HR 3400 — TRAVEL Act of 2025

changes in existing law made by 
the bill, as reported, are shown as follows (existing law 
proposed to be omitted is enclosed in black brackets, new 
matter is printed in italics, and existing law in which no 
change is proposed is shown in roman):

 TITLE 38, UNITED STATES CODE

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PART IV--GENERAL ADMINISTRATIVE PROVISIONS

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CHAPTER 55--MINORS, INCOMPETENTS, AND OTHER WARDS

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Sec. 5503. Hospitalized veterans and estates of incompetent 
 institutionalized veterans

 (a)(1)(A) Where any veteran having neither spouse nor child 
is being furnished domiciliary care by the Department, no 
pension in excess of $90 per month shall be paid to or for the 
veteran for any period after the end of the third full calendar 
month following the month of admission for such care.
 (B) Except as provided in subparagraph (D) of this 
paragraph, where any veteran having neither spouse nor child is 
being furnished nursing home care by the Department, no pension 
in excess of $90 per month shall be paid to or for the veteran 
for any period after the end of the third full calendar month 
following the month of admission for such care. Any amount in 
excess of $90 per month to which the veteran would be entitled 
but for the application of the preceding sentence shall be 
deposited in a revolving fund at the Department medical 
facility which furnished the veteran nursing care, and such 
amount shall be available for obligation without fiscal year 
limitation to help defray operating expenses of that facility.
 (C) No pension in excess of $90 per month shall be paid to 
or for a veteran having neither spouse nor child for any period 
after the month in which such veteran is readmitted for care 
described in subparagraph (A) or (B) of this paragraph and 
furnished by the Department if such veteran is readmitted 
within six months of a period of care in connection with which 
pension was reduced pursuant to subparagraph (A) or (B) of this 
paragraph.
 (D) In the case of a veteran being furnished nursing home 
care by the Department and with respect to whom subparagraph 
(B) of this paragraph requires a reduction in pension, such 
reduction shall not be made for a period of up to three 
additional calendar months after the last day of the third 
month referred to in such subparagraph if the Secretary 
determines that the primary purpose for the furnishing of such 
care during such additional period is for the Department to 
provide such veteran with a prescribed program of 
rehabilitation services, under chapter 17 of this title, 
designed to restore such veteran's ability to function within 
such veteran's family and community. If the Secretary 
determines that it is necessary, after such period, for the 
veteran to continue such program of rehabilitation services in 
order to achieve the purposes of such program and that the 
primary purpose of furnishing nursing home care to the veteran 
continues to be the provision of such program to the veteran, 
the reduction in pension required by subparagraph (B) of this 
paragraph shall not be made for the number of calendar months 
that the Secretary determines is necessary for the veteran to 
achieve the purposes of such program.
 (2) The provisions of paragraph (1) shall also apply to a 
veteran being furnished such care who has a spouse but whose 
pension is payable under section 1521(b) of this title. In such 
a case, the Secretary may apportion and pay to the spouse, upon 
an affirmative showing of hardship, all or any part of the 
amounts in excess of the amount payable to the veteran while 
being furnished such care which would be payable to the veteran 
if pension were payable under section 1521(c) of this title.
 (b) Notwithstanding any other provision of this section or 
any other provision of law, no reduction shall be made in the 
pension of any veteran for any part of the period during which 
the veteran is furnished hospital treatment, or institutional 
or domiciliary care, for Hansen's disease, by the United States 
or any political subdivision thereof.
 (c) Where any veteran in receipt of an aid and attendance 
allowance described in subsection (r) or (t) of section 1114 of 
this title is hospitalized at Government expense, such 
allowance shall be discontinued from the first day of the 
second calendar month which begins after the date of the 
veteran's admission for such hospitalization for so long as 
such hospitalization continues. Any discontinuance required by 
administrative regulation, during hospitalization of a veteran 
by the Department, of increased pension based on need of 
regular aid and attendance or additional compensation based on 
need of regular aid and attendance as described in subsection 
(l) or (m) of section 1114 of this title, shall not be 
effective earlier than the first day of the second calendar 
month which begins after the date of the veteran's admission 
for hospitalization. In case a veteran affected by this 
subsection leaves a hospital against medical advice and is 
thereafter admitted to hospitalization within six months from 
the date of such departure, such allowance, increased pension, 
or additional compensation, as the case may be, shall be 
discontinued from the date of such readmission for so long as 
such hospitalization continues.
 (d)(1) For the purposes of this subsection--
 (A) the term ``Medicaid plan'' means a State plan 
 for medical assistance referred to in section 1902(a) 
 of the Social Security Act (42 U.S.C. 1396a(a)); and
 (B) the term ``nursing facility'' means a nursing 
 facility described in section 1919 of such Act (42 
 U.S.C. 1396r), other than a facility that is a State 
 home with respect to which the Secretary makes per diem 
 payments for nursing home care pursuant to section 
 1741(a) of this title.
 (2) If a veteran having neither spouse nor child is covered 
by a Medicaid plan for services furnished such veteran by a 
nursing facility, no pension in excess of $90 per month shall 
be paid to or for the veteran for any period after the month of 
admission to such nursing facility.
 (3) Notwithstanding any provision of title XIX of the 
Social Security Act, the amount of the payment paid a nursing 
facility pursuant to a Medicaid plan for services furnished a 
veteran may not be reduced by any amount of pension permitted 
to be paid such veteran under paragraph (2) of this subsection.
 (4) A veteran is not liable to the United States for any 
payment of pension in excess of the amount permitted under this 
subsection that is paid to or for the veteran by reason of the 
inability or failure of the Secretary to reduce the veteran's 
pension under this subsection unless such inability or failure 
is the result of a willful concealment by the veteran of 
information necessary to make a reduction in pension under this 
subsection.
 (5)(A) The provisions of this subsection shall apply with 
respect to a surviving spouse having no child in the same 
manner as they apply to a veteran having neither spouse nor 
child.
 (B) The provisions of this subsection shall apply with 
respect to a child entitled to pension under section 1542 of 
this title in the same manner as they apply to a veteran having 
neither spouse nor child.
 (6) The costs of administering this subsection shall be 
paid for from amounts available to the Department of Veterans 
Affairs for the payment of compensation and pension.
 (7) This subsection expires on [November 30, 2031] December 
31, 2032.

