[Congressional Bills 114th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4234 Introduced in House (IH)]

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114th CONGRESS
  1st Session
                                H. R. 4234

 To establish a demonstration program to facilitate physician reentry 
       into clinical practice to provide primary health services.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                           December 10, 2015

 Mr. Sarbanes introduced the following bill; which was referred to the 
                    Committee on Energy and Commerce

_______________________________________________________________________

                                 A BILL


 
 To establish a demonstration program to facilitate physician reentry 
       into clinical practice to provide primary health services.

    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 ``Primary Care Physician Reentry Act 
of 2015''.

SEC. 2. FINDINGS.

    Congress finds as follows:
            (1) According to the Association of American Medical 
        Colleges--
                    (A) the shortage of primary care physicians will 
                reach 45,000 by the year 2020, as fewer than 20 percent 
                of medical students choose to enter primary care 
                medicine; and
                    (B) the overall shortage of physicians in the 
                United States is expected to surpass 130,000 by 2025.
            (2) Medical schools in the United States train only 
        approximately 18,000 new physicians every year.
            (3) The Department of Health and Human Services estimates 
        that the United States needs at least 16,000 more primary care 
        physicians.
            (4) According to a survey of 1,600 pediatricians over the 
        age of 50 conducted by the Association of American Medical 
        Colleges and the American Academy of Pediatrics, 22 percent of 
        female pediatricians took extended leave (6 months or more) 
        from medicine, compared to only 6.5 percent of male 
        pediatricians. Seventy-one percent of the female pediatricians 
        who took extended leave did so to care for a child or family 
        member.

SEC. 3. REENTRY PROGRAM FOR PHYSICIANS.

