A new legislation introduced by Congresswoman Lauren Underwood and co-led by Representative David P. Joyce, the co-chair of the Congressional Nursing Caucus, addresses the health care professional shortage in the Department of Veterans Affairs (VA) by increasing maximum pay rates for advanced practice providers.

The bipartisan VA Nurse and Physician Assistant RAISE Act aims to increase the pay limitation on salaries for nurses, advanced practice registered nurses (APRNs), and PAs  employed within the VA to “attract and retain top health care talent to ensure veterans receive timely, high-quality care,” according to a statement by Underwood.

The RAISE Act would change the maximum rate of basic pay for PAs and NPs from level V to level I in the Executive Schedule. Currently, these advanced practice providers are subject to an overall pay cap set to level V of the Executive Schedule, or $161,700 in fiscal year 2021, according to a statement from the American Academy of PAs (AAPA). For nurses, the maximum rate of basic pay would change to level II under the act.

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Currently, PAs and NPs comprise nearly 50% of the primary care workforce at the VA. Action should be taken “to ensure the VA is able to recruit and retain the clinical workforce that the Department needs to provide our veterans with the timely, high-quality care they have earned, no matter where they live,” Underwood said.

AAPA Supports the RAISE Act

The implementation of the RAISE Act is being fully supported by the AAPA. “On behalf of more than 150,000 PAs in the US including the 2650 PAs currently employed full-time by the VA, AAPA would like to thank Representatives Lauren Underwood and David Joyce for their leadership in introducing the RAISE Act,” said AAPA President and Chair of the Board of Directors Jennifer M. Orozco, MMS, PA-C, DFAAPA. “Enactment of this legislation will adjust the salary cap on PAs and allow the VA to offer more competitive salaries to this essential group of providers. AAPA strongly supports this legislation to increase veterans’ access to high-quality, timely care at VA medical facilities.”

“Importantly, this change in the Executive Schedule more accurately reflects the professional responsibility and level of care that PAs provide as front-line and often principal health care providers for patients at VA medical facilities,” the AAPA wrote. The increase in maximum pay rate would ensure that salaries are “competitive with private sector healthcare providers, especially in higher salary locations.”

AAPA also noted that this legislation is especially important during the ongoing COVID-19 pandemic that continues to put stress on the nation’s health care infrastructure.

As the model of primary care in the US continues to evolve from a traditional physician model to a patient-centric model, and as roles and responsibilities of PAs and other health care workers are expanding to meet the needs of an aging population, “it is vital for the VA to attract and retain a robust PA workforce,” the AAPA wrote.


1. Underwood works to ensure veterans receive world-class care; introduces legislation to address Department of Veterans Affairs nurse and physician assistant shortage. News release. October 12, 2021. Accessed October 13, 2021. https://underwood.house.gov/media/press-releases/underwood-works-ensure-veterans-receive-world-class-care-introduces-legislation

2. American Academy of PAs. Statement for the record submitted to the committee on Veterans Affairs, subcommittee on Health US House of Representatives October 13, 2021 on behalf of the American Academy of PAs. Accessed October 13, 2021. https://docs.house.gov/meetings/VR/VR03/20211013/114119/HHRG-117-VR03-20211013-SD015-U2.pdf