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PART V--BOARDS, ADMINISTRATIONS, AND SERVICES

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 CHAPTER 74--VETERANS HEALTH ADMINISTRATION--PERSONNEL

 SUBCHAPTER I--APPOINTMENTS

Sec.
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7415. Traveling physicians.
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SUBCHAPTER I--APPOINTMENTS

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Sec. 7410. Additional pay authorities

 (a) In General.--(1) The Secretary may authorize the Under 
Secretary for Health to pay advance payments, recruitment or 
relocation bonuses, and [retention allowances] retention 
bonuses to 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,[,] or interview expenses to 
candidates for appointment as such personnel, in a manner 
consistent with the authority provided under sections 5524a, 
5706b, 5753, and 5754 of title 5.
 (2) Payments under paragraph (1) shall not be considered in 
calculating the limitation under section 7431(e)(4) of this 
title.
 (b) Special Incentive Pay for Department Pharmacist 
Executives.--(1) In order to recruit and retain highly 
qualified Department pharmacist executives, the Secretary may 
authorize the Under Secretary for Health to pay special 
incentive pay of not more than $40,000 per year to an 
individual of the Veterans Health Administration who is a 
pharmacist executive.
 (2) In determining whether and how much special pay to 
provide to such individual, the Under Secretary shall consider 
the following:
 (A) The grade and step of the position of the 
 individual.
 (B) The scope and complexity of the position of the 
 individual.
 (C) The personal qualifications of the individual.
 (D) The characteristics of the labor market 
 concerned.
 (E) Such other factors as the Secretary considers 
 appropriate.
 (3) Special incentive pay under paragraph (1) for an 
individual is in addition to all other pay (including basic 
pay) and allowances to which the individual is entitled.
 (4) Except as provided in paragraph (5), special incentive 
pay under paragraph (1) for an individual shall be considered 
basic pay for all purposes, including retirement benefits under 
chapters 83 and 84 of title 5, and other benefits.
 (5) Special incentive pay under paragraph (1) for an 
individual shall not be considered basic pay for purposes of 
adverse actions under subchapter V of this chapter.
 (6) Special incentive pay under paragraph (1) may not be 
awarded to an individual in an amount that would result in an 
aggregate amount of pay (including bonuses and awards) received 
by such individual in a year under this title that is greater 
than the annual pay of the President.

