Veterans' Administration Physicians and Dentists Comparability Pay Act
PL 94-123 (H.R.8240), enacted 10/22/1975

PUBLIC LAW 94-123—OCT. 22, 1975 
Public Law 94-123 
94th Congress 
An Act 
To amend title 38, United States Code, to provide special pay and incentive pay 
for certain physicians and dentists employed by the Department of Medicine 
and Surgery of the Veterans' Administration in order to enhance the recruit-
ment and retention of such personnel, and for other purposes. 
Be it enacted hy the Senate and House of Representatives 
of the 
United States of America 
in Congress assemhled^ That this Act may 
be cited as the "Veterans' Administration Physician and Dentist Pay 
Comparability Act of 1975". 
SEC. 2. (a) The Congress hereby finds and declares (1) that the 
ceiling: on the salary of physicians employed in the Department of 
Medicine and Surgery due to the Federal salary limitation under the 
Executive Schedule rates of pay in title 5, United States Code, accom-
panied by the sharp escalation in the cost of living since those rates of 
pay were last increased in 1969, has seriously impaired the recruitment 
and retention of qualified physicians by the Department of Medicine 
and Surgery in the Veterans' Administration; and (2) that the com-
pensation provided to physicians and dentists in the Department of 
Medicine and Surgery has been rendered noncompetitive by virtue of 
the payment of special pay of up to $13,500 per annum, in addition 
to basic compensation and other benefits, to certain medical officers, 
and monthly special and continuation pay cumulating approximately 
half such amount to certain dental officers, of the uniformed services, 
pursuant to title 37 of the United States Code and Public Law 93-274. 
The Congress further finds and declares that these recruitment and 
retention difficulties have created an inequitable and demoralizing 
situation in the Department of Medicine and Surgery that threatens 
to erode seriously the ability of the Department to compete for the 
services of necessary health care professionals and thereby to continue 
to provide quality health care to eligible veterans. 
(b) Section 4i07 of title 38, United States Code, is amended by— 
(1) striking out the comma and "other than Chief Medical 
Director and Deputy Chief Medical Director," after "title" in the 
first sentence of subsection ( a ) ; 
(2) striking out in subsection (a) the following: 
"Associate Deputy Chief Medical Director, at the annual rate 
provided in section 5316 of title 5 of the United States Code for 
positions in level V of the Executive Schedule. 
"Assistant Chief Medical Director, $41,734. 
"Medical Director, $36,103 minimum to $40,915 maximum." 
and inserting in lieu thereof the following: 
"Chief Medical Director, $54,000. 
"Deputy Chief Medical Director, $52,000. 
"Associate Deputy Chief Medical Director, $50,000. 
"Assistant Chief Medical Director, $48,654. 
"Medical Director, $42,066 minimum to $47,674 maximum."^* 
(3) amending the Physician and Dentist Schedule in section 
(b) (1) to read as follows: 
89 STAT. 669 
Oct. 22, 1975 
[H.R. 8240] 
Veterans' 
Administration 
Physician and 
Dentist Pay 
Comparability 
Act of 1975.' 
38 use 4118 
note. 
38 use 4118 
note. 
5 use 5311. 
37 use 101 
et seq. 
37 use 302 note. 
38 use 4107. 
89 STAT. 670 
PUBLIC LAW 94-123—OCT. 22, 1975 
"PHYSICIAN AND DENTIST SCHEDULE 
"Director grade, $36,338 minimum to $46,026 maximum. 
"Executive grade, $33,736 minimum to $43,861 maximum. 
"Chief grade, $31,309 minimum to $40,705 maximum. 
"Senior grade, $26,861 minimum to $34,916 maximum. 
"Intermediate grade, $22,906 minimum to $29,782 maximum. 
"Full ^rade, $19,386 minimum to $25,200 maximum. 
"Associate grade, $16,256 minimum to $21,133 maximum."; and 
(4) amending subsection (d) to read as follows: 
"(d) Notwithstanding any other provision of law, and except as 
Infra. 
provided in section 4118 of this title, pay may not be paid at a rate in 
excess of the rate of basic pay for an appropriate level authorized by 
5 use 
section 5314, 5315, or 5316 of title 5 for positions in the Executive 
5314-5316. 
Schedule, as follows: 
" (1) Level III for the Chief Medical Director; 
"(2) Level IV for the Deputy Chief Medical Director; and 
"(3) Level V for all other positions for which such basic pay is 
paid under this section.". 
