This might be of some interest to my fellow future military docs. Congress has signed into law fairly substantial multi-year special pay cielings, incentive special pay cielings, and retention bonuses. As of yet it remains an unfunded mandate.
From US Medicine
December 2002
Military Health Bonus Pays Raised In Bill - Matt Pueschel
WASHINGTON-Congress passed legislation last month that would raise the ceilings of several military health professional bonus pays.
The Conference Report of the FY 2003 National Defense Authorization Act (H.R. 4546) was approved by the House and Senate in mid-November, and included both House and Senate previously proposed provisions for bonus pays as long as those who are eligible serve for any 12-month period beginning after FY '02. The bill was delivered to the President in late November for his signature.
Under section 615 of the conference report, the House/Senate conferees increased the maximum rates of muti-year retention bonuses for certain medical officers and dentists from $14,000 to $50,000; the maximum rates of special pay for nurse anesthetists from $15,000 to $50,000; the maximum rate of incentive special pay for medical officers from $36,000 to $50,000; the maximum level of accession bonuses for registered nurses from $5,000 to $30,000; the maximum annual special pay for pharmacy officers from $12,000 to $15,000; and the maximum retention special pay for optometrists from $6,000 to $15,000. The conferees also increased the maximum accession bonuses for nurse officer candidates to $10,000 and their maximum monthly stipend to $1,000.
In section 618 of the conference report, the conferees accepted the House's original provision to amend the Critical Skills Retention Bonus (CSRB) awarding criteria for certain health care professionals to allow exceptions to the limits on bonus amounts and years of service for bonuses paid. Previously, the law limited the total amount a military physician could receive under the CSRB to $200,000 over the course of his or her military career, but not past 25 years, according to a House staff member. Section 618 sets no dollar or service year limits for DoD if they find it necessary to pay extra to keep qualified military physicians in certain critical skills. "It's a flexible tool with no dollar limits for the CSRB," the staff member said.
The new provision only requires DoD to notify Congress 90 days in advance when they design a new CSRB program (See sidebar for the Department of Defense Health Affairs currently proposed CSRB plan).
Funding Paucity
However since the FY '03 Defense appropriations bill passed in October did not include funding for these newly authorized medical special pay ceiling increases (pending Presidential approval) under sections 615 and 618 of the new bill, it's possible that significant funds to cover the provisions may not be garnered for another couple of years. "Although the NDAA [National Defense Authorization Act] has authorized increases to each of the special pays, it did not appropriate any additional moneys to cover the bill," an Air Force surgeon general spokesperson told U.S. MEDICINE. "The next step in the process is for [the] DoD special pays working group to determine where critical shortages justify an increase in a special pay and set the FY '04 rates and project FY '05 and '06 rates. Because each service will need to POM [Program Objective Memorandum tool used to budget in outyears] for the money, we are looking at FY '05 before a significant increase in special pays [is seen]. We are requesting that P&R [Office of the Secretary of Defense Progams and Resources] issue a directive to each service to POM for the increases, rather than relying on each service deciding whether to POM or not. We still need to use short term fixes for the next two years unless Congress should appropriate increased funds to cover the increased spcial pay bills."
However, a Congressional staff member told U.S. MEDICINE that if DoD officials find the new bonus ceilings to be worthwhile enough to try to fund them this year, they could try to partially fund them at a feasible increase somewhere underneath the new limit, or ask for additional money later in a supplemental bill. According to a House Armed Services Committee staff member, the special pay ceiling increases in the bill are discretionary, so the services can choose whether or not to fund it this fiscal year if they can find the funds for it.
Conference Agreement
In reaching an agreement on the conference report, the House and Senate conferees accepted all provisions the two sides had previously proposed with an additional increase in one of new the pay ceilings.
The original Senate version of the bill had proposed an increase in the maximum multi-year retention bonus from $14,000 to $25,000 a year. The conferees not only accepted this provision, but decided to bump the increase up to $50,000.
The other original Senate provision called for an increase in the maximum incentive special pay for medical officers from $36,000 to $50,000 a year, which was accepted as is. The orginal House provision called for exceptions to be granted to the limitation on maximum bonus amounts for healthcare providers qualified in a critical military health skill and exceptions to the years of service limitation for medical officers, which was accepted as section 618 in the conference report.
The conferees also added in bonus pay ceiling increases for four other healthcare professional specialties.
