‘‘(4)(A) The Secretary shall evaluate the amount of 
market pay payable to a Director under this section not 
less frequently than once every two years and may adjust 
the market pay payable to such Director as a result of 
such evaluation. 
‘‘(B) A Director whose market pay is evaluated under 
subparagraph (A) shall receive written notice of the re-
sults of such evaluation. 
‘‘(c) REQUIREMENTS AND LIMITATIONS ON TOTAL 
PAY.—(1) Not less frequently than once every two years, 
the Secretary shall set forth a Department-wide minimum 
and maximum amount for total annual pay under sub-
section (a) that may be paid to a Director and shall pub-
lish each such amount in the Federal Register. 
‘‘(2) The minimum and maximum amounts set forth 
under paragraph (1) shall take effect not earlier than the 
date that is 60 days after the publication of such amounts 
under such paragraph. 
‘‘(3) The sum of the basic pay set forth under section 
7404(a) of this title and market pay determined under 
subsection (b) for a Director for a calendar year— 
‘‘(A) may not be less than the most recent min-
imum amount set forth under paragraph (1) before 
the beginning of such calendar year; and 
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‘‘(B) may not be more than the most recent 
maximum amount set forth under such paragraph 
before the beginning of such calendar year. 
‘‘(4) The total amount of compensation paid to a Di-
rector under this title in any calendar year may not exceed 
the amount of annual compensation (excluding expenses) 
of the President under section 102 of title 3. 
‘‘(5) The Secretary may not delegate to an officer or 
employee of the Department the requirement of the Sec-
retary to set forth a Department-wide minimum and max-
imum amount under paragraph (1). 
‘‘(d) TREATMENT OF PAY.—Pay under this section 
shall be considered pay for all purposes, including retire-
ment benefits under chapters 83 and 84 of title 5 and 
other benefits. 
‘‘(e) ANCILLARY EFFECTS OF DECREASES IN PAY.— 
(1) A decrease in pay of a Director resulting from an ad-
justment in the amount of market pay of the Director 
under subsection (b) shall not be treated as an adverse 
action. 
‘‘(2) A decrease in the amount of pay of a Director 
resulting from an involuntary reassignment in connection 
with a disciplinary action taken against the Director is not 
subject to appeal or judicial review.’’. 
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(b) CLERICAL AMENDMENT.—The table of sections 
at the beginning of chapter 74 of such title is amended 
by adding at the end the following: 
‘‘SUBCHAPTER VII. PAY FOR MEDICAL DIRECTORS AND DIRECTORS OF 
VETERANS INTEGRATED SERVICE NETWORKS 
‘‘7481. Pay for Medical Directors and Directors of Veterans Integrated Service 
Networks.’’. 
TITLE IV—OTHER HEALTH CARE 
MATTERS 
SEC. 401. PILOT PROGRAM ON PROVIDING NURSE ADVICE 
LINE FOR VETERANS IN RURAL AND HIGHLY 
RURAL AREAS. 
(a) IN GENERAL.—Commencing not later than one 
year after the date of the enactment of this Act, the Sec-
retary of Veterans Affairs shall conduct a two-year pilot 
program to assess the feasibility and advisability of imple-
menting in rural areas and highly rural areas with a large 
percentage of veterans a nurse advice line to furnish to 
veterans medical advice, appointment and cancellation 
services, and information on the availability of benefits 
from the Department of Veterans Affairs. 
(b) NURSE ADVICE LINE.—In carrying out the pilot 
program under subsection (a) the Secretary shall establish 
a nurse advice line that— 
(1) operates free of charge; 
(2) is based on, and improves upon, the nurse 
advice line implemented by the Department of De-
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fense for beneficiaries under the TRICARE program 
(as defined in section 1072(5) of title 10, United 
States Code); 
(3) complies with call center requirements set 
forth by URAC; 
(4) operates in close consultation with the Sec-
retary to— 
(A) establish a process through which the 
eligibility of a caller for the nurse advice line 
can be validated; 
(B) allow eligibility and benefit information 
in possession of the Department of Veterans 
Affairs to be shared with the nurse advice line; 
and 
(C) allow the nurse advice line to connect 
with appropriate technology and personnel of 
the Department for purposes of scheduling ap-
pointments for the receipt of health care from 
the Department; and 
(5) maintains quality controls to ensure that 
calls are answered by a customer service representa-
tive within 30 seconds and with an abandonment 
rate of less than 5 percent. 
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(c) SERVICES PROVIDED.—The nurse advice line es-
tablished under the pilot program shall provide an array 
of services to veterans, including the following: 
(1) Medical advice from licensed registered 
nurses who assess the symptoms of the caller using 
a proprietary clinical algorithm that— 
(A) has been shown in peer-reviewed med-
ical journals to most closely emulate the clinical 
decisionmaking processes of physicians; and 
(B) triages the caller to the appropriate 
venue at which the caller may receive the health 
care that they need. 
(2) Information to address basic questions re-
garding the eligibility of the caller for benefits from 
the Department of Veterans Affairs and the avail-
ability of those benefits. 
(3) Use of an appointment clerk to facilitate the 
scheduling, rescheduling, and cancellation of ap-
pointments for health care from the Department. 
(d) REPORT.— 
(1) IN
GENERAL.—Not later than 120 days 
after the date of the completion of the pilot pro-
gram, the Secretary of Veterans Affairs shall submit 
to Congress a report on the findings of the Secretary 
with respect to the pilot program. 
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