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Sec. 7415. Traveling physicians

 (a) In General.--(1) The Secretary may assign a physician 
appointed under section 7401 or section 7431 of this title to 
serve as a traveling physician for a period of not more than 
one year at a time. A physician assigned to serve as a 
traveling physician under this section may be assigned to 
provide health care to veterans residing in American Samoa, 
Guam, the Commonwealth of the Northern Mariana Islands, the 
Commonwealth of Puerto Rico, the Virgin Islands of the United 
States, or any other territory or possession of the United 
States at Department facilities or other approved facilities 
located in such territory or possession.
 (2) The Secretary may assign multiple physicians to serve 
as traveling physicians under this section and may assign each 
such physician to serve in a specific territory or possession.
 (b) Coordination of Care.--In providing care under this 
section, traveling physicians shall coordinate with non-
Department medical providers to the extent practicable and 
necessary to ensure high quality and coordinated care for 
veterans receiving hospital care and medical services.
 (c) Pay.--In addition to pay under section 7431 of this 
title, the Secretary shall provide a relocation or retention 
bonus to traveling physicians under this section. Such 
relocation or retention bonus shall be substantially similar to 
a relocation or retention bonus offered under section 7410(a) 
of this title, as the Secretary considers appropriate.

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 SUBCHAPTER III--PAY FOR PHYSICIANS, PODIATRISTS, OPTOMETRISTS, AND 
 DENTISTS

