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42 U.S.C. § 211a — Promotion of commissioned officers
Federal law — U.S. Code and appendices · legal_authorities
**(a) Permanent or temporary promotions; examination** Promotions of officers of the Regular Corps to any grade up to and including the director grade shall be either permanent promotions based on length of service, other permanent promotions to fill vacancies, or temporary promotions. Permanent promotions shall be made by the President, and temporary promotions shall be made by the President. Each permanent promotion shall be to the next higher grade, and shall be made only after examination given in accordance with regulations of the President.
**(b) Promotion to certain grades only to fill vacancies; regulations; “restricted grade” defined** The President may by regulation provide that in a specified professional category permanent promotions to the senior grade, or to both the full grade and the senior grade, shall be made only if there are vacancies in such grade. A grade in any category with respect to which such regulations have been issued is referred to in this section as a “restricted grade”.
**(c) Examinations** Examinations to determine qualification for permanent promotions may be either noncompetitive or competitive, as the Surgeon General shall in each case determine; except that examinations for promotions to the assistant or senior assistant grade shall in all cases be noncompetitive. The officers to be examined shall be selected by the Surgeon General from the professional category, and in the order of seniority in the grade, from which promotion is to be recommended. In the case of a competitive examination the Surgeon General shall determine in advance of the examination the number (which may be one or more) of officers who, after passing the examination, will be recommended to the President for promotion; but if the examination is one for promotio
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Source location: Title 42, Chapter 6A, § 211a; chapter-6a-public-health-service.md
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**(a) Permanent or temporary promotions; examination** Promotions of officers of the Regular Corps to any grade up to and including the director grade shall be either permanent promotions based on length of service, other permanent promotions to fill vacancies, or temporary promotions. Permanent promotions shall be made by the President, and temporary promotions shall be made by the President. Each permanent promotion shall be to the next higher grade, and shall be made only after examination given in accordance with regulations of the President.
**(b) Promotion to certain grades only to fill vacancies; regulations; “restricted grade” defined** The President may by regulation provide that in a specified professional category permanent promotions to the senior grade, or to both the full grade and the senior grade, shall be made only if there are vacancies in such grade. A grade in any category with respect to which such regulations have been issued is referred to in this section as a “restricted grade”.
**(c) Examinations** Examinations to determine qualification for permanent promotions may be either noncompetitive or competitive, as the Surgeon General shall in each case determine; except that examinations for promotions to the assistant or senior assistant grade shall in all cases be noncompetitive. The officers to be examined shall be selected by the Surgeon General from the professional category, and in the order of seniority in the grade, from which promotion is to be recommended. In the case of a competitive examination the Surgeon General shall determine in advance of the examination the number (which may be one or more) of officers who, after passing the examination, will be recommended to the President for promotion; but if the examination is one for promotions based on length of service, or is one for promotions to fill vacancies other than vacancies in the director grade or in a restricted grade, such number shall not be less than 80 per centum of the number of officers to be examined.
**(d) Permanent promotions to qualified officers on length of service** Officers of the Regular Corps, found pursuant to subsection (c) to be qualified, shall be given permanent promotions based on length of service, as follows:
(1) Officers in the warrant officer (W–1) grade, chief warrant officer (W–2) grade, chief warrant officer (W–3) grade, chief warrant officer (W–4) grade, and junior assistant grade shall be promoted at such times as may be prescribed in regulations of the President.
(2) Officers with permanent rank in the assistant grade, the senior assistant grade, and the full grade shall (except as provided in regulations under subsection (b)) be promoted after completion of three, ten, and seventeen years, respectively, of service in grades above the junior assistant grade; and such promotions, when made, shall be effective, for purposes of pay and seniority in grade, as of the day following the completion of such years of service. An officer with permanent rank in the assistant, senior assistant, or full grade who has not completed such years of service shall be promoted at the same time, and his promotion shall be effective as of the same day, as any officer junior to him in the same grade in the same professional category who is promoted under this paragraph.
