I 111th CONGRESS 1st Session H. R. 914 IN THE HOUSE OF REPRESENTATIVES February 9, 2009 Mr. Burgess (for himself and Mr. Gene Green of Texas) 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.

1.

Short title

This Act may be cited as the Physician Workforce Enhancement Act of 2009.

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:

771.

Hospital residency loan program

(a)

Establishment

Not later than January 1, 2010, 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 of the Health Resources and Services Administration that such loan shall be used, consistent with subsection (d), only for the purposes of establishing and conducting an allopathic or osteopathic physician residency training program in at least one of the following medical specialties, or a combination of the following: (i)Family medicine. (ii)Internal medicine. (iii)Emergency medicine. (iv)Obstetrics or gynecology. (v)General surgery. (vi)Preventive Medicine. (vii)Pediatrics. (viii)Behavioral and Mental Health. (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 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 areas (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, only for costs directly attributable to the residency training program, except as otherwise provided by the Administrator of the Health Resources and Services Administration. (e)

Repayment of loans

(1)

Repayment plans

For purposes of subsection (c)(1)(D), a repayment plan for an eligible hospital is in accordance with this subsection if it provides for the repayment of the loan amount in installments, in accordance with a schedule that is agreed to by the Administrator of the Health Resources and Services Administration and the hospital and that is in accordance with this subsection. (2)

Commencement of repayment

Repayment by an eligible hospital of a loan under this section shall commence not later than the date that is 18 months after the date on which the loan amount is disbursed to such hospital. (3)

Repayment period

A loan made under this section shall be fully repaid not later than the date that is 24 months after the date on which the repayment is required to commence. (4)

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 not later than 45 days after 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, 2014, and annually thereafter (before January 2, 2020), 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 of appropriations

For the purpose of providing amounts for loans under this section, there are authorized to be appropriated $25,000,000 for the period of fiscal years 2010 through 2020. (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 (k) 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, 2019.

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