A Congressional staff member told U.S. MEDICINE that the House expects DoD to implement the ceiling increases over time.
From US Medicine
December 2002
Military Health Bonus Pays Raised In Bill - Matt Pueschel
WASHINGTON-Congress passed legislation last month that would raise the ceilings of several military health professional bonus pays.
The Conference Report of the FY 2003 National Defense Authorization Act (H.R. 4546) was approved by the House and Senate in mid-November, and included both House and Senate previously proposed provisions for bonus pays as long as those who are eligible serve for any 12-month period beginning after FY '02. The bill was delivered to the President in late November for his signature.
Under section 615 of the conference report, the House/Senate conferees increased the maximum rates of muti-year retention bonuses for certain medical officers and dentists from $14,000 to $50,000; the maximum rates of special pay for nurse anesthetists from $15,000 to $50,000; the maximum rate of incentive special pay for medical officers from $36,000 to $50,000; the maximum level of accession bonuses for registered nurses from $5,000 to $30,000; the maximum annual special pay for pharmacy officers from $12,000 to $15,000; and the maximum retention special pay for optometrists from $6,000 to $15,000. The conferees also increased the maximum accession bonuses for nurse officer candidates to $10,000 and their maximum monthly stipend to $1,000.
In section 618 of the conference report, the conferees accepted the House's original provision to amend the Critical Skills Retention Bonus (CSRB) awarding criteria for certain health care professionals to allow exceptions to the limits on bonus amounts and years of service for bonuses paid. Previously, the law limited the total amount a military physician could receive under the CSRB to $200,000 over the course of his or her military career, but not past 25 years, according to a House staff member. Section 618 sets no dollar or service year limits for DoD if they find it necessary to pay extra to keep qualified military physicians in certain critical skills. "It's a flexible tool with no dollar limits for the CSRB," the staff member said.
The new provision only requires DoD to notify Congress 90 days in advance when they design a new CSRB program (See sidebar for the Department of Defense Health Affairs currently proposed CSRB plan).
Funding Paucity
However since the FY '03 Defense appropriations bill passed in October did not include funding for these newly authorized medical special pay ceiling increases (pending Presidential approval) under sections 615 and 618 of the new bill, it's possible that significant funds to cover the provisions may not be garnered for another couple of years. "Although the NDAA [National Defense Authorization Act] has authorized increases to each of the special pays, it did not appropriate any additional moneys to cover the bill," an Air Force surgeon general spokesperson told U.S. MEDICINE. "The next step in the process is for [the] DoD special pays working group to determine where critical shortages justify an increase in a special pay and set the FY '04 rates and project FY '05 and '06 rates. Because each service will need to POM [Program Objective Memorandum tool used to budget in outyears] for the money, we are looking at FY '05 before a significant increase in special pays [is seen]. We are requesting that P&R [Office of the Secretary of Defense Progams and Resources] issue a directive to each service to POM for the increases, rather than relying on each service deciding whether to POM or not. We still need to use short term fixes for the next two years unless Congress should appropriate increased funds to cover the increased spcial pay bills."
However, a Congressional staff member told U.S. MEDICINE that if DoD officials find the new bonus ceilings to be worthwhile enough to try to fund them this year, they could try to partially fund them at a feasible increase somewhere underneath the new limit, or ask for additional money later in a supplemental bill. According to a House Armed Services Committee staff member, the special pay ceiling increases in the bill are discretionary, so the services can choose whether or not to fund it this fiscal year if they can find the funds for it.
Conference Agreement
In reaching an agreement on the conference report, the House and Senate conferees accepted all provisions the two sides had previously proposed with an additional increase in one of new the pay ceilings.
The original Senate version of the bill had proposed an increase in the maximum multi-year retention bonus from $14,000 to $25,000 a year. The conferees not only accepted this provision, but decided to bump the increase up to $50,000.
The other original Senate provision called for an increase in the maximum incentive special pay for medical officers from $36,000 to $50,000 a year, which was accepted as is. The orginal House provision called for exceptions to be granted to the limitation on maximum bonus amounts for healthcare providers qualified in a critical military health skill and exceptions to the years of service limitation for medical officers, which was accepted as section 618 in the conference report.
The conferees also added in bonus pay ceiling increases for four other healthcare professional specialties.
A Congressional staff member told U.S. MEDICINE that the House expects DoD to implement the ceiling increases over time.
