such employment is offered. 
(2) The terms ‘‘rural’’ and ‘‘highly rural’’ have 
the meanings given those terms under the rural- 
urban commuting areas coding system of the De-
partment of Agriculture. 
(h) SUNSET.—This section shall terminate on Sep-
tember 30, 2027. 
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SEC. 5. QUALIFICATIONS FOR HUMAN RESOURCES POSI-
TIONS WITHIN DEPARTMENT OF VETERANS 
AFFAIRS AND PLAN TO RECRUIT AND RETAIN 
HUMAN RESOURCES EMPLOYEES. 
(a) ESTABLISHMENT
OF
QUALIFICATIONS.—Not 
later than 180 days after the date of the enactment of 
this Act, the Secretary of Veterans Affairs shall— 
(1) establish qualifications for each human re-
sources position within the Department of Veterans 
Affairs in coordination with the Office of Personnel 
Management; 
(2) establish standardized performance metrics 
for each such position; and 
(3) submit to the Committee on Veterans’ Af-
fairs of the Senate and the Committee on Veterans’ 
Affairs of the House of Representatives a report 
containing the qualifications and standardized per-
formance metrics established under paragraphs (1) 
and (2). 
(b) IMPROVEMENT
OF
HUMAN
RESOURCES
AC-
TIONS.—Not later than 90 days after the date of the en-
actment of this Act, the Secretary shall establish or en-
hance systems of the Department to monitor the hiring 
and other human resources actions that occur at the local, 
regional, and national levels of the Department to improve 
the performance of those actions. 
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(c) REPORT.—Not later than one year after the es-
tablishment of the qualifications and performance metrics 
under subsection (a), the Comptroller General of the 
United States shall submit to the Committee on Veterans’ 
Affairs of the Senate and the Committee on Veterans’ Af-
fairs of the House of Representatives a report con-
taining— 
(1) a description of the implementation of such 
qualifications and performance metrics; 
(2) an assessment of the quality of such quali-
fications and performance metrics; 
(3) an assessment of performance and outcomes 
based on such metrics; and 
(4) such other matters as the Comptroller Gen-
eral considers appropriate. 
(d) PLAN TO RECRUIT AND RETAIN HUMAN RE-
SOURCES EMPLOYEES.—Not later than one year after the 
date of the enactment of this Act, the Secretary of Vet-
erans Affairs shall submit to the Committee on Veterans’ 
Affairs of the Senate and the Committee on Veterans’ Af-
fairs of the House of Representatives a plan for the re-
cruitment and retention of human resources employees 
within the Department of Veterans Affairs. 
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SEC. 6. MODIFICATION OF PAY CAP FOR CERTAIN EMPLOY-
EES OF VETERANS HEALTH ADMINISTRA-
TION. 
(a) IN GENERAL.—Section 7455(c) is amended— 
(1) in paragraph (1), by striking ‘‘30 percent’’ 
inserting ‘‘50 percent’’; 
(2) in paragraph (2), by striking ‘‘level IV’’ in-
serting ‘‘level II’’; and 
(3) by adding at the end the following new 
paragraph: 
‘‘(3)(A) Notwithstanding section 5304 of title 5 or 
any other provision of law, but subject to the limitation 
under paragraph (2), pursuant to an increase under sub-
section (a), the Secretary may pay a special rate or an 
adjusted rate of basic pay in excess of the rate of basic 
pay payable for level IV of the Executive Schedule. 
‘‘(B) If an employee is in receipt of a special rate 
of pay under subparagraph (A) in excess of the rate of 
basic pay payable for level IV of the Executive Schedule 
with an established special rate supplement of greater 
value than a supplement based on the applicable locality- 
based comparability payment percentage under section 
5304 of title 5, but a pay adjustment would cause such 
established special rate supplement to be of lesser value, 
the special rate supplement shall be converted to a supple-
ment based on the applicable locality-based comparability 
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percentage unless the Secretary determines that some 
other action is appropriate.’’. 
(b) 
PAY
FOR
CRITICAL
POSITIONS.—Section 
7404(a)(1)(B) is amended by inserting ‘‘7306 or’’ before 
‘‘7401(4)’’. 
SEC. 7. EXPANSION OF OPPORTUNITIES FOR HOUSE-
KEEPING AIDES. 
Section 3310 of title 5, United States Code, is 
amended by inserting ‘‘(other than for positions of house-
keeping aides in the Department of Veterans Affairs)’’ 
after ‘‘competitive service’’. 