(c) Title 5, United States Code, is amended by— 
5 use 5314. 
(1) striking out in section 5314 the following: 
"(38) Chief Medical Director in the Department of Medicine 
and Surgery, Veterans' Administration."; and 
5 use 5315. 
(2) striking out in section 5315 the following: 
"(31) Deputy Chief Medical Director in the Department of 
Medicine and Surgery, Veterans' Administration.". 
(d) (1) Subchapter I of chapter 73 of title 38, United States Code, 
is amended by adding at the end thereof the following new section: 
38 use 4118. 
"§4118. Special pay for physicians and dentists 
Supra. 
"(a) (1) Notwithstanding the provisions of section 4107(d) or any 
other provision of law, in order to recruit and retain highly qualified 
physicians and dentists in the Department of Medicine and Surgery, 
the Administrator, pursuant to the provisions of this section and regu-
lations which he shall prescribe hereunder, shall provide, in addition 
to any pay or allowance to which such physician or dentist is entitled, 
special pay in an amount not more than (A) $13,500 per annum to 
any physician employed in the Department of Medicine and Surgery, 
or (B) $6,750 per annum to any dentist so employed, except as pro-
vided in paragraphs (2) and (3) of this subsection, upon the execu-
tion, and for the duration of, a written agreement by such physician 
or dentist to complete a specified number of years of service in the 
Department. 
"(2) Special pay may not be paid under this section to any phy-
sician or dentist w^ho— 
"(A) is employed on less than a half-time or intermittent basis, 
"(B) occupies an internship or residency training position, or 
"(C) is a reemployed annuitant. 
"(3) The Chief Medical Director, pursuant to such regulations, may 
determine categories of positions applicable to both physicians and 
dentists in the Department of Medicine and Surgery as to which there 
is no significant recruitment and retention problem. Physicians and 
dentists serving in such positions shall not be eligible for special pay 
under this section. 
PUBLIC LAW 94-123—OCT. 22, 1975 
89 STAT. 671 
"(b) The Administrator shall exercise the authority contained in 
this section to provide— 
"(1) the maximum amount of such special pay to the Chief 
Medical Director and Deputy Chief Medical Director; 
"(2) primary special pay of $5,000 to any eligible full-time 
physician, or $2,500 to any eligible full-time dentist, appointed 
under this chapter; and 
"(3) a proportional amount of primary special pay of $5,000 to 
any eligible part-time physician, or of $2,500 to any eligible part-
time dentist, appointed under this chapter, which proportional 
amount shall be calculated on the basis of the proportion which 
the part-time employment in the Department of Medicine and 
Surgery of such physician or dentist bears to full-time employ-
ment. 
"(c) The Administrator shall, in accordance with such regulations, 
provide, in addition to the primary special pay provided for in sub-
section (b) of this section, incentive special pay of no more than 
$8,500 to any eligible physician, or $4,250 to any eligible dentist, 
described in clauses (2) and (3) of subsection (b) of this section. In 
prescribing regulations to carry out this subsection, the Administrator 
shall take into account only the following factors and may pay no more 
than the following per annum amounts of incentive special pay to any 
full-time physician eligible therefor, one-half the following per 
annum amounts to any full-time dentist eligible therefor (except that 
the full amount as specified in clause (1) (A) (iii) may be paid), or 
a proportional amount of the following per annum amounts to any 
part-time physician or dentist to the extent eligible therefor which 
proportional amount shall be calculated on the basis of the propor-
tion which the part-time employment in the Department of Medicine 
and Surgery of such physician or dentist bears to 
full-time 
employment: 
"(1) (A) (i) full-time status, $2,000, and 
"(ii) tenure of service within the Department of Medicine and 
Surgery as follows: 
"(aa) completion of probationary period or three years, 
whichever is the lesser, $1,000, or 
" (bb) completion of seven years, $2,000; and 
" (iii) scarcity of medical or dental specialty $2,000; or 
"(B) professional responsibility as follows: 
" (i) Service Chief not in a scarce medical or dental specialty 
or Associate Chief of Staff, $5,500, 
"(ii) Service Chief in a scarce medical or dental specialty, 
$7,000, 
"(iii) Chief of Staff or Executive Grade, $7,000, 
"(iv) Director Grade or Deputy Service Director, $7,250, 
"(v) Service Director, $7,500, 
"(vi) Deputy Assistant Chief Medical Director, $8,000, or 
"(vii) Associate Deputy Chief Medical Director or Assist-
ant Chief Medical Director, $8,500; and 
"(2) continuing education certification, $500. 
