[Federal Register Volume 84, Number 247 (Thursday, December 26, 2019)]
[Proposed Rules]
[Pages 70908-70913]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2019-27511]


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DEPARTMENT OF VETERANS AFFAIRS

38 CFR Part 17

RIN 2900-AQ63


Specialty Education Loan Repayment Program

AGENCY: Department of Veterans Affairs.

ACTION: Proposed rule.

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SUMMARY: The Department of Veterans Affairs (VA) proposes to amend its 
regulations that govern scholarship programs to certain health care 
professionals. This rulemaking would implement the mandates of the VA 
MISSION Act of 2018 by establishing a Specialty Education Loan 
Repayment Program, which would assist VA in meeting the staffing needs 
of VA physicians in medical specialties for which VA has determined 
that recruitment or retention of qualified personnel is difficult.

DATES: Comments must be received on or before February 24, 2020.

ADDRESSES: Written comments may be submitted through http://www.Regulations.gov; by mail or hand-delivery to: Director, Office of 
Regulation Policy and Management (00REG), Department of Veterans 
Affairs, 810 Vermont Ave. NW, Room 1064, Washington, DC 20420; or by 
fax to (202) 273-9026. (This is not a toll-free telephone number.) 
Comments should indicate that they are submitted in response to ``RIN 
2900-AQ63--Specialty Education Loan Repayment Program.'' Copies of 
comments received will be available for public inspection in the Office 
of Regulation Policy and Management, Room 1063B, between the hours of 8 
a.m. and 4:30 p.m., Monday through Friday (except holidays). Please 
call (202) 461-4902 for an appointment. (This is not a toll-free 
telephone number.) In addition, during the comment period, comments may 
be viewed online through the Federal Docket Management System (FDMS) at 
http://www.Regulations.gov.

FOR FURTHER INFORMATION CONTACT: Whitney Henderson, Manager, Education 
Loan Repayment Services, 810 Vermont Avenue NW, Washington, DC 20420, 
[email protected], (501) 918-3256. (This is not a toll-free 
number.)

SUPPLEMENTARY INFORMATION: On June 6, 2018, section 303 of Public Law 
115-182, the John S. McCain III, Daniel K. Akaka, and Samuel R. Johnson 
VA Maintaining Internal Systems and Strengthening Integrated Outside 
Networks Act of 2018, or the VA MISSION Act of 2018, amended title 38 
of the United States Code (U.S.C.) by establishing new sections 7691 
through 7697 and created a new student loan repayment program known as 
the Specialty Education Loan Repayment Program (SELRP). The SELRP would 
serve as an incentive for physicians starting or currently in residency 
programs in medical specialties for which VA has determined that 
recruitment and retention of qualified personnel is difficult to work 
for VA at VA facilities that need more physicians with that medical 
specialty after the individual completes their residency program. VA 
would determine the anticipated needs for medical specialties during a 
period of two to six years in the future. In taking this proactive 
approach, VA would commence recruitment for physicians in these 
specialties before the projected need to help ensure adequate health 
care coverage for VA beneficiaries. This proposed rule would establish 
the requirements for the SELRP in proposed 38 CFR 17.525 through 
17.531.

17.525 Purpose

    Proposed Sec.  17.525 would establish the purpose of the SELRP. We 
would state that the SELRP is an incentive program for certain 
individuals to meet VA's need for physicians in medical specialties for 
which VA determines that recruitment and retention of qualified 
personnel is difficult. We would also state that assistance under the 
SELRP may be in addition to other assistance available to individuals 
under the Educational Assistance Program under 38 U.S.C. 7601. This 
section would be in alignment with 38 U.S.C. 7691 and 7692.

17.526 Definitions

    Proposed Sec.  17.526 would be the definitions section applicable 
to Sec. Sec.  17.525 through 17.530. The term educational loan is 
defined in Sec.  17.641 for the Program for the Repayment of 
Educational Loans for Certain VA Psychiatrists (PREL). We would use 
this definition, with minimal edits by eliminating references to the 
PREL, to state that the term applies to the SELRP, to maintain 
consistency in application of similar VA scholarship programs and to 
ease the implementation of such programs by VA personnel.
    We propose to define the term SELRP to mean the Specialty Education 
Loan Repayment Program established in Sec. Sec.  17.525 through 17.530.
    To define the term State, we would refer to 38 U.S.C. 101(20), or a 
political subdivision of such a State. We propose to provide this 
definition to inform the potential participant where the period of 
obligated service would be performed.
    We would also define the term ``VA'' to mean the Department of 
Veterans Affairs.

17.527 Eligibility

    Proposed Sec.  17.527 would establish the eligibility criteria for 
participants of the SELRP. Proposed paragraph (a) would state that to 
be eligible to participate in the SELRP, an individual will be eligible 
for appointment under 38 U.S.C. 7401 to work as a physician in a 
medical specialty for which VA determines that recruitment or retention 
of qualified personnel is difficult. We would add that in determining 
staffing needs, VA will consider the anticipated needs of VA for a 
period of two to six years in the future, and utilize staffing shortage 
occupation, vacancy data, and national health care workforce and other 
relevant data in such determinations. VA will publish these vacancies 
in a notice in the Federal Register on a yearly basis until vacancies 
are filled. Although sections 7691 to 7697 do not provide for how VA 
would publish the vacancies or the frequency of such publications, we 
believe that adding these requirements via regulation would provide for 
transparency in VA's needs. See Public Law 115-182, Title III, Sec.  
303(f). The individual must also owe any amount of principal or 
interest for an educational loan where the proceeds were used by or on 
behalf of the individual to pay costs relating to a course of medical 
education or training that leads to employment as a physician. Lastly, 
the individual must have graduated from an accredited medical or 
osteopathic school and matched to an accredited residency program in a 
medical specialty designated by VA; or [is] a physician in training 
with more than 2 years remaining in such training. These requirements 
are stated in 38 U.S.C. 7693.
    Proposed paragraph (b) would provide for instances where an 
individual applies for the SELRP before there is a posting of a 
residency match for the individual's medical specialty. See section 
303(e) of the VA MISSION Act of 2018. We would state that an applicant 
may apply for the SELRP before receiving a residency match

