I 111th CONGRESS 1st Session H. R. 1185 IN THE HOUSE OF REPRESENTATIVES February 25, 2009 Ms. Castor of Florida introduced the following bill; which was referred to the Committee on Energy and Commerce A BILL To amend the Public Health Service Act to provide for a competitive loan repayment program for primary care physicians who commit to volunteering part-time at community health centers.

1.

Short title

This Act may be cited as the Primary Care Volunteer Incentive Act of 2009.

2.

Primary care loan repayment program

Part C of title VII of the Public Health Service Act is amended by adding at the end the following new section:

749.

Primary care loan repayment program

(a)

Purpose

It is the purpose of this section to alleviate critical shortages of primary care physicians. (b)

Loan Repayments

The Secretary shall establish a loan repayment program of entering into contracts (under terms and conditions specified by the Secretary and consistent with this section) with eligible individuals under which, subject to subsection (i)(2)— (1)the individual agrees to serve without pay for at least 4 hours each week for a period of 5 consecutive years— (A)as a primary care physician; and (B)at a health center, as defined in section 330, designated by the Secretary (as of the date of the application of the individual for a contract under this section) as serving an area with a shortage of primary care physicians; and (2)the Secretary agrees to pay, for each year of such service, not more than $5,000 of the principal and interest of the graduate educational loans of the individual. (c)

Eligibility

To be eligible to participate in the loan repayment program under this section, an individual must— (1)have a degree in medicine or osteopathic medicine; (2)(A)have completed an accredited graduate medical residency training program in primary care medicine; or (B)be enrolled in such a residency training program; and (3)submit to the Secretary an application, in such form, manner, and time as specified by the Secretary, for a contract under this section. (d)

Application, Contract, and Information Requirements

The provisions of section 338B(c) shall, except as inconsistent with this section, apply to the loan repayment program under this section in the same manner and to the same extent as such provisions apply to the National Health Service Corps Loan Repayment Program under section 338B, except that each reference to a health professional shortage area shall be deemed a reference to a community health center described in subsection (b)(1)(B). (e)

Priority

In providing contracts under the loan repayment program under this section, the Secretary shall give priority to individuals who agree to serve in community health centers described in subsection (b)(1)(B) that are located in areas that the Secretary, as of the date of the individual’s application for a contract under this section, has designated under section 332 as health professional shortage areas. (f)

Approval Required for Participation

An individual becomes a participant in the loan repayment program under this section only upon the Secretary and the individual entering into a written contract under this section. (g)

Payments

(1)

In general

A loan repayment provided for an individual under a written contract under this section shall consist of payment, in accordance with paragraph (2), on behalf of the individual of the principal, interest, and related expenses on government and commercial loans received by the individual regarding the graduate education of the individual, which loans were made for— (A)tuition expenses; (B)all other reasonable educational expenses, including fees, books, and laboratory expenses, incurred by the individual; or (C)reasonable living expenses as determined by the Secretary. (2)

Payments for years served

(A)

In general

For each year of service described in subsection (b)(1) that an individual contracts to serve under this section the Secretary may pay not more than $5,000 on behalf of the individual for loans described in paragraph (1). In making a determination of the amount to pay for a year of such service by an individual, the Secretary shall consider the extent to which each such determination— (i)affects the ability of the Secretary to maximize the number of contracts that can be provided under the loan repayment program under this section from the amounts appropriated for such contracts; (ii)provides an incentive to serve in community health centers with the greatest shortage of primary care physicians; and (iii)provides an incentive with respect to the individual involved remaining in an area with a shortage of primary care physicians, and continuing to provide health services in primary care medicine, after the completion of the period of service described in subsection (b)(1). (B)

Repayment schedule

Any arrangement made by the Secretary for the making of loan repayments in accordance with this subsection shall provide that any repayments for a year of service described in subsection (b)(1) shall be made no later than the end of the fiscal year in which the individual completes such year of service. (3)

Tax liability

For the purpose of providing reimbursements for tax liability resulting from payments under paragraph (2) on behalf of an individual— (A)the Secretary shall, in addition to such payments, make payments to the individual in an amount equal to 39 percent of the total amount of loan repayments made for the taxable year involved; and (B)may make such additional payments as the Secretary determines to be appropriate with respect to such purpose. (4)

Payment schedule

The Secretary may enter into an agreement with the holder of any loan for which payments are made under the loan repayment program under this section to establish a schedule for the making of such payments. (h)

Breach of contract

The provisions of section 338E shall apply to an individual who breaches a contract under this section in the same manner and to the same extent as such provisions apply to an individual who breaches a contract under section 338B. (i)

Definitions

For purposes of this section: (1)

Primary care medicine

The term primary care medicine shall include family medicine, general pediatrics, and general internal medicine. (2)

Primary care physician

The term primary care physician means a physician specializing in primary care medicine. (j)

Authorization of Appropriations

(1)

In general

To carry out this section, there is authorized to be appropriated such sums as are necessary for each of the fiscal years 2009 through 2013. (2)

Contingency

Any financial obligation of the United States arising out of a contract entered into under this section and any obligation of the individual that is conditioned thereon, is contingent on funds being appropriated for loan repayments under paragraph (1).

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