"(d) (1) The annual rate of special pay provided pursuant to this 
section shall be reduced by an amount calculated as of the effective 
date of an agreement entered into under this section, as follows: the 
difference between the annual rate of basic pay for the grade and step 
Incentive special 
pay-
Special pay 
formula. 
89 STAT. 672 
PUBLIC LAW 94-123—OCT. 22, 1975 
of a physician or dentist in effect and payable on the day before the 
effective date of this section and the annual rate of basic pay in effect 
and payable on such effective date for such jrrade and step. 
"(2) No part-time physician may be paid an aggregate amount of 
basic pay, pursuant to the rates applicable on the effective date of this 
section to physicians employed under this title, and special pay under 
this section in excess of $42,000 per annum, and no part-time dentist 
may be paid an aggregate amount of basic pay, pursuant to the rates 
applicable on the effective date of this section to dentists employed 
under this title, and special pay under this section in excess of $37,000 
per annum. 
" (e) (1) Any agreement entered into by a physician or dentist under 
this section shall be with respect to a period of one year of service in 
the Department of Medicine and Surgery unless the physician or 
dentist requests an agreement for a longer period of service not to 
exceed four years. 
"(2) (A) Any such agreement shall provide that the physician or 
dentist, in the event that such physician or dentist voluntarily, or 
because of misconduct, fails to complete at least one year of service 
pursuant to such agreement, shall be required to refund the total 
amount received under this section, unless the Chief Medical Director, 
pursuant to the regulations prescribed under this section, determines 
that such failure is necessitated by circumstances beyond the control 
of the physician or dentist. 
"(B) Any such agreement shall specify the terms under which the 
Veterans' Administration and the physician or dentist may elect to 
terminate such agreement. 
"(3) Any amount of special pay payable under this section shall 
be paid in biweekly installments. 
(4) (A) Any physician or dentist who is employed in the Depart-
ment of Medicine and Surgery on or before the effective date of this 
section and who enters into an agreement under this section during the 
forty-five-day period beginning on the date of the enactment of the 
Veterans' Administration Physician and Dentist Pay Comparability 
Act of 1975 is entitled to special pay beginning on the effective date 
of this section. 
"(B) Any physician or dentist who becomes emploj'^ed in the 
Department of Medicine and Surgery after the effective date of this 
section and who enters into an agreement under this section before 
the close of the forty-five-day period beginning on the date of the 
enactment of the Veterans' Administration Physician and Dentist 
Pay Comparabilit}^ Act of 1975 is entitled to special pay beginning 
on the date on which the physician or dentist becomes employed. 
"(C) Any physician or dentist who becomes employed in the 
Department of Medicine and Surgeiy after the close of the forty-five-
day period beginning on the date of the enactment of the Veterans' 
Administration Physician and Dentist Pay Comparability Act of 
1975, or who does not enter into any agreement under this section 
before the close of such 45-day period, and who thereafter enters into 
an agreement under this section is entitled to special pay beginning on 
the date on which the agreement is entered into, or the date on which 
the physician or dentist be^comes employed, whichever date is later. 
"(f) Any additional compensation provided as special pay under 
this section shall not be considered as basic pay for the purposes of 
PUBLIC LAW 94-123—OCT. 22, 1975 
89 STAT. 673 
subchapter VI and section 5595 of chapter 55, chapter 81, 83, or 87 
of title 5, or other benefits related to basic pay.". 
(2) The table of sections at the beginning of chapter 73 of title 38, 
United States Code, is amended by inserting 
"4118. Special pay for physicians and dentists." 
immediately after 
"4117. Contracts foi* scarce medical specialist services.". 
SEC. 3. The Administrator of Veterans' Affairs shall submit a report 
each year to the Committees on Veterans' Affairs of the House of Rep-
resentatives and the Senate regarding the operation of the special 
pay program authorized by section 4118 of title 38, United States 
Code, as added by section 2(d) (1) of this Act. The report shall be on 
a fiscal year basis and shall contain— 
(1) a review of the program to date for the fiscal year during 
which the report is submitted and for such portion of the preced-
ing fiscal year as was not included in the previous annual report; 
and 
(2) any plan in connection with the program for the remainder 
of such fiscal year and for the succeeding fiscal year. 