**(e) Promotion of professional category officers to fill certain vacancies** Officers in a professional category of the Regular Corps, found pursuant to subsection (c) to be qualified, may be given permanent promotions to fill any or all vacancies in such category in the senior assistant grade, the full grade, the senior grade, or the director grade; but no officer who has not had one year of service with permanent or temporary rank in the next lower grade shall be promoted to any restricted grade or to the director grade.
**(f) Reexamination upon failure of promotion; effective date of promotion** If an officer who has completed the years of service required for promotion to a grade under paragraph (2) of subsection (d) fails to receive such promotion, he shall (unless he has already been twice examined for promotion to such grade) be once reexamined for promotion to such grade. If he is thereupon promoted (otherwise than under subsection (e)), the effective date of such promotion shall be one year later than it would have been but for such failure. Upon the effective date of any permanent promotion of such officer to such grade, he shall be considered as having had only the length of service required for such promotion which he previously failed to receive.
**(g) Separation from service upon failure of promotion** If, for reasons other than physical disability, an officer of the Regular Corps in the warrant officer (W–1) grade or junior assistant grade is found pursuant to subsection (c) not to be qualified for promotion he shall be separated from the Service. If, for reasons other than physical disability, an officer of the Regular Corps in the chief warrant officer (W–2), chief warrant officer (W–3), assistant, senior assistant, or full grade, after having been twice examined for promotion (other than promotion to a restricted grade), fails to be promoted—
(1) if in the chief warrant officer (W–2) or assistant grade he shall be separated from the Service and paid six months’ basic pay and allowances;
(2) if in the chief warrant officer (W–3) or senior assistant grade he shall be separated from the Service and paid one year’s basic pay and allowances;
(3) if in the full grade he shall be considered as not in line for promotion and shall, at such time thereafter as the Surgeon General may determine, be retired from the Service with retired pay (unless he is entitled to a greater amount by reason of another provision of law)—
(A) in the case of an officer who first became a member of a uniformed service before September 8, 1980, at the rate of 2½ percent of the retired pay base determined under [section 1406(h) of title 10](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title10-section1406/h&num=0&edition=prelim) for each year, not in excess of 30, of his active commissioned service in the Service; or
(B) in the case of an officer who first became a member of a uniformed service on or after September 8, 1980, at the rate determined by multiplying—
(i) the retired pay base determined under [section 1407 of title 10](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title10-section1407&num=0&edition=prelim); by
(ii) the retired pay multiplier determined under section 1409 of such title for the number of years of his active commissioned service in the Service.
**(h) Separation from service upon refusal to stand examination** If an officer of the Regular Corps, eligible to take an examination for promotion, refuses to take such examination, he may be separated from the Service in accordance with regulations of the President.
**(i) Review of record; separation from service** At the end of his first three years of service, the record of each officer of the Regular Corps originally appointed to the senior assistant grade or above, shall be reviewed in accordance with regulations of the President and, if found not qualified for further service, he shall be separated from the Service and paid six months’ pay and allowances.
**(j) Determination of order of seniority**
(1) The order of seniority of officers in a grade in the Regular Corps shall be determined, subject to the provisions of paragraph (2) of this subsection, by the relative length of time spent in active service after the effective date of each such officer’s original appointment or permanent promotion to that grade. When permanent promotions of two or more officers to the same grade are effective on the same day, their relative seniority shall be the same as it was in the grade from which promoted. In all other cases of original appointments or permanent promotions (or both) to the same grade effective on the same day, relative seniority shall be determined in accordance with regulations of the President.
(2) In the case of an officer originally appointed in the Regular Corps to the grade of assistant or above, his seniority in the grade to which appointed shall be determined after inclusion, as service in such grade, of any active service in such grade or in any higher grade in the Ready Reserve Corps, but (if the appointment is to the grade of senior assistant or above) only to the extent of whichever of the following is greater: (A) His active service in such grade or any higher grade in the Ready Reserve Corps after the first day on which, under regulations in effect on the date of his appointment to the Regular Corps, he had the training and experience necessary for such appointment, or (B) the excess of his total active service in the Ready Reserve Corps (above the grade of junior assistant) over three years if his appointment in the Regular Corps is to the senior assistant grade, over ten years if the appointment is to the full grade, or over seventeen years if the appointment is to the senior grade.