SEC. 8. MODIFICATION OF AUTHORITY OF THE SECRETARY 
OF VETERANS AFFAIRS RELATING TO HOURS, 
CONDITIONS OF EMPLOYMENT, AND PAY FOR 
CERTAIN EMPLOYEES OF VETERANS HEALTH 
ADMINISTRATION. 
(a) EXPANSION OF ELIGIBILITY OF EMPLOYEES FOR 
CERTAIN AWARDS.—Section 7404(c) is amended— 
(1) by striking ‘‘Notwithstanding’’ and insert-
ing ‘‘(1) Notwithstanding’’; 
(2) by inserting ‘‘or 7401(4)’’ after ‘‘section 
7306’’; 
(3) by striking ‘‘who is not eligible for pay 
under subchapter III’’ and inserting ‘‘or in a covered 
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executive position under section 7401(1) of this 
title’’; 
(4) by striking ‘‘sections 4507 and 5384’’ and 
inserting ‘‘section 4507’’; and 
(5) by adding at the end the following new 
paragraph: 
‘‘(2) In this subsection, the term ‘covered executive 
position’ means a position that the Secretary has deter-
mined is of equivalent rank to a Senior Executive Service 
position (as such term is defined in section 3132(a) of title 
5) and is subject to an agency performance management 
system.’’. 
(b) AUTHORITY FOR AWARDS PROGRAMS OF DE-
PARTMENT OF VETERANS AFFAIRS.— 
(1) IN GENERAL.—Subchapter I of chapter 74 
is amended by inserting after section 7404 the fol-
lowing new section: 
‘‘§ 7404A. Awards 
‘‘(a) SUPERIOR ACCOMPLISHMENTS AND PERFORM-
ANCE AWARDS PROGRAM.—The Secretary may establish 
an awards program for personnel listed in section 7421(b) 
of this title consistent with chapter 45 of title 5, to the 
extent practicable. 
‘‘(b) EXECUTIVE
PERFORMANCE
AWARDS
PRO-
GRAM.—Notwithstanding section 7425 of this title or any 
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other provision of law, the Secretary may establish a per-
formance awards program consistent with section 5384 of 
title 5 for— 
‘‘(1) personnel appointed under section 7401(1) 
of this title for a position that the Secretary has de-
termined is of equivalent rank to a Senior Executive 
Service position (as such term is defined in section 
3132(a) of title 5) and is subject to an agency per-
formance management system; and 
‘‘(2) personnel appointed under section 7306 or 
7401(4) of this title. 
‘‘(c) PAYMENT OF AWARDS.—Awards under this sec-
tion may be paid based on criteria established by the Sec-
retary and shall not be considered in calculating the limi-
tation under section 7431(e)(4) of this title. 
‘‘(d) NOT CONSIDERED BASIC PAY.—Awards under 
this section shall not be considered basic pay for any pur-
pose. 
‘‘(e) REGULATIONS.—The Secretary may prescribe 
regulations for the administration of this section.’’. 
(2) LIMITATION ON PAST AWARDS.—Notwith-
standing any other provision of law, awards made by 
the Secretary of Veterans Affairs for any period on 
or after January 1, 2017, and before the date of the 
enactment of this Act for an employee under section 
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7306 or 7401(4) of title 38, United States Code, or 
for a position described in section 7401(1) of such 
title that the Secretary has determined is of equiva-
lent rank to a Senior Executive Service position (as 
such term is defined in section 3132(a) of title 5, 
United States Code), may be subject to section 
7404A of title 38, United States Code, as added by 
paragraph (1). 
(c) MODIFICATION
OF EMPLOYEES SUBJECT
TO 
REGULATION BY SECRETARY OF VETERANS AFFAIRS OF 
HOURS AND CONDITIONS OF EMPLOYMENT AND LEAVES 
OF ABSENCE.— 
(1) IN GENERAL.—Section 7421 is amended— 
(A) in subsection (a), by striking ‘‘chap-
ter’’ and inserting ‘‘title’’; and 
(B) in subsection (b), by adding at the end 
the following new paragraph: 
‘‘(9) Any position for which the employee is ap-
pointed under section 7306 or 7401(4) of this 
title.’’. 
(2) ADMINISTRATION OF FULL-TIME EMPLOY-
EES.—Section 7423 is amended— 
(A) in subsection (a)(2), by adding at the 
end the following new subparagraph: 
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‘‘(D) The Secretary may exclude from the require-
ments of paragraph (1) employees hired under section 
7306 or 7401(4) of this title or for a position described 
in section 7401(1) of this title that the Secretary has de-
termined is of equivalent rank to a Senior Executive Serv-
ice position (as such term is defined in section 3132(a) 
of title 5).’’; and 
(B) in subsection (e)(1), by striking 
‘‘7401(1)’’ and inserting ‘‘7421(b)’’. 