This report shall be submitted no later than April 30 of each year. 
SEC. 4. (a) No later than August 31,1976, the Comptroller General 
of the United States and the Director of the Office of Management 
and Budget shall complete the following activities and shall each 
submit a report thereon to the Congress: 
(1) An investigation of the short-term and long-term prob-
lems facing the departments and agencies of the Federal Gov-
ernment (including the uniformed services) in recruiting and 
retaining qualified physicians and dentists. 
(2) An evaluation of the extent to which the implementation 
of a uniform system of pay, allowances, and benefits for all physi-
cians and dentists employed in such Federal departments and 
agencies would alleviate or solve such recruitment and retention 
problems. 
(3) An investigation and evaluation of such other solutions to 
such recruitment and retention problems as each deems appro-
priate. 
(4) On the basis of the investigations and evaluations required 
to be made under paragraphs (1), (2), and (3) of this subsection, 
(A) an identification of appropriate alternative suggested courses 
of legislative or administrative action (including proposed legis-
lation) and cost estimates therefor, which in the judgment of the 
Comptroller General or Director, as the case may he, will solve 
such recruitment and retention problems, and (B) a recommenda-
tion, and justification therefore, of which such course should be 
undertaken. 
(b) The reports required by subsection (a) of this section shall 
also include— 
(1) a comprehensive analysis of— 
(A) the existing laws and regulations relating to the 
employment of physicians and dentists by such departments 
and agencies of the Government, including an analysis of 
the various pay systems established pursuant to such laws, 
5 u s e 5551, 
8101, 8301, 
8701. 
Report to 
congressional 
committees. 
38 use 4118 
note. 
Reports to 
Congress. 
38 use 4118 
note. 
89 STAT. 674 
PUBLIC LAW 94-123—OCT. 22, 1975 
(B) the existing physician and dentist recruitment, selec-
tion, utilization, and promotion practices of such departments 
aind agencies, and 
(C) the degree to which the various pay systems referred 
to in subparagraph (A), the practices referred to in subpara-
graph (B), and other relevant departmental and agency 
practices are effective in alleviating or solving such recruit-
ment and retention problems; and 
(2) a comparison of the remuneration received by physicians 
and dentists employed by such departments and agencies with 
the remuneration received by physicians and dentists in private 
practice or academic medicine who have equivalent professional 
or administrative qualifications, based upon information avail-
able through medical, dental, and health associations and other 
available sources. 
Consultation. 
(c) In preparing their respective reports required by subsection 
(a) of this section, the Comptroller General and the Director of the 
Office of Management and Budget shall consult, to the maximum 
extent feasible, with each other as well as with the Administrator 
of Veterans' Affairs, the Secretary of Defense, the Secretary of Health, 
iEducation, and Welfare, the Chairman of the Civil Service Com-
mission, and the heads of other appropriate Federal departments and 
agencies. 
Report to 
(d) No later than March 1, 1977, the Comptroller General shall 
Congress. 
complete, and shall submit a report thereon to the Congress, a com-
prehensive investigation and analysis of recruitment and retention 
problems, both nationwide and geographically, of health care per-
sonnel other than physicians and dentists in the Department of 
Medicine and Surgery with respect to basic pay and premium and 
overtime pay rates. 
(e) The report required by subsection (d) of this section shall 
specify— 
(1) pay relationships which exist, both nationwide and geo-
graphically, between such personnel and similar employees of 
non-Federal health care facilities; 
(2) pay relationships which exist, both nationwide and geo-
graphically, among such personnel in the Department of Medicine 
and Surgery (including an analysis of the effect of differing pay 
systems); 
(3) the degree to which the pay relationships referred to in 
clauses (1) and (2) of this subsection create recruitment and 
retention or other personnel or related problems in the effective 
administration and achievement of the mission of the Department 
of Medicine and Surgery; 
(4) the degree to which existing title 38 and title 5, United 
States Code, authorities have been able to be exercised in a way 
adequate to deal with any such recruitment and retention and pay 
problems as to such personnel; and 
(5) (A) alternative suggested courses of legislative or admin-
istrative action (including proposed legislation) and cost esti-
mates therefor, which in the judgment of the Comptroller General 
will alleviate or solve any such recruitment and retention and pay 
problems, and (B) a recommendation, and justification therefor, 
of which such course should be undertaken. 
