VA Implements Competitive Pay, Other Advances in PA Practice

For Immediate Release
Jenni Roberson, 703.380.2764

ALEXANDRIA, Va. (October 9, 2020) – The American Academy of PAs (AAPA) applauds the United States Department of Veterans Affairs (VA) for releasing an updated PA Handbook which implements competitive pay for PAs along with other changes related to the PA profession that will modernize the VA’s qualification standards for PAs and expand access to care to our nation’s veterans.

The VA is the single largest employer of PAs in the U.S., employing more than 2,600 PAs. PAs are state-licensed medical providers who conduct physical exams, diagnose and treat illnesses, order and interpret tests, write prescriptions and perform medical procedures in nearly every practice setting and medical specialty. The PA profession has long been connected and committed to veterans and veterans’ healthcare. The first PA students previously served as Navy Corpsmen.

These changes to the VA’s PA Handbook were required as part of the VA Choice and Quality Employment Act of 2017, which was signed into law by the president on August 12, 2017.

The handbook provides details on how the VA will move to a pay system designed to ensure PAs receive locally competitive wages. The new system is expected to begin on October 18; thereafter, local facilities will begin the process of establishing local rates where necessary to ensure PAs are paid competitive wages. The new pay system will also improve the pay ladder for PAs at the VA by adding two additional levels that will apply to PAs in leadership and management positions. These changes were supported by a 2015 VA report that found starting pay for new PA graduates is typically 20 to 30% higher in the private sector than it is in the VA, which  made it challenging for the VA to recruit, hire, and retain PAs.

“Ensuring veterans have access to high-quality care is very important to the PA profession, and we are pleased that through these necessary updates to VA policy, PAs serving at the VA will now receive locally competitive wages that were previously only guaranteed to physicians and nurses,” said AAPA President and Chair of the Board Beth R. Smolko, DMSc, MMS, PA-C.

The handbook makes several significant changes related to PA practice at the VA, including removing the requirement for maintenance of NCCPA Certification and instead requiring state licensure from any state for PAs practicing at the VA who are not included within the old system. Approximately 98% of PAs practicing within the VA currently hold state licenses. PAs will continue to largely practice under a federal scope of practice at the VA previously established by the agency, and AAPA will continue to work with the Veterans Affairs PA Association (VAPAA) and PA leaders at the VA to move toward removing collaboration requirements with physicians.

“AAPA extends our gratitude to the leaders in Congress who were instrumental in making this progress – Senators Jon Tester (D-MT) and Jerry Moran (R-KS), and Representatives Annie Kuster (D-NH) and Jack Bergman (R-MI),” said Tillie Fowler, senior vice president of advocacy and government relations at AAPA. “We also thank the Administration for its support in ensuring the timely implementation of the VA Choice and Quality Employment Act.”

AAPA and VAPAA worked hard over many years to build Congressional support for competitive pay for PAs at the VA and to push the for the law to be implemented following its passage in 2017.

“The Veterans Affairs Physician Assistant Association is very proud of and greatly appreciates implementation of the new pay system. It will help address the pay disparity for PAs in the VA system, and thus improve the retention and recruitment of PAs at the VA,” said VAPAA Past President and Chair of the legislative committee Rubina DaSilva, PA-C. “Ultimately, this change is a win for veterans on many levels; it will improve access and quality of care for veterans.”


About the American Academy of PAs
AAPA is the national membership organization for all PAs. PAs are medical professionals who diagnose illness, develop and manage treatment plans, prescribe medications, and often serve as a patient’s principal healthcare provider. Learn more about the profession at and engage through Facebook, LinkedIn, Instagram, and Twitter.