(3) ADDITIONAL
PAY
AUTHORITIES.—Section 
7410(a) is amended— 
(A) by striking ‘‘The Secretary’’ and in-
serting ‘‘(1) The Secretary’’; 
(B) by striking ‘‘the personnel described in 
paragraph (1) of section 7401 of this title’’ and 
inserting ‘‘personnel appointed under section 
7306 of this title or section 7401(4) of this 
title, or personnel described in section 7401(1) 
of this title,’’; 
(C) by striking ‘‘in the same manner, and 
subject to the same limitations, as in the case 
of’’ and inserting ‘‘in a manner consistent 
with’’; and 
(D) by adding at the end the following new 
paragraph: 
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‘‘(2) Payments under paragraph (1) shall not be con-
sidered in calculating the limitation under section 
7431(e)(4) of this title.’’. 
(4) 
TREATMENT
OF
PAY
AUTHORITY 
CHANGES.—For the purposes of the amendments 
made by paragraph (3), the Secretary of Veterans 
Affairs shall treat any award or payment made by 
the Secretary between January 1, 2017, and the 
date of the enactment of this Act to employees ap-
pointed under sections 7306, 7401(1), and 7401(4) 
of title 38, United States Code, that the Secretary 
has determined are of equivalent rank to a Senior 
Executive Service position (as such term is defined 
in section 3132(a) of title 5, United States Code), 
as if such amendments had been in effect at the 
time of such award or payment. 
(5) TREATMENT OF PRIOR LEAVE BALANCES.— 
Notwithstanding any other provision of law, the Sec-
retary may adjust the leave balance and carryover 
leave balance of any employee described in section 
7421(b)(9) of title 38, United States Code, as 
amended by paragraph (1)(B), to ensure any leave 
accrued or carried over before the date of the enact-
ment of this Act remains available to such employee. 
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(d) TREATMENT OF CERTAIN EMPLOYEES AS AP-
POINTED
UNDER
SECTION
7306.—Section 7306 is 
amended— 
(1) in subsection (a), by redesignating the sec-
ond paragraph (11) as paragraph (12); and 
(2) by adding at the end the following new sub-
section: 
‘‘(g) For purposes of applying any provision of chap-
ter 74 of this title, including sections 7404, 7410, and 
7421, or any other provision of law, the Secretary may 
treat any appointment for a position under this chapter 
to be an appointment under this section.’’. 
(e) CONFORMING AMENDMENT.—Section 7431(e)(4) 
is amended by striking ‘‘In no case’’ and inserting ‘‘Except 
as provided in sections 7404A(c) and 7410(a)(2) of this 
title, in no case’’. 
SEC. 9. WAIVER OF PAY LIMITATION FOR CERTAIN EM-
PLOYEES OF DEPARTMENT OF VETERANS AF-
FAIRS. 
Subchapter I of chapter 7 is amended by inserting 
after section 703 the following new section: 
‘‘§ 704. Waiver of pay limitation for certain employees 
‘‘(a) EMPLOYEES OF VETERANS HEALTH ADMINIS-
TRATION IMPACTED BY CLOSURE OR REALIGNMENT.— 
Notwithstanding any other provision of law, the Secretary 
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may waive any annual premium or aggregate limitation 
on pay for an employee of the Veterans Health Adminis-
tration for the calendar year during which— 
‘‘(1) the official duty station of the employee is 
closed; or 
‘‘(2) the office, facility, activity, or organization 
of the employee is realigned. 
‘‘(b) EMPLOYEES PROVIDING CARE TO VETERANS 
EXPOSED TO OPEN BURN PITS.— 
‘‘(1) IN GENERAL.—Notwithstanding any other 
provision of law, the Secretary may waive any an-
nual premium or aggregate limitation on pay for an 
employee of the Department whose primary duties 
include providing expanded care for veterans exposed 
to open burn pits. 
‘‘(2) OPEN BURN PIT DEFINED.—In this sub-
section, the term ‘open burn pit’ has the meaning 
given that term in section 201(c) of the Dignified 
Burial and Other Veterans’ Benefits Improvement 
Act of 2012 (Public Law 112–260; 38 U.S.C. 527 
note). 
‘‘(c) COORDINATION WITH OFFICE OF PERSONNEL 
MANAGEMENT.—In implementing this section, the Sec-
retary shall coordinate with the Director of the Office of 
Personnel Management. 
