[Congressional Bills 110th Congress]
[From the U.S. Government Publishing Office]
[H.R. 2583 Introduced in House (IH)]







110th CONGRESS
  1st Session
                                H. R. 2583

To amend title VII of the Public Health Service Act to establish a loan 
    program for eligible hospitals to establish residency training 
                               programs.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                              June 6, 2007

  Mr. Burgess (for himself and Mr. Matheson) introduced the following 
    bill; which was referred to the Committee on Energy and Commerce

_______________________________________________________________________

                                 A BILL


 
To amend title VII of the Public Health Service Act to establish a loan 
    program for eligible hospitals to establish residency training 
                               programs.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Physician Workforce and Graduate 
Medical Education Enhancement Act of 2007''.

SEC. 2. HOSPITAL RESIDENCY LOAN PROGRAM.

    Subpart 2 of part E of title VII of the Public Health Service Act 
is amended by adding at the end the following new section:

``SEC. 771. HOSPITAL RESIDENCY LOAN PROGRAM.

    ``(a) Establishment.--Not later than January 1, 2008, the 
Secretary, acting through the Administrator of the Health Resources and 
Services Administration, shall establish a loan program that provides 
loans to eligible hospitals to establish residency training programs.
    ``(b) Application.--No loan may be provided under this section to 
an eligible hospital except pursuant to an application that is 
submitted and approved in a time, manner, and form specified by the 
Administrator of the Health Resources and Services Administration. A 
loan under this section shall be on such terms and conditions and meet 
such requirements as the Administrator determines appropriate, in 
accordance with the provisions of this section.
    ``(c) Eligibility; Preference for Rural and Small Urban Areas.--
            ``(1) Eligible hospital defined.--For purposes of this 
        section, an `eligible hospital' means, with respect to a loan 
        under this section, a hospital that, as of the date of the 
        submission of an application under subsection (b), meets, to 
        the satisfaction of the Administrator of the Health Resources 
        and Services Administration, each of the following criteria:
                    ``(A) The hospital does not operate a residency 
                training program and has not previously operated such a 
                program.
                    ``(B) The hospital has secured initial 
                accreditation by the American Council for Graduate 
                Medical Education or the American Osteopathic 
                Association.
                    ``(C) The hospital provides assurances to the 
                satisfaction of the Administrator that such loan shall 
                be used, consistent with subsection (d), only for the 
                purposes of establishing and conducting an allopathic 
                or osteopathic residency program in at least one of the 
                following medical specialities (or a combination of 
                such specialties):
                            ``(i) Family medicine.
                            ``(ii) Internal medicine.
                            ``(iii) Emergency medicine.
                            ``(iv) Obstetrics or gynecology.
                            ``(v) General surgery.
                    ``(D) The hospital enters into an agreement with 
                the Administrator that certifies the hospital will 
                provide for the repayment of the loan in accordance 
                with subsection (e).
            ``(2) Preference for rural and small urban areas.--In 
        making loans under this section, the Administrator of the 
        Health Resources and Services Administration shall give 
        preference to any applicant for such a loan that is a hospital 
        located in a rural area (as such term is defined in section 
        1886(d)(2)(D) of the Social Security Act) or an urban area that 
        is not a large urban area (as such terms are respectively 
        defined in such section).
    ``(d) Permissible Uses of Loan Funds.--A loan provided under this 
section shall be used, with respect to a residency training program, 
for only the following purposes:
            ``(1) Stipends and benefits available to residents.
            ``(2) Salaries of faculty.
            ``(3) Any other costs directly attributable to the 
        residency training program, as specified by the Administrator 
        of the Health Resources and Services Administration.
    ``(e) Repayment of Loans.--
            ``(1) Repayment plans.--Under the agreement described in 
        subsection (c)(1)(D), with respect to a loan under this section 
        provided to an eligible hospital, the hospital may select one 
        of the following repayment plans:
                    ``(A) Direct payments on installment basis plan.--
                The repayment plan under this subparagraph is a plan 
                under which the eligible hospital provides for the 
                repayment of the loan amount in installments, in 
                accordance with a schedule agreed to by the 
                Administrator and the hospital.