Sec. 7431. Pay

 (a) Elements of Pay.--Pay of physicians, podiatrists, 
optometrists, and dentists in the Veterans Health 
Administration shall consist of three elements as follows:
 (1) Base pay as provided for under subsection (b).
 (2) Market pay as provided for under subsection 
 (c).
 (3) Performance pay as provided under subsection 
 (d).
 (b) Base Pay.--One element of pay for physicians, 
podiatrists, optometrists, and dentists shall be base pay. Base 
pay shall meet the following requirements:
 (1) Each physician, podiatrist, optometrist and 
 dentist is entitled to base pay determined under the 
 Physician, Podiatrist, and Dentist Base and Longevity 
 Pay Schedule.
 (2) The Physician, Podiatrist, and Dentist Base and 
 Longevity Pay Schedule is composed of 15 rates of base 
 pay designated, from the lowest rate of pay to the 
 highest rate of pay, as base pay steps 1 through 15.
 (3) The rate of base pay payable to a physician, 
 podiatrist, optometrist or dentist is based on the 
 total number of the years of the service of the 
 physician, podiatrist, optometrist or dentist in the 
 Veterans Health Administration as follows:
 (4) At the same time as rates of basic pay are 
 increased for a year under section 5303 of title 5, the 
 Secretary shall increase the amount of base pay payable 
 under this subsection for that year by a percentage 
 equal to the percentage by which rates of basic pay are 
 increased under such section for that year.
 (5) The non-foreign cost of living adjustment 
 allowance authorized under section 5941 of title 5 for 
 physicians, podiatrists, optometrists, and dentists 
 whose pay is set under this section shall be determined 
 as a percentage of base pay only.
 (c) Market Pay.--One element of pay for physicians, 
podiatrists, optometrists, and dentists shall be market pay. 
Market pay shall meet the following requirements:
 (1) Each physician, podiatrist, optometrist and 
 dentist is eligible for market pay.
 (2) Market pay shall consist of pay intended to 
 reflect the recruitment and retention needs for the 
 specialty or assignment (as defined by the Secretary) 
 of a particular physician, podiatrist, optometrist or 
 dentist in a facility of the Department of Veterans 
 Affairs.
 (3) The annual amount of the market pay payable to 
 a physician, podiatrist, optometrist or dentist shall 
 be determined by the Secretary on a case-by-case basis.
 (4) The determination of the amount of market pay 
 of a physician, podiatrist, optometrist or dentist 
 shall take into account--
 (A) the level of experience of the 
 physician, podiatrist, optometrist or dentist 
 in the specialty or assignment of the 
 physician, podiatrist, optometrist or dentist;
 (B) the need for the specialty or 
 assignment of the physician, podiatrist, 
 optometrist or dentist at the medical facility 
 of the Department concerned;
 (C) the health care labor market for the 
 specialty or assignment of the physician, 
 podiatrist, optometrist or dentist, which may 
 cover any geographic area the Secretary 
 considers appropriate for the specialty or 
 assignment;
 (D) the board certifications, if any, of 
 the physician, podiatrist, optometrist or 
 dentist;
 (E) the prior experience, if any, of the 
 physician, podiatrist, optometrist or dentist 
 as an employee of the Veterans Health 
 Administration; and
 (F) such other considerations as the 
 Secretary considers appropriate.
 (5) The amount of market pay of a physician, 
 podiatrist, optometrist or dentist shall be evaluated 
 by the Secretary not less often than once every 24 
 months. The amount of market pay may be adjusted as the 
 result of an evaluation under this paragraph. A 
 physician, podiatrist, optometrist or dentist whose 
 market pay is evaluated under this paragraph shall 
 receive written notice of the results of such 
 evaluation in accordance with procedures prescribed 
 under section 7433 of this title. Such a notice shall 
 include a statement of whether the market pay will 
 increase, decrease, or remain unchanged following such 
 evaluation.
 (6) No adjustment of the amount of market pay of a 
 physician, podiatrist, optometrist or dentist under 
 paragraph (5) may result in a reduction of the amount 
 of market pay of the physician, podiatrist, optometrist 
 or dentist while in the same position or assignment at 
 the medical facility of the Department concerned, 
 unless there is a change in board certification or 
 reduction of privileges.
 (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 described in subparagraph (F) of 
 paragraph (4);
 (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 end of each 
 fiscal year, the Secretary shall submit to the 
 Committees on Veterans' Affairs of the Senate and the 
 House of Representatives a report that includes the 
 following:
 (A) A list of each facility and specialty 
 that conducted an evaluation of pay during the 
 period 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 have not conducted an evaluation of market 
 pay, pursuant to paragraph (5), during the 18-
 month-period that precedes the date of the 
 submission of such report.
 (d) Performance Pay.--(1) One element of pay for 
physicians, podiatrists, optometrists, and dentists shall be 
performance pay.
 (2) Performance pay shall be paid to a physician, 
podiatrist, optometrist or dentist on the basis of the 
physician's or dentist's achievement of specific goals and 
performance objectives prescribed by the Secretary.
 (3) The Secretary shall ensure that each physician, 
podiatrist, optometrist and dentist of the Department is 
advised of the specific goals or objectives that are to be 
measured by the Secretary in determining the eligibility of 
that physician, podiatrist, optometrist or dentist for 
performance pay.
 (4) The amount of the performance pay payable to a 
physician, podiatrist, optometrist or dentist may vary annually 
on the basis of individual achievement or attainment of the 