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‘‘(d) REPORTS.— 
‘‘(1) IN GENERAL.—For each quarter that the 
Secretary waives a limitation under this section, the 
Secretary shall submit to the Committee on Vet-
erans’ Affairs of the Senate, the Committee on Vet-
erans’ Affairs of the House of Representatives, and 
the Office of Personnel Management a report on the 
waiver or waivers. 
‘‘(2) CONTENTS.—Each report submitted under 
paragraph (1) with respect to a waiver or waivers 
shall include the following: 
‘‘(A) Where the waiver or waivers were 
used, including in which component of the De-
partment and, as the case may be, which med-
ical center of the Department. 
‘‘(B) For how many employees the waiver 
or waivers were used, disaggregated by compo-
nent of the Department and, if applicable, med-
ical center of the Department. 
‘‘(C) The average amount by which each 
payment exceeded the pay limitation that was 
waived, disaggregated by component of the De-
partment and, if applicable, medical center of 
the Department. 
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‘‘(e) EMPLOYEE DEFINED.—In this section, the term 
‘employee’ means any employee regardless of the authority 
under which the employee was hired. 
‘‘(f) TERMINATION.—This section shall terminate on 
September 30, 2027.’’. 
SEC. 10. ELIMINATION OF LIMITATION ON AWARDS AND 
BONUS FOR EMPLOYEES OF DEPARTMENT OF 
VETERANS AFFAIRS. 
(a) IN GENERAL.—Section 705(a) of the Veterans 
Access, Choice, and Accountability Act of 2014 (Public 
Law 113–146; 38 U.S.C. 703 note) is amended by striking 
paragraph (3). 
(b) APPLICABILITY.—Subsection (a) shall take effect 
on the date of the enactment of this Act and apply as 
if such subsection had been enacted on September 30, 
2021. 
SEC. 11. ADDITIONAL AUTHORITY OF THE SECRETARY OF 
VETERANS AFFAIRS RELATING TO RECRUIT-
MENT AND RETENTION OF PERSONNEL. 
Subchapter I of chapter 7 is amended by inserting 
after section 705 the following new section: 
‘‘§ 706. Additional authority relating to recruitment 
and retention of personnel 
‘‘(a) RECRUITMENT AND RELOCATION BONUSES.— 
The Secretary may pay a recruitment or relocation bonus 
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under section 5753(e) of title 5 without regard to any re-
quirements for certification or approval under that sec-
tion. 
‘‘(b) RETENTION BONUSES.—(1) The Secretary may 
pay a retention bonus under section 5754(f) of title 5 
without regard to any requirement for certification or ap-
proval under that subsection. 
‘‘(2) The Secretary may pay a retention bonus as 
specified in subsection (e)(2) of section 5754 of title 5 and 
may pay the bonus as a single lump-sum payment at the 
beginning of the full period of service required by an 
agreement under subsection (d) of such section. 
‘‘(c) MERIT AWARDS.—The Secretary may grant a 
cash award under section 4502(b) of title 5 without regard 
to any requirement for certification or approval under that 
section. 
‘‘(d) INCENTIVES FOR CRITICAL SKILLS.—(1) Sub-
ject to the provisions of this paragraph, the Secretary may 
provide a critical skill incentive to an employee in a case 
in which the Secretary determines— 
‘‘(A) the employee possesses a high-demand 
skill or skill that is at a shortage; 
‘‘(B) such skill is directly related to the duties 
and responsibilities of the employee’s position; and 
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‘‘(C) employment of an individual with such 
skill in such position serves a critical mission-related 
need of the Department. 
‘‘(2) An incentive provided to an employee under 
paragraph (1) may not to exceed 25 percent of the basic 
pay of the employee. 
‘‘(3) Provision of an incentive under paragraph (1) 
shall be contingent on the employee entering into a written 
agreement to complete a period of employment with the 
Department. 
‘‘(4) An incentive provided under paragraph (1) shall 
not be considered basic pay for any purpose. 
‘‘(5) The Secretary may prescribe conditions, includ-
ing with respect to eligibility, and limitations on provision 
of incentive under paragraph (1). 
‘‘(6) Incentive provided under paragraph (1) shall not 
be included in the calculation of total amount of com-
pensation under section 7431(e)(4) of this title. 
‘‘(e) STUDENT LOAN REPAYMENTS.—(1) Subject to 
the provisions of this subsection, the Secretary may repay 
a student loan pursuant to section 5379(b) of title 5. 
‘‘(2) Paragraph (2) of such section shall not apply 
to payment under this subsection. 
‘‘(3) Payment under this subsection shall be made 
subject to such terms, limitations, or conditions as may 
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be mutually agreed to by the Secretary and the employee 
concerned, except that the amount paid by the Secretary 
under this subsection may not exceed— 
‘‘(A) $40,000 for any employee in any calendar 
year; or 
‘‘(B) a total of $100,000 in the case of any em-
ployee. 
