I 118th CONGRESS 2d Session H. R. 10142 IN THE HOUSE OF REPRESENTATIVES November 15, 2024 Mr. Harder of California introduced the following bill; which was referred to the Committee on Veterans' Affairs A BILL To improve the workforce of the Department of Veterans Affairs, and for other purposes.

1. Short title; table of contents This Act may be cited as the Department of Veterans Affairs Compensation Optimization and Modernization for Physicians to Ensure Treatment Excellence and Service Act or the VA COMPETES Act . 2. Modification of pay limitation for physicians, podiatrists, optometrists, and dentists of Department of Veterans Affairs (a) Market pay (1) In general Section 7431 of title 38, United States Code, is amended— (A) by striking subsections (a), (b), and (d); (B) by redesignating subsections (c), (e), (f), (g), and (h) as subsections (a), (b), (c), (d), and (e), respectively; (C) by inserting optometrists, after podiatrists, each place it appears; (D) by inserting optometrist, after podiatrist, each place it appears; (E) in subsection (a), as so redesignated— (i) by striking the matter preceding paragraph (1) and inserting Pay of physicians, podiatrists, optometrists, and dentists in the Veterans Health Administration shall consist of market pay, which shall meet the following requirements: ; (ii) in paragraph (4)— (I) in subparagraph (E), by striking and at the end; (II) by redesignating subparagraph (F) as subparagraph (I); and (III) by inserting after subparagraph (E) the following new subparagraphs: (F) the performance of the physician, podiatrist, optometrist, or dentist based on specific criteria prescribed by the Secretary, including the parameters to determine the relevant timeframe of performance; (G) the annual pay adjustments under section 5303 of title 5; (H) the nonforeign cost of living adjustment allowance authorized under section 5941 of title 5; and ; (iii) in paragraph (5), by adding at the end the following new sentence: Such a notice shall include a statement of whether the market pay will increase, decrease, or remain unchanged following such evaluation. ; and (iv) by adding at the end the following new paragraphs: (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 referred to in paragraph (4)(F); (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 last day of each fiscal year, the Secretary shall submit to the Committees on Veterans’ Affairs of the Senate and the House of Representatives a report covering that fiscal year that includes the following: (A) A list of each medical specialty clinic that conducted an evaluation of market pay during the fiscal year 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 did not conduct an evaluation of market pay, pursuant to paragraph (5), during the fiscal year covered by the report. ; (F) in subsection (b), as so redesignated— (i) in the heading, by striking total and inserting market ; (ii) in paragraph (1)(A)— (I) by striking annual each place it appears and inserting market ; and (II) by inserting , optometrists, after podiatrists ; (iii) by striking paragraphs (2) and (3); (iv) by redesignating paragraph (4) as paragraph (2); (v) in paragraph (2), as so redesignated— (I) by striking Except as provided in sections 7404A(c) and 7410(a)(2) of this title, in no case may the total amount of compensation and inserting The total amount of market pay under subsection (a) ; and (II) by inserting not before exceed ; and (vi) by adding at the end the following new paragraphs: (3) 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 section 7410(a) of this title or as otherwise provided by law; (C) incentives or bonuses under section 706 of this title or as otherwise provided by law; and (D) earnings from fee-basis appointments under section 7405(a)(2) of this title. (4) (A) The Secretary may waive any pay limitation described in this section (including tier limitations) as the Secretary determines necessary for the recruitment or retention of critical health care personnel that the Secretary determines would provide direct patient care. (B) Priority for such waivers shall be given for positions, locations, and care provided through contracts at a high cost to the Department. (C) During the period the authority under subparagraph (A) is effective, the Secretary may not issue more than 300 waivers under such subparagraph. (D) The Secretary may prescribe requirements, limitations, and other considerations for waivers under such subparagraph. (E) Not later than 180 days after the date of enactment of the VA COMPETES 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 (G); (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 contracted care purchased by the Department for the region; 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. (F) The authority of the Secretary under subparagraph (A) shall terminate on the date that is five years after the date of enactment of the VA COMPETES Act. (G) 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 pursuant to subparagraph (A).; ; (G) in subsection (c), as so redesignated, by striking subsections (a) and (b) of and ; (H) in subsection (d), as so redesignated— (i) in paragraph (1), by striking subsection (c) and inserting subsection (a) ; and (ii) by adding at the end the following new paragraph: (3) An individual receiving market pay under subsection (a) may not receive an adjustment or a nonforeign cost of living allowance under sections 5303 or 5941 of title 5. ; and (I) in subsection (e), as so redesignated, by striking subsection (c), (d), or (e) except for the responsibilities of the Secretary under subsection (e)(1) and inserting subsection (a) or (b) except for the