goals or objectives applicable to the physician, podiatrist, 
optometrist or dentist under paragraph (2).
 (5) The amount of performance pay payable to a physician, 
podiatrist, optometrist or dentist in a fiscal year shall be 
determined in accordance with regulations prescribed by the 
Secretary, but may not exceed the lower of--
 (A) $15,000; or
 (B) the amount equal to 7.5 percent of the sum of 
 the base pay and the market pay payable to such 
 physician, podiatrist, optometrist or dentist in that 
 fiscal year.
 (6) A failure to meet goals or objectives applicable to a 
physician, podiatrist, optometrist or dentist under paragraph 
(2) may not be the sole basis for an adverse personnel action 
against that physician, podiatrist, optometrist or dentist.
 (e) Requirements and Limitations on Total Pay.--(1)(A) Not 
less often than once every two years, the Secretary shall 
prescribe for Department-wide applicability the minimum and 
maximum amounts of annual pay that may be paid under this 
section to physicians and the minimum and maximum amounts of 
annual pay that may be paid under this section to podiatrists 
and dentists.
 (B) The Secretary may prescribe for Department-wide 
applicability under this paragraph separate minimum and maximum 
amounts of pay for a specialty or assignment. If the Secretary 
prescribes separate minimum and maximum amounts for a specialty 
or assignment, the Secretary may establish up to four tiers of 
minimum and maximum amounts for such specialty or assignment 
and prescribe for each tier a minimum amount and a maximum 
amount that the Secretary determines appropriate for the 
professional responsibilities, professional achievements, and 
administrative duties of the physicians, podiatrists, 
optometrists, or dentists (as the case may be) whose pay is set 
within that tier.
 (C) Amounts prescribed under this paragraph shall be 
published in the Federal Register, and shall not take effect 
until at least 60 days after the date of publication.
 (2) Except as provided in paragraph (3) and subject to 
paragraph (4), the sum of the total amount of the annual rate 
of base pay payable to a physician, podiatrist, optometrist or 
dentist under subsection (b) and the market pay determined for 
the physician, podiatrist, optometrist or dentist under 
subsection (c) may not be less than the minimum amount, nor 
more than the maximum amount, applicable to specialty or 
assignment of the physician, podiatrist, optometrist or dentist 
under paragraph (1).
 (3) The sum of the total amount of the annual rate of base 
pay payable to a physician, podiatrist, optometrist or dentist 
under subsection (b) and the market pay determined for the 
physician, podiatrist, optometrist or dentist under subsection 
(c) may exceed the maximum amount applicable to the specialty 
or assignment of the physician, podiatrist, optometrist or 
dentist under paragraph (1) as a result of an adjustment under 
paragraph (3) or (4) of subsection (b).
 (4) Except as provided in sections 7404A(c) and 7410(a)(2) 
of this title, in no case may the total amount of compensation 
paid to a physician, podiatrist, optometrist or dentist under 
this title in any year exceed the amount of annual compensation 
(excluding expenses) specified in section 102 of title 3.
 (5) 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] retention bonuses 
 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.
 (6)(A) The Secretary may waive any pay limitation described 
in this section (including tier limitations) that the Secretary 
determines necessary for the recruitment or retention of 
critical health care personnel whom the Secretary determines 
would provide direct patient care.
 (B) Priority for such waivers shall be given for positions, 
locations, and care provided through agreements that are costly 
to the Department.
 (C) 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 under subparagraph (A).
 (D) During the period the authority under subparagraph (A) 
is effective, the Secretary may not issue more than 300 waivers 
under such subparagraph.
 (E) The Secretary may prescribe requirements, limitations, 
and other considerations for waivers under such subparagraph.
 (F) Not later than 180 days after the date of the enactment 
of the Senator Elizabeth Dole 21st Century Veterans Healthcare 
and Benefits Improvement 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 (C);
 (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 care 
 furnished by the Department pursuant to an 
 agreement regarding the geographic area; 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.
 (G) The authority of the Secretary under subparagraph (A) 
shall terminate on the last day of the third full fiscal year 
following the date of the enactment of the Senator Elizabeth 
Dole 21st Century Veterans Healthcare and Benefits Improvement 
Act.
 (f) Treatment of Pay.--Pay under subsections (b) and (c) of 
this section shall be considered pay for all purposes, 
including retirement benefits under chapters 83 and 84 of title 
5 and other benefits.
 (g) Ancillary Effects of Decreases in Pay.--(1) A decrease 
in pay of a physician, podiatrist, optometrist or dentist 
resulting from an adjustment in the amount of market pay of the 
physician, podiatrist, optometrist or dentist under subsection 
(c) shall not be treated as an adverse action.
 (2) If the pay of a physician, podiatrist, optometrist or 
dentist is reduced under this subchapter as a result of an 
involuntary reassignment in connection with a disciplinary 
action taken against the physician, podiatrist, optometrist or 
dentist, the involuntary reassignment shall be subject to 
appeal under subchapter V of this chapter.
 (h) Delegation of Responsibilities.--The Secretary may 
delegate to an appropriate officer or employee of the 
Department any responsibility of the Secretary under subsection 
(c), (d), or (e) except for the responsibilities of the 
Secretary under subsection (e)(1).

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