PUBLIC LAW 94-123—OCT. 22, 1975 
89 STAT. 675 
(f) In preparing the report required by subsection (d) of this sec-
tion, the Comptroller General shall consult with the Chief Medical 
Director of the Veterans' Administration and with the heads of other 
appropriate Federal departments and agencies. 
(g) The heads of all Federal departments and agencies shall fully 
cooperate with and respond expeditiously to all reasonable requests 
for information and assistance in connection with the preparation of 
the reports required by this section. 
(h) The Administrator of Veterans' Affairs shall submit to the 
appropriate Committees of the House of Representatives and the 
Senate reports, prepared by the Chief Medical Director, specifying 
the effect on the administration and achievement of the mission of 
the Department of Medicine and Surgery of the alternative courses 
and recommended course of action identified in the reports required 
by this section. Each such report shall be submitted no later than one 
hundred and twenty days after the date on which such other report 
in question is submitted to the Congress. 
SEC. 5. Chapter 73 of title 38, United States Code is amended as 
follows: 
(a) Clause (1) of section 4104 is amended to read as follows: 
"(1) 
Physicians, dentists, nurses, physicians' assistants, and 
expanded-duty dental auxiliaries;". 
(b) Section 4105 is amended by— 
(1) inserting at the end of subsection (a) the following new 
paragraph: 
"(8) Physicians' assistants and expanded-duty dental auxiliaries 
shall have such medical or dental and technical qualifications and 
experience as the Administrator shall prescribe."; and 
(2) striking out in subsection (b) "or nurse unless he" and 
inserting in lieu thereof "nurse, physicians' assistant, or expanded-
duty dental auxiliary unless such person". 
(c) Section 4106 is amended by adding at the end thereof the fol-
lowing new subsection: 
"(f) The provisions of this section shall apply to physicians' assist-
ants and expanded-duty dental auxiliaries.". 
(d) Section 4107 is amended by^— 
(1) inserting before the period at the end of the third sentence 
of paragraph (5) of subsection (e) a comma and "except as volun-
tarily requested in writing by the nurse in question"; and 
(2) inserting at the end thereof the following new subsection: 
"(f) Under standards which the Administrator shall prescribe in 
regulations, physicians' assistants and expanded-duty dental auxil-
iaries shall be compensated by use of Nurse Schedule grade titles and 
related pay ranges and shall be entitled to additional pay on the same 
basis as provided for nurses in paragraphs (2) through (8) of subsec-
tion (e) of this section.". 
(e) Section 4108 is amended by— 
(1) striking out in the language preceding clause (1) in subsec-
tion (a) "and nurses" and inserting in lieu thereof a comma and 
"nurses, physicians' assistants, and expanded-duty dental auxil-
iaries" ; and 
(2) striking out "or nurse" in the same language in such sub-
section and in clause (6) (B) thereof and inserting in lieu thereof 
Consultation. 
Agency 
cooperation. 
Report to 
congressional 
committees. 
38 
use 
4104. 
38 
use 
4105. 
38 
use 
4106. 
38 
use 
4107. 
38 
use 
4108. 
89 STAT. 676 
PUBLIC LAW 94-123—OCT. 22, 1975 
in each place "nurse, physicians' assistant, or expanded-duty 
dental auxiliary". 
Effective dates. 
SEC. 6. (a) (1) The amendments made by section 2 of this Act shall 
38 use 4118 
become effective on October 12,1975. 
note- 
(2) No agreement to provide special pay may be entered into pur-
suant to section 4118 of title 38, United States Code (as added by sec-
tion 2(d) (1) of this Act), after October 11, 1976. 
38 use 4104 
(b) Except as provided in subsection (a)(1) of this section, the 
note. 
amendments made by this Act shall become effective beginning the first 
pay period following thirty days after the date of the enactment of 
this Act. 
Approved October 22, 1975. 
LEGISLATIVE HISTORY: 
HOUSE REPORT No. 94-339 (Coram, on Veterans' Affairs). 
SENATE REPORT No. 94-325 accompanying S. 1711 (Coram, on Veterans' Affairs). 
CONGRESSIONAL RECORD, VoL 121 (1975): 
July 21, considered and passed House. 
Aug. 1, considered and passed Senate, amended, in lieu of S. 1711. 
Oct. 8, House concurred in Senate araendraent with an amendraent. 
Oct. 9, Senate concurred in House amendment.