responsibilities of the Secretary under subsection (b)(1) . (2) Report on waiver authority Not later than 180 days after the date of enactment of this Act, the Secretary of Veterans Affairs shall submit to the Committees on Veterans’ Affairs of the Senate and the House of Representatives a report that includes a description of the requirements, limitations, and other considerations prescribed under section 7431(b)(4)(B) of title 38, United States Code, as added by paragraph (1). (3) Conforming amendments (A) Incentives for recruitment Section 706(d)(6) of title 38, United States Code, is amended by striking total amount of compensation under section 7431(e)(4) and inserting total amount of market pay under section 7431 . (B) Awards Section 7404A(c) of such title is amended by striking the limitation under section 7431(e)(4) and inserting a limitation under section 7431 . (C) Additional pay authorities Section 7410(a)(2) of such title is amended by striking the limitation under section 7431(e)(4) and inserting a limitation under section 7431 . (D) Pay of Under Secretary for Health Section 7432(b)(1) of such title is amended— (i) by inserting , podiatrist, optometrist, after physician ; (ii) by striking the market pay element of pay of physicians and dentists and inserting market pay ; and (iii) by striking 7431(c) and inserting 7431 . (E) Administrative matters Section 7433 of such title is amended by inserting optometrists, after physicians, each place it appears. (F) Competitive pay Section 7451(a)(2)(C) of such title is amended by inserting optometrist, after physician, . (G) Compensation and professional standards for certain medical officers Section 27(b) of the Central Intelligence Agency Act of 1949 ( 50 U.S.C. 3528(b) ) is amended by striking section 7431(e)(1)(C) and inserting section 7431(b)(1)(C) . (4) Clerical amendments (A) Section heading (i) In general The heading for section 7431 of title 38, United States Code is amended to read as follows: 7431. Market pay . (ii) Table of sections The table of sections at the beginning of subchapter III of chapter 74 of title 38, United States Code, is amended by striking the item relating to section 7431 and inserting the following new item: 7431. Market pay. . (B) Subchapter heading (i) In general The heading for subchapter III of chapter 74 of such title is amended to read as follows: III Pay for Physicians, Podiatrists, Optometrists, and Dentists . (ii) Table of sections The table of sections at the beginning of chapter 74 of such title is amended by striking the item relating to subchapter III and inserting the following new item: SUBCHAPTER III—Pay for physicians, podiatrists, optometrists, and dentists . (5) Applicability dates (A) In general The amendments made by this subsection shall apply to any pay period of the Department of Veterans Affairs beginning on or after the date that is 180 days after the date of enactment of this Act. (B) Performance pay The Secretary of Veterans Affairs may pay performance pay under section 7431(d) of title 38, United States Code, as in effect on the day before the date of the enactment of this Act, for the calendar year during which this Act is enacted. (b) Modification and clarification of pay grade for optometrists Section 7404 of such title is amended— (1) in subsection (a)(2)(A), by inserting optometrists, after podiatrists, ; and (2) in the list in subsection (b)— (A) in the first heading of the list following the colon, by striking PODIATRIST (DPM), AND DENTIST and inserting PODIATRIST (DPM), OPTOMETRIST (OD), AND DENTIST ; (B) by inserting and optometrist grade after Podiatrist grade ; and (C) in the third heading of the list following the colon, by striking CLINICAL CHIROPRACTOR AND OPTOMETRIST SCHEDULE and inserting CLINICAL CHIROPRACTOR SCHEDULE . (c) Retroactive authority for compensation (1) In general The Secretary of Veterans Affairs may pay retroactive compensation to a covered employee in an amount that equals the amount of compensation that was authorized to be paid to such covered employee during the period specified in paragraph (2), but was deferred and paid to such employee in the calendar year following the calendar year in which such compensation was authorized because the payment of such compensation would have exceeded an applicable cap on annual compensation. (2) Period specified The period specified in this paragraph is the period beginning on January 8, 2006, and ending on December 31, 2017. (3) Exclusion Compensation authorized under this subsection shall not be included in the calculation of any aggregate limit on compensation for a covered employee for the year in which it is paid. (4) Charging of compensation Compensation authorized under this subsection shall be charged to the appropriate medical care appropriation account of the Department of Veterans Affairs for the fiscal year in which the work was performed except as follows: (A) In the case of an account that has closed pursuant to section 1552 of title 31, United States Code, the compensation shall be charged to a current appropriation account in accordance with section 1553 of such title. (B) In the case of an expired account that has not closed, if charging the compensation to the expired account would cause such account to have a negative unliquidated or unexpended balance, the compensation may be charged to a current appropriation account available for the same purpose. (5) Definitions In this subsection: (A) The term compensation means any pay, including salary, awards, and incentives. (B) The term covered employee means a physician, podiatrist, or dentist subject to market pay under section 7431 of title 38, United States Code.