**(k) Temporary promotions; fill vacancy in higher grade; war or national emergency; selection of officers; termination of appointment** Any commissioned officer of the Regular Corps in any grade in any professional category may be recommended to the President for temporary promotion to fill a vacancy in any higher grade in such category, up to and including the director grade. In time of war, or of national emergency proclaimed by the President, any commissioned officer of the Regular Corps in any grade in any professional category may be recommended to the President for promotion to any higher grade in such category, up to and including the director grade, whether or not a vacancy exists in such grade. The selection of officers to be recommended for temporary promotions shall be made in accordance with regulations of the President. Promotion of an officer recommended pursuant to this subsection may be made without regard to length of service, without examination, and without vacating his permanent appointment, and shall carry with it the pay and allowances of the grade to which promoted. Such promotions may be terminated at any time, as may be directed by the President.
**(l) Determination of requirements of Service by Secretary; assignment of Reserve Officers to professional categories; temporary promotions; termination of temporary promotions** Whenever the number of officers of the Regular Corps on active duty, plus the number of officers of the Ready Reserve Corps who have been on active duty for thirty days or more, exceeds the authorized strength of the Regular Corps, the Secretary shall determine the requirements of the Service in each grade in each category, based upon the total number of officers so serving on active duty and the tasks being performed by the Service; and the Surgeon General shall thereupon assign each officer of the Ready Reserve Corps on active duty to a professional category. If the Secretary finds that the number of officers fixed under [section 210b(c) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section210b/c&num=0&edition=prelim) for any grade and category (or the number of officers, including officers of the Ready Reserve Corps, on active duty in such grade in such category, if such number is greater than the number fixed under [section 210b(c) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section210b/c&num=0&edition=prelim)) is insufficient to meet such requirements of the Service, officers of either the Regular Corps or the Ready Reserve Corps may be recommended for temporary promotion to such grade in such category. Any such promotion may be terminated at any time, as may be directed by the President.
**(m) Acceptance of promotion; oath and affidavit** Any officer of the Regular Corps, or any officer of the Ready Reserve Corps on active duty, who is promoted to a higher grade shall, unless he expressly declines such promotion, be deemed for all purposes to have accepted such promotion; and shall not be required to renew his oath of office, or to execute a new affidavit as required by [section 3332 of title 5](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title5-section3332&num=0&edition=prelim).
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Federal law — U.S. Code and appendices · legal_authorities
In addition to the definitions in sections 1–5 of title 1, the following definitions apply in this title:
(1)
(A) The term “United States”, in a geographic sense, means the States and the District of Columbia.
(B) The term “continental United States” means the 48 contiguous States and the District of Columbia.
(2) The term “possessions” includes Guam, American Samoa, and the guano islands.
(3) The term “uniformed services” means the Army, Navy, Air Force, Marine Corps, Space Force, Coast Guard, National Oceanic and Atmospheric Administration, and Public Health Service.
(4) The term “armed forces” means the Army, Navy, Air Force, Marine Corps, Space Force,and Coast Guard.
(5) The term “Secretary concerned” means—
(A) the Secretary of the Army, with respect to matters concerning the Army;
(B) the Secretary of the Navy, with respect to matters concerning the Navy, the Marine Corps, and the Coast Guard when it is operating as a service in the Navy;
(C) the Secretary of the Air Force, with respect to matters concerning the Air Force and the Space Force;
(D) the Secretary of Homeland Security, with respect to matters concerning the Coast Guard when it is not operating as a service in the Navy;
(E) the Secretary of Commerce, with respect to matters concerning the National Oceanic and Atmospheric Administration; and
(F) the Secretary of Health and Human Services, with respect to matters concerning the Public Health Service.
(6) The term “National Guard” means the Army National Guard and the Air National Guard.
