[Federal Register Volume 88, Number 102 (Friday, May 26, 2023)]
[Notices]
[Pages 34234-34235]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2023-11306]


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DEPARTMENT OF VETERANS AFFAIRS


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

AGENCY: Department of Veterans Affairs.

ACTION: Notice.

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SUMMARY: VA hereby gives notice of the annual pay ranges, which are the 
sum of the base pay rate and market pay for VHA physicians, dentists 
and podiatrists as prescribed by the VA 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: The annual pay ranges are applicable July 30, 2023.

FOR FURTHER INFORMATION CONTACT: Ophelia A. Vicks, Executive Director 
of Human Capital Policies, Office of the Chief Human Capital Officer 
(05), Department of Veterans Affairs, 810 Vermont Avenue NW, 
Washington, DC 20420, 202-461-7765. 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. Per 
38 U.S.C. 7431(e)(1)(B), the Secretary is allowed 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 subsection 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 section 
7431(e)(4), the total amount of compensation includes base pay, market 
pay, performance pay, and fee basis earnings, but excludes recruitment, 
relocation and retention incentives \1\ and awards for performance and 
superior accomplishments from total compensation calculations.
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    \1\ In accordance with Title IX, 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 awards 
for performance and superior accomplishments, shall not be 
considered in calculating the limitation under 38 U.S.C. 7431(e)(4).
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Background

    The Department of Veterans Affairs Health Care Personnel 
Enhancement Act of 2004, Public Law 108-445, was signed by the 
President on December 3, 2004. The major provisions of the law 
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 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 this amendment, podiatrists are also 
subject to the same limitations and requirements as physicians and 
dentists under section 7431.
    VA will be reducing the number of pay tables from 6 to 5 by 
consolidating pay tables 3 and 4. Pay tables 1, 2 and 3 will cover the 
clinical specialties, and pay tables 4 and 5 will cover executive 
assignments. The maximum amount for the newly combined pay table 3 will 
remain unchanged as described in the 2016 Federal Register publication. 
However, there have been changes to the minimum and maximum amounts for 
pay tables 1, 2 and 5.

Discussion

    VA identified and utilized salary survey data sources that most 
closely represent VA comparability in practice setting, employment, 
environment and hospital/health care system. 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 when constructing annual pay ranges to accommodate the more 
than 40 specialties that currently exist in the VA system. This allows 
VA to use multiple sources that yield high numbers of salary data which 
help minimize disparities and aberrations that may surface from data 
involving smaller numbers for comparison and from sample changes year-
to-year. By aggregating multiple survey sources into like groupings, 
greater confidence exists that the average compensation reported is 
truly representative. Additionally, the aggregation of data provides 
for a substantial sample size to provide vast pay ranges with maximum 
flexibility 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 salary are at a 
level that accommodate special employment situations, from fellowships 
and medical research career development awards to Nobel Laureates, 
high-cost areas and internationally renowned clinicians. The second 
principle is to provide ranges large enough to accommodate career 
progression, geographic differences,

[[Page 34235]]

sub-specialization and other special factors.
    Clinical specialties were reviewed against available relevant 
private sector data. The specialties are grouped into three (formerly 
four) clinical pay ranges that reflect comparable complexity in salary, 
recruitment and retention considerations. The Steering Committee 
recommendations included consolidating former pay tables 3 and 4; 
designating three clinical pay ranges (pay tables 1, 2 and 3) for the 
varying clinical specialties; and designating pay tables 4 and 5 for 
executive assignments. The Steering Committee also recommends adding 
new and realigning existing specialties to different clinical pay 
ranges, as well as changes to the minimum and maximum pay ranges.
    VHA organizational improvement is focused on making operational 
improvements by redesigning VHA Central Office (VHACO); revising its 
governance functions; and creating integrated clinical communities. 
Additionally, as part of the VHACO organizational improvement and for 
consistency with the position titles outlined in 38 U.S.C. 7306, VHA is 
modifying titles for a senior-level physician, dentist and podiatrist 
leaders assigned to pay table 5 (formerly 6) of the VHA physician, 
dentist, and podiatrist pay system. The new structure clarifies office 
roles and streamlines responsibilities to eliminate fragmentation, 
overlap and duplication. It also allows VHA to be more agile and 
respond to changes and make decisions more quickly, positioning VHA to 
better support the Veteran Integrated Services Networks and facilities 
directly serving Veterans.
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    \2\ Tier 1 and Tier 2 Minimums for Pay Tables 1 and 2 reflect 
the statutory minimum rate of pay for this pay system in accordance 
with Schedule 3 of the President's Executive Order 14090, 
Adjustments of Certain Rates of Pay, dated December 23, 2022.
    \3\ Tier 1 Minimum for Pay Table 3 reflects the statutory 
minimum rate of pay for this pay system in accordance with Schedule 
3 of the President's Executive Order 14090, Adjustments of Certain 
Rates of Pay, dated December 23, 2022.
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    Denis McDonough, Secretary of Veterans Affairs, approved this 
document on May 19, 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.

