of pay (1) In general Pay under subsection (b) shall be considered pay for all purposes, including retirement benefits under chapters 83 and 84 of title 5 and other benefits. (2) Cost-of-living allowance An individual receiving pay under subsection (b) may not receive a cost-of-living allowance under section 5941 of title 5. (e) Annual report Not later than one year after the date of the enactment of the VA Clinician Appreciation, Recruitment, Education, Expansion, and Retention Support (CAREERS) Act of 2023 , and annually thereafter, the Secretary shall submit to the Committee on Veterans' Affairs of the Senate and the Committee on Veterans’ Affairs of the House of Representatives a report on the implementation by the Secretary of the requirements under this section. . (2) Clerical amendment The table of sections at the beginning of such subchapter is amended by inserting after the item relating to section 7413 the following new item: 7414. Pay for directors of medical centers and directors of Veterans Integrated Service Networks. . (b) Conforming amendments Section 7404(a)(1) of title 38, United States Code, is amended— (1) in subparagraph (A)— (A) by striking (A) The annual and inserting The annual