(7) The term “Army National Guard” means that part of the organized militia of the several States, Puerto Rico, Guam, the Canal Zone, the Virgin Islands, and the District of Columbia, active and inactive, that—
(A) is a land force;
(B)
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Federal law — U.S. Code and appendices · legal_authorities
For purposes of promotion which is now or may hereafter be authorized for officers appointed after June 30, 1922, there shall be counted in addition to active commissioned service, service as deck officer and junior engineer.
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Federal law — U.S. Code and appendices · legal_authorities
When used in this chapter—
**(a)** The term “Service” means the Public Health Service;
**(b)** The term “Surgeon General” means the Surgeon General of the Public Health Service;
**(c)** Unless the context otherwise requires, the term “Secretary” means the Secretary of Health and Human Services.
**(d)** The term “regulations”, except when otherwise specified, means rules and regulations made by the Surgeon General with the approval of the Secretary;
**(e)** The term “executive department” means any executive department, agency, or independent establishment of the United States or any corporation wholly owned by the United States;
**(f)** Except as provided in sections 246(g)(4)(B),11 See References in Text note below. 247c(c)(1),1 254d(h)(3),1 263c(5),1 264(d), 292a(9),1 300a(c), 300f(13), and 300n(1) 1 of this title, the term “State” includes, in addition to the several States, only the District of Columbia, Guam, the Commonwealth of Puerto Rico, the Northern Mariana Islands, the Virgin Islands, American Samoa, the Federated States of Micronesia, the Republic of the Marshall Islands, and the Republic of Palau.
**(g)** The term “possession” includes, among other possessions, Puerto Rico and the Virgin Islands;
**(h)** Repealed. Pub. L. 97–35, title IX, § 986(a), Aug. 13, 1981, 95 Stat. 603.
**(i)** The term “vessel” includes every description of watercraft or other artificial contrivance used, or capable of being used, as a means of transportation on water, exclusive of aircraft and amphibious contrivances;
**(j)** The term “habit-forming narcotic drug” or “narcotic” means opium and coca leaves and the several alkaloids derived therefrom, the best known of these alkaloids being morphia, heroin, and codeine, obtained from opium, and cocaine derived from the coca
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Federal law — U.S. Code and appendices · legal_authorities
The Surgeon General shall be appointed from the Regular Corps for a four-year term by the President by and with the advice and consent of the Senate. The Surgeon General shall be appointed from individuals who (1) are members of the Regular Corps, and (2) have specialized training or significant experience in public health programs. Upon the expiration of such term the Surgeon General, unless reappointed, shall revert to the grade and number in the Regular Corps or Ready Reserve Corps that he would have occupied had he not served as Surgeon General.
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Federal law — U.S. Code and appendices · legal_authorities
Notwithstanding any other provision of this chapter, any report, notification, or consultation addressing directly or indirectly the use of appropriated funds and stipulated by this chapter to be submitted to, or held with, the Congress or any Congressional committee shall also be submitted to, or held with, the Committees on Appropriations of the Senate and the House of Representatives under the same conditions and with the same restrictions as stipulated by this chapter.
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Federal law — U.S. Code and appendices · legal_authorities
**(a) Use of Retired Pay Base in Computing Retired Pay.—** The retired pay or retainer pay of any person entitled to that pay who first became a member of a uniformed service after September 7, 1980, is computed using the retired pay base or retainer pay base determined under this section.
**(b) High-Three Average.—** Except as provided in subsection (f), the retired pay base or retainer pay base of a person under this section is the person’s high-three average determined under subsection (c) or (d).
**(c) Computation of High-Three Average for Members Entitled to Retired or Retainer Pay for Regular Service.—**
(1) **General rule.—** — The high-three average of a member entitled to retired or retainer pay under any provision of law other than section 1204 or 1205 or [section 12731 of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title10-section12731&num=0&edition=prelim) is the amount equal to—
(A) the total amount of monthly basic pay to which the member was entitled for the 36 months (whether or not consecutive) out of all the months of active service of the member for which the monthly basic pay to which the member was entitled was the highest, divided by
(B) 36.