‘‘(f) EXPEDITED HIRING AUTHORITY FOR COLLEGE 
GRADUATES; COMPETITIVE SERVICE.—(1) Subject to 
paragraph (2) of this subsection, the Secretary may expe-
dite hiring for college graduates under section 3115 of 
title 5 without regard to subsection (e) of such section or 
any regulations prescribed by the Office of Personnel 
Management for administration of such subsection. 
‘‘(2) The number of employees the Secretary may ap-
point under section 3115 of title 5 may not exceed the 
number equal to 25 percent of individuals that the Sec-
retary appointed during the previous fiscal year to a posi-
tion in the competitive service classified in a professional 
or administrative occupational category, at the GS–11 
level, or an equivalent level, or below, under a competitive 
examining procedure. 
‘‘(g) EXPEDITED HIRING AUTHORITY
FOR POST- 
SECONDARY
STUDENTS; COMPETITIVE
SERVICE.—(1) 
Subject to paragraph (2) of this subsection, the Secretary 
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may expedite hiring of post-secondary students under sec-
tion 3116 of title 5, without regard to subsection (d) of 
such section or any regulations prescribed by the Office 
of Personnel Management for administration of such sub-
section. 
‘‘(2) The number of employees the Secretary may ap-
point under section 3116 of title 5 may not exceed the 
number equal to 25 percent of the number of students 
that the Secretary appointed during the previous fiscal 
year to a position at the GS–11 level, or an equivalent 
level, or below. 
‘‘(h) PAY AUTHORITY FOR CRITICAL POSITIONS.— 
(1) Subject to the provisions of this subsection, the Sec-
retary may authorize the fixing of the rate of pay for a 
critical position in the Department consistent with the au-
thorities and requirements of section 5377 of title 5 that 
apply to the Office of Personnel Management. 
‘‘(2) The Secretary may fix the rate of pay for a crit-
ical position under this subsection in excess of the limita-
tion set forth by section 5377(d)(2) of such title. 
‘‘(3) Basic pay may not be fixed under this subsection 
at a rate greater than the rate payable for the Vice Presi-
dent of the United States established under section 104 
of title 3, except upon written approval of the President. 
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‘‘(4) Notwithstanding section 5377(f) of title 5, the 
Secretary may authorize the exercise of authority under 
this subsection with respect to up to 200 positions at any 
time. 
‘‘(i) RATES OF SPECIAL PAY.—(1) The Secretary 
may establish a rate for special pay under section 
5305(a)(1) of title 5. 
‘‘(2) In applying such section to the Secretary’s au-
thority under paragraph (1)— 
‘‘(A) ‘50 percent’ shall be substituted for ‘30 
percent’; and 
‘‘(B) ‘level II of the Executive Schedule’ shall 
be substituted for ‘level IV of the Executive Sched-
ule’. 
‘‘(j) WAIVER OF LIMITATIONS ON CERTAIN PAY-
MENTS UNDER PAY COMPARABILITY SYSTEM.—The Sec-
retary may waive the limitation in section 5307 of title 
5 for an employee or a payment. 
‘‘(k) TERMINATION.—The authorities under this sec-
tion shall terminate on September 30, 2027.’’. 
SEC. 12. PRESCRIPTION OF MEDICATION BY HEALTH CARE 
PROVIDERS OF DEPARTMENT OF VETERANS 
AFFAIRS VIA TELEMEDICINE. 
Section 1730C is amended— 
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(1) in the section heading, by inserting ‘‘and 
authorization to prescribe controlled sub-
stances via telemedicine’’ after ‘‘telemedi-
cine’’; 
(2) in subsection (a)— 
(A) by striking ‘‘Notwithstanding’’ and in-
serting ‘‘(1) Notwithstanding’’; and 
(B) by adding at the end the following new 
paragraph: 
‘‘(2)(A) A covered health care professional who is au-
thorized to dispense controlled substances in the State in 
which the health care professional is licensed may pre-
scribe controlled substances through the use of telemedi-
cine notwithstanding any conflicting requirements under 
the Controlled Substances Act (21 U.S.C. 801 et seq.). 
‘‘(B) Covered health care professionals dispensing 
controlled substances under subparagraph (A) shall be 
subject to such quality, control, and safety requirements 
as the Secretary may establish in consultation with the 
Attorney General.’’; and 
(3) in subsection (e), by striking ‘‘Nothing’’ and 
inserting ‘‘Except as provided in subsection (a)(2), 
nothing’’. 
Æ 
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