    (a) Activities of the Secretary.--
            (1) Establishment of demonstration program.--The Secretary 
        of Health and Human Services (referred to in this section as 
        the ``Secretary'') shall establish a demonstration program to 
        assist the development of innovative programs that facilitate 
        physician reentry into clinical practice to provide primary 
        health services. Under such demonstration program, the 
        Secretary shall--
                    (A) award one grant, on a competitive basis, to an 
                eligible entity described in subsection (b) in each of 
                the 10 regions served by a regional office of the 
                Department of Health and Human Services to carry out 
                physician reentry projects to assist reentering 
                physicians participating in such projects through any 
                of the activities described in subsection (d); and
                    (B) in consultation with key stakeholders and 
                subject to paragraph (2)(B), carry out the 
                administrative activities described in paragraph 
                (2)(A).
            (2) Administrative activities.--
                    (A) In general.--For purposes of paragraph (1)(B), 
                the administrative activities described in this 
                subparagraph are the following:
                            (i) Conduct a national needs assessment 
                        with regard to the supply of physicians who 
                        provide primary health services, using, to the 
                        extent feasible, information collected for use 
                        in other similar completed or forthcoming 
                        studies, such as studies conducted by the 
                        Agency for Healthcare Research and Quality and 
                        the Health Resources and Services 
                        Administration.
                            (ii) Develop a database that contains a 
                        directory of programs that help physicians 
                        reenter clinical practice.
                            (iii) Disseminate evidence-based 
                        assessments and evaluation tools as such 
                        assessments and tools become available to 
                        measure the basic core competencies of 
                        physicians reentering clinical practice that 
                        are consistent with the guidelines published by 
                        the Federation of State Medical Boards for such 
                        physicians.
                            (iv) Assist State regulatory authorities 
                        and hospital credentialing committees to 
                        structure requirements for physicians to return 
                        to clinical practice in a manner that ensures 
                        patient safety while addressing the burdens on 
                        such reentering physicians.
                    (B) Limitation.--The Secretary shall use not more 
                than 15 percent of the funds appropriated to carry out 
                this section to carry out the activities described in 
                subparagraph (A).
    (b) Eligible Entities.--Entities eligible to receive a grant under 
this section are the following:
            (1) A State (as defined in section 2(f) of the Public 
        Health Service Act, 42 U.S.C. 201(f)).
            (2) A hospital.
            (3) An academic medical center.
            (4) A medical school.
            (5) A health center (as defined in section 330(a) of the 
        Public Health Service Act (42 U.S.C. 254b(a))).
            (6) A teaching health center.
            (7) A nonprofit organization with a demonstrated history or 
        expertise in providing physician education and with the ability 
        to offer programs specifically targeted at reentering 
        physicians.
    (c) Application.--In order to receive a grant under this section, 
an eligible entity shall submit to the Secretary an application at such 
time, in such manner, and containing such information as the Secretary 
may require.
    (d) Uses of Funds.--An eligible entity that receives funds under 
this section shall use such funds to carry out a physician reentry 
project to assist reentering physicians participating in the project 
through any of the following activities:
            (1) Training such reentering physicians to reenter clinical 
        practice.
            (2) Paying credentialing fees and other fees that are 
        necessary for such reentering physicians to reenter clinical 
        practice.
            (3) Paying the salaries of such reentering physicians who 
        are so eligible to reenter clinical practice during the period 
        for which such physicians provide primary health services at a 
        center described in subsection (e)(1).
            (4) Providing loan repayment assistance and other financial 
        assistance, including scholarships and grants for education and 
        training, to such reentering physicians.
    (e) Requirements of Reentry Physicians To Participate in 
Projects.--To be eligible to participate in a physician reentry project 
carried out by an eligible entity under this section, a reentering 
physician shall provide assurances satisfactory to the Secretary that 
the physician will comply with the following:
            (1) Service locations.--The reentering physician shall 
        provide primary health services at--
                    (A) a health center (as defined in section 330(a) 
                of the Public Health Service Act (42 U.S.C. 254b(a)));
                    (B) a Veterans Administration Medical Center if the 
                Secretary of Veterans Affairs certifies that there is a 
                shortage of physicians at such medical center; or
                    (C) a school-based health center (as defined in 
                section 2110(c)(9) of the Social Security Act (42 
                U.S.C. 1397jj(c)(9))).
            (2) Length of service.--The reentering physician shall 
        provide such services at such a center, consistent with 
        paragraph (1), for not less than 2 years.
    (f) Liability Protections.--For purposes of section 224 of the 
Public Health Service Act (42 U.S.C. 233), a reentering physician 
participating in a physician reentry project under this section shall 
be deemed to be an employee of the Public Health Service working within 
the scope of such employment with respect to primary health services 
provided by such reentering physician at a center described in 
subsection (e)(1) under the terms of such participation in such 
project. The remedy against the United States for a physician described 
in paragraph (2) who is deemed to be an employee of the Public Health 
Service pursuant to the previous sentence shall be exclusive of any 
other civil action or proceeding to the same extent as the remedy 
against the United States is exclusive pursuant to subsection (a) of 
such section.
    (g) Annual Review and Report.--For any year during which the 
demonstration program under this section is carried out, the Secretary 
shall conduct a review and comprehensive evaluation of such program and 
shall prepare and submit to Congress a report assessing such program, 
including an assessment of the performance of the reentering physicians 
who participate in physician reentry projects under such program.
    (h) Reentering Physicians.--
            (1) Definition.--Subject to paragraph (2), for purposes of 
        this section, the term ``reentering physician'' means an 
        individual--
                    (A) who is a physician (as defined in section 
                1861(r)(1) of the Social Security Act, 42 U.S.C. 
                1395x(r)(1));
                    (B) who received training in primary care or 
                primary health services, including family medicine, 
                internal medicine, pediatrics, obstetrics and 
                gynecology, dentistry, and mental health.
                    (C) who was previously (and may currently be) 
                legally authorized to practice medicine and surgery by 
                a State;
                    (D) who previously engaged in the clinical practice 
                of medicine, but who is not currently engaged in the 
                clinical practice of medicine and has not been engaged 
                in such practice for a period of 2 years or such longer 
                period determined to be sufficient by the Secretary; 
                and
                    (E) who provides assurances satisfactory to the 
                Secretary and the respective State licensing board that 
                the individual will return to clinical practice in the 
                discipline in which such individual was trained or 
                certified, including, if applicable, by regaining 
                necessary training and certification for legal 
                authorization to practice medicine and surgery by a 
                State.
            (2) Exclusions.--For purposes of this section, the term 
        ``reentering physician'' does not include an individual if--
                    (A) such individual has failed to complete an 
                obligation to provide health care services under a 
                Federal, State, or local program (including any period 
                of obligated service under subpart III of part D of 
                title III of the Public Health Service Act (42 U.S.C. 
                254l et seq.)); or
                    (B) the individual has a debt due to the United 
                States.
    (i) Primary Health Services Defined.--For purposes of this section, 
the term ``primary health services'' has the meaning given such term in 
section 331(a)(3) of the Public Health Service Act (42 U.S.C. 
254d(a)(3)).
    (j) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section such sums as may be necessary 
for fiscal year 2016.
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