President Joseph Biden signed the bipartisan VA Nurse and PA Retention and Income Security Enhancement (RAISE) Act into law on March 15, 2022, increasing the pay limitation on salaries for nurses, advanced practice registered nurses (APRNs), and PAs employed within the VA. The act is part of the omnibus appropriations bill (HR 2471) passed by Congress to fund the federal government through the end of the 2022 fiscal year.

These advanced practice providers were 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 Physician Associates (AAPA). The RAISE Act changes the maximum rate of basic pay for PAs and NPs from level V to level I in the Executive Schedule. For nurses, the maximum rate of basic pay changes to level II under the act.

“AAPA applauds Congress for including the RAISE Act in the omnibus appropriations bill,” said AAPA President and Chair of the Board of Directors Jennifer M. Orozco, MMS, PA-C, DFAAPA. “The VA is the largest employer of PAs, and enactment of this legislation will allow the VA to offer more competitive salaries to PAs and increase veterans’ access to high-quality, timely care at VA medical facilities.”

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The previous pay caps impeded competition in the marketplace in high-salary areas and prevented the VA from recruiting and retaining PAs and other high-quality health care providers, according to a statement from AAPA. Passage of the RAISE Act will help address the health care professional shortage by allowing the VA to offer more competitive salaries in high-salary areas, the AAPA said.

Omnibus Appropriations Bill (HR 2471)

The omnibus bill also included provisions extending certain telehealth flexibilities and provisions for 151 days beyond the end of the COVID-19 public health emergency (PHE), which currently expires on April 16 but is expected to be extended until at least July 16.

The bill will temporarily extend telehealth flexibilities issued during the PHE that removed geographic restrictions allowing Medicare beneficiaries to receive telehealth services in their homes, in nonrural communities, and through audio-only communication. For 151 days after the end of the PHE, the bill also delays implementation of a requirement for health professionals to have an in-person visit with a beneficiary before conducting certain mental health services through telecommunication technology.

AAPA supports a permanent extension of these flexibilities.

Representatives Lauren Underwood (D-IL) and David Joyce (R-OH) introduced the bill in the House of Representatives and Senators Richard Blumenthal (D-CT) and Mazie Hirono (D-HI) introduced the legislation in the Senate.


1. Consolidated Appropriations Act, 2022, HR 2471, 117th Congress (2021-2022). March 15, 2022. Accessed March 29, 2022.

2. AAPA-championed VA nurse and PA Retention and Income Security Enhancement (RAISE) act signed into law. American Academy of Physician Associates. March 15, 2022. Accessed March 29, 2022.