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                  Tier level                      Minimum      Maximum
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                     Pay Table 1--Clinical Specialty
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Tier 1........................................          \2\     $243,000
                                                   $115,587
Tier 2........................................      115,587      260,000
Tier 3........................................      120,000      280,340
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                Pay Table 1--Covered Clinical Specialties
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Endocrinology; Family Medicine; General Practice--Dentistry; Internal
 Medicine; Palliative Care; Podiatry (General); Preventive Medicine;
 Primary Care; Prosthodontics; Rheumatology; All other specialties or
 assignments............................................................
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                     Pay Table 2--Clinical Specialty
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Tier 1........................................     $115,587     $300,000
Tier 2........................................      115,587      320,000
Tier 3........................................      130,000      336,000
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                Pay Table 2--Covered Clinical Specialties
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Allergy and Immunology; Endodontics; Geriatrics; Health Informatics;
 Hospitalist; Infectious Diseases; Neurology; Nocturnist; Periodontics;
 Physical Medicine and Rehabilitation/Spinal Cord Injury; Podiatry
 (surgery--forefoot, rearfoot/ankle, advanced rearfoot/ankle);
 Psychiatry; Sleep Medicine.............................................
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                     Pay Table 3--Clinical Specialty
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Tier 1........................................          \3\     $400,000
                                                   $115,587
Tier 2........................................      120,000      400,000
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                Pay Table 3--Covered Clinical Specialties
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Anatomic Pathology; Anesthesiology; Cardiology (invasive/non-
 interventional); Cardiology (non-invasive); Cardio-Thoracic Surgery;
 Critical Care; Dermatology; Dermatology Mohs (a micrographic surgery)-
 ; 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 and non-operating room anesthesiology); Pain Management
 (physical medicine and rehabilitation); Pathology; Plastic Surgery;
 Pulmonary; Radiology (diagnostic); Radiation Oncology; Urology;
 Vascular Surgery.......................................................
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     Pay Table 4--Chief of Staff and Network Chief Medical Officers
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Tier 1........................................     $150,000     $400,000
Tier 2........................................      147,000      375,000
Tier 3........................................      145,000      350,000
Tier 4........................................      140,000      325,000
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                    Pay Table 4--Covered Assignments
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VHA Chiefs of Staff and Network Chief Medical Officers Tier assignments
 for Chiefs of Staff are based on published facility complexity level.
 Tier 1--Network Chief Medical Officer and Chief of Staff--Complexity
 Levels 1a and 1b. Tier 2--Chief of Staff--Complexity Levels 1c and 2.
 Tier 3--Chief of Staff--Complexity Level 3 and facilities with no
 designation level. Tier 4--Deputy Network Chief Medical Officer and
 Deputy Chief of Staff..................................................
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                   Pay Table 5--Executive Assignments
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Tier 1........................................     $145,000     $310,000
Tier 2........................................      145,000      295,000
Tier 3........................................      145,000      285,000
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                    Pay Table 5--Covered Assignments
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The Deputy Under Secretary for Health; Assistant Under Secretaries for
 Health; Associate Deputy Under Secretary for Health; Assistant Deputy
 Under Secretary for Health; Chief Officers (VHACO); Network Directors;
 Medical Center Directors; Executive Directors (VHACO); Deputy to the
 Assistant Under Secretaries for Health; Chief Consultants (VHACO);
 Deputy Chief Officers (VHACO); Deputy Chief Consultants (VHA CO);
 Deputy to the Executive Directors (VHACO); and VHACO physicians,
 dentists or podiatrists (non-senior executive service equivalents) with
 an administrative/executive role for more than 50% of their full-time
 equivalent employees...................................................
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Signing Authority

Luvenia Potts,
Regulation Development Coordinator, Office of Regulation Policy & 
Management, Office of General Counsel, Department of Veterans Affairs.
[FR Doc. 2023-11306 Filed 5-25-23; 8:45 am]
BILLING CODE 8320-01-P