(2) **Special rule for short-term disability retirees.—** — In the case of a member who is entitled to retired pay under section 1201 or 1202 of this title and who has completed less than 36 months of active service, the member’s high-three average (notwithstanding paragraph (1)) is the amount equal to—
(A) the total amount of basic pay to which the member was entitled during the period of the member’s active service, divided by
(B) the number of months (including any fraction thereof) of the member’s active service.
(3) **Special Rule for Reserve Component Members.
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Federal law — U.S. Code and appendices · legal_authorities
An officer, within 30 days after the effective date of his appointment, shall file with the oath of office required by [section 3331 of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title5-section3331&num=0&edition=prelim) an affidavit that neither he nor anyone acting in his behalf has given, transferred, promised, or paid any consideration for or in the expectation or hope of receiving assistance in securing the appointment.
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Federal law — U.S. Code and appendices · legal_authorities
**(a) Entities operating as health maintenance organizations** In the case of any entity—
(1) which cannot do business as a health maintenance organization in a State in which it proposes to furnish basic and supplemental health services because that State by law, regulation, or otherwise—
(A) requires as a condition to doing business in that State that a medical society approve the furnishing of services by the entity,
(B) requires that physicians constitute all or a percentage of its governing body,
(C) requires that all physicians or a percentage of physicians in the locale participate or be permitted to participate in the provision of services for the entity,
(D) requires that the entity meet requirements for insurers of health care services doing business in that State respecting initial capitalization and establishment of financial reserves against insolvency, or
(E) imposes requirements which would prohibit the entity from complying with the requirements of this subchapter, and
(2) for which a grant, contract, loan, or loan guarantee was made under this subchapter or which is a qualified health maintenance organization for purposes of [section 300e–9 of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section300e-9&num=0&edition=prelim) (relating to employees’ health benefits plans),
such requirements shall not apply to that entity so as to prevent it from operating as a health maintenance organization in accordance with [section 300e of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section300e&num=0&edition=prelim).
**(b) Advertising** No State may establish or enforce any law which prevents a health maintenance organization for which a grant, contract, loan, or loan guarantee w
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Federal law — U.S. Code and appendices · legal_authorities
Page 74
TITLE 42—THE PUBLIC HEALTH AND WELFARE
§ 211a
1986—Subsec. (g)(3). Pub. L. 99–348 added subpars. (A)
and (B) and struck out former subpars. (A) and (B)
which read as follows:
‘‘(A) in the case of an officer who first became a
member of a uniformed service before September 8,
1980, at the rate of 21⁄2 per centum of basic pay of the
permanent grade held by him at the time of retirement
for each year, not in excess of thirty, of his active com-
missioned service in the Service; or
‘‘(B) in the case of an officer who first became a mem-
ber of a uniformed service on or after September 8, 1980,
21⁄2 per centum of the monthly retired pay base com-
puted under section 1407(h) of title 10, for each year,
not in excess of thirty, of his active commissioned serv-
ice in the Service.’’
1980—Subsec. (g)(3). Pub. L. 96–342 revised provisions
into subpars. (A) and (B) and substituted provisions re-
specting computation of retired pay for officers who be-
came members of the uniformed service before Sept. 8,
1980, and for officers who became members of the uni-
formed service on or after Sept. 8, 1980, for provisions
respecting computation of retired pay for officers.
1979—Subsec. (d)(1). Pub. L. 96–76, § 307(a), inserted ap-
plicability to warrant officers and chief warrant offi-
cers.
Subsec. (g). Pub. L. 96–76, § 307(b), in provision before
par. (1), inserted applicability to separation from Serv-
ice of warrant officers and chief warrant officers subse-
quent to one examination or two examinations, respec-
tively, in par. (1), inserted applicability to a chief war-
rant officer (W–2), and in par. (2), inserted applicability
to a chief warrant officer (W–3).
1962—Subsec. (g). Pub. L. 87–649 substituted ‘‘basic
pay’’ for ‘‘pay’’ in cls. (1) and (2).
1960
Source: Supplied 2024 U.S. Code historical extraction · 42 U.S.C. § 211a
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