                    ``(B) Deduction in medicare reimbursement plan.--
                            ``(i) In general.--Subject to clause (ii), 
                        the repayment plan under this subparagraph is a 
                        plan established by the Administrator of the 
                        Health Resources and Services Administration, 
                        in consultation with the Administrator of the 
                        Centers for Medicare & Medicaid Services, with 
                        respect to an eligible hospital receiving a 
                        loan under this section, under which the loan 
                        is repaid through deductions from the amounts 
                        otherwise payable to the hospital under title 
                        XVIII of the Social Security Act, in accordance 
                        with a formula and schedule agreed to by the 
                        Administrator and the hospital.
                            ``(ii) Limitation.--A deduction described 
                        in clause (i) applicable to an eligible 
                        hospital for a fiscal year may not exceed 2 
                        percent of the total amounts otherwise payable 
                        to the hospital under title XVIII of the Social 
                        Security Act during such year.
                    ``(C) Combination plan.--The repayment plan under 
                this subparagraph is a plan, agreed to by the 
                Administrator and the eligible hospital involved, that 
                provides for a combination of the repayment elements of 
                the plans described in subparagraphs (A) and (B), in 
                accordance with the provisions of this subsection.
            ``(2) Changes in selection.--An eligible hospital that 
        borrows a loan made under this section may change the selection 
        made by the hospital of a repayment plan under paragraph (1) 
        under such terms and conditions as may be established by the 
        Administrator of the Health Resources and Services 
        Administration and with the approval of the Administrator.
            ``(3) Commencement of repayment.--Repayment by an eligible 
        hospital of a loan under this section shall commence not later 
        than the date that is 24 months after the date on which the 
        loan amount is disbursed to such hospital.
            ``(4) Repayment period.--A loan made under this section 
        shall be fully repaid not later than the date that is five 
        years after the date on which the repayment is required to 
        commence under paragraph (3).
            ``(5) Loan payable in full if residency training program 
        canceled.--In the case that an eligible hospital borrows a loan 
        under this section, with respect to a residency training 
        program, and terminates such program before the date on which 
        such loan has been fully repaid in accordance with a plan under 
        paragraph (1), such loan shall be payable by the hospital 
        within 90 days of the date of such termination.
    ``(f) No Interest Charged.--The Administrator of the Health 
Resources and Services Administration may not charge or collect 
interest on any loan made under this section.
    ``(g) Limitation on Total Amount of Loan.--The cumulative dollar 
amount of a loan made to an eligible hospital under this section may 
not exceed $1,000,000.
    ``(h) Penalties.--The Administrator of the Health Resources and 
Services Administration shall establish penalties to which an eligible 
hospital receiving a loan under this section would be subject if such 
hospital is in violation of any of the criteria described in subsection 
(c)(1).
    ``(i) Reports.--Not later than January 1, 2012, and annually 
thereafter (before January 2, 2018), the Administrator of the Health 
Resources and Services Administration shall submit to Congress a report 
on the efficacy of the program under this section in increasing the 
number of residents practicing in each medical specialty described in 
subsection (c)(1)(C) during such year and the extent to which the 
program resulted in an increase in the number of available 
practitioners in each of such medical specialties that serve medically 
underserved populations.
    ``(j) Funding.--
            ``(1) Authorization for appropriations.--For the purpose of 
        carrying out the loan program under this section, there are 
        authorized to be appropriated $25,000,000 for the period of 
        fiscal years 2008 through 2018.
            ``(2) Availability.--Amounts appropriated under paragraph 
        (1) shall remain available until expended.
            ``(3) Repaid loan amounts.--Any amount repaid by, or 
        recovered from, an eligible hospital under this section on or 
        before the date of termination described in subsection (j) 
        shall be credited to the appropriation account from which the 
        loan amount involved was originally paid. Any amount so 
        credited shall be available only for the purpose of carrying 
        out the loan program under this section. Any amount repaid by, 
        or recovered from, such a hospital under this section after 
        such date shall be credited to the general fund in the 
        Treasury.
    ``(k) Termination of Program.--No loan may be made under this 
section after December 31, 2017.''.
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