[[Page 70909]]

during the applicant's senior year of medical or osteopathic school. We 
would add that Once the applicant is matched with a residency specialty 
stated in Sec.  17.525 and upon selection of the SELRP, VA must offer 
the applicant participation in the SELRP no later than 28 days after 
the applicant is matched with the residency; and VA has published the 
residency in a Notice in the Federal Register. Such notices are 
published on a yearly basis until vacancies are filled. Although 
section 7691 does not provide for how VA would publish the residencies 
or the frequency of such publications, we believe that adding these 
requirements via regulation would provide for transparency in VA's 
needs.
    Proposed paragraph (c) would state the order of preference for VA 
to select participants to the SELRP. This order of preference would 
reflect medically underserved locations where VA has identified a 
shortage of physicians. We would state that VA would give preference to 
eligible participants who are, or will be, participating in residency 
programs in health care facilities that are: Located in rural areas; 
Operated by Indian tribes, tribal organizations, or the Indian Health 
Services; or Are affiliated with underserved health care facilities of 
VA. VA would also give preference to eligible individuals who are 
veterans. Proposed paragraph (c) would be in alignment with 38 U.S.C. 
7693(b).

17.528 Application

    Section 303 of the VA MISSION Act of 2018 did not establish an 
application procedure for the SELRP. To maintain consistency in the 
application process of similar VA scholarship programs and to ease the 
implementation such programs by VA personnel, we would mirror proposed 
Sec.  17.528 to current Sec.  17.643, Application for the Program for 
Repayment of Educational Loans for Certain VA Psychiatrists (PREL.) 
Consistent with Sec.  17.643(a), proposed paragraph Sec.  17.528(a) 
would state that a complete application for the SELRP consists of a 
completed application form, letters of reference, and personal 
statement.
    Proposed paragraph Sec.  17.528(b) would state what documents 
qualify as letters of reference. These documents would be those stated 
in Sec.  17.643(a), however, we would not include as a reference a 
letter from the Program Director for the specialty in which the 
applicant is training, as stated in Sec.  17.643(b)(1), because an 
applicant for the SELRP cannot apply during their fellowship. We would 
state in proposed paragraph (b)(1) that a reference includes one letter 
of reference from the Program Director of the core program in which the 
applicant is training, which indicates that the applicant is in good to 
excellent standing, or, for individuals who have yet to initiate 
training, a letter of reference from a facility member or dean. 
Proposed paragraphs Sec.  17.528(b)(2) and (b)(3) would restate Sec.  
17.643(b)(2) and (b)(3) with minor edits to apply to the SELRP. We 
would state that references include one or more letters of reference 
from faculty members under which the applicant trained; and one letter 
of reference from a peer colleague who is familiar with the practice 
and character of the applicant.
    Proposed paragraph Sec.  17.528(c) would state what constitutes as 
a personal statement for purposes of the SELRP. We would restate Sec.  
17.643(c). We would edit current Sec.  17.643(c)(1)(ii) by requesting 
that the applicant provide their interest in working at a particular 
medical specialty and underserved area. This would facilitate placement 
of the individual in an underserved location that holds interest to the 
applicant and for which VA has a vacancy in the medical specialty. We 
would not restate current Sec.  17.643(c)(2)(i) because the applicant 
may participate in any program under 38 U.S.C. 7601. We would also make 
one minor edit in from current Sec.  17.643(c)(2)(ii) in proposed 
paragraph (c)(2)(i) to state that the covered loan must be specific to 
education that was required, used, and qualified the applicant for 
appointment as a physician.

17.529 Award Procedures

    Proposed Sec.  17.529 would state the award procedures for the 
SELRP. Proposed paragraph Sec.  17.529(a) would state the repayment 
amount for the educational loan. We would state in paragraph (a)(1) 
that VA may pay no more than $40,000 in educational loan repayment for 
each year of obligated service for a period not to exceed four years 
for a total payment of $160,000.00. The yearly amount may depend on the 
total amount of the educational loan of the individual. We would add in 
proposed paragraph (a)(2) that an educational loan repayment may not 
exceed the actual amount of principal and interest on an educational 
loan or loans. Proposed paragraph (a) would be in alignment with 38 
U.S.C. 7694.
    Section 303 of the VA MISSION Act of 2018 did not contain a 
provision for the payment of the SELRP. To maintain consistency in the 
application processes for similar VA scholarship programs and to ease 
the implementation of such programs by VA, we would mirror the payment 
provision in Sec.  17.645(b) for the SELRP in proposed paragraph Sec.  
17.529(b) with one minor edit. We would change the term depending on 
the acceptance of conditions to depending on the terms of the agreement 
to maintain consistency in terminology in the SELRP.
    Proposed paragraph Sec.  17.529(c) would provide for a waiver of 
the maximum amount of repayment of the applicant's educational loans 
under certain circumstances. We would state that a waiver may be 
available if VA determines that there is a shortage of qualified 
employees due to either the location of where the participant will 
serve the period of obligated service or due to the requirements of the 
position (medical specialty) that the participant will hold in VA. 
Proposed Sec.  17.529(c) would include the caveat that the waiver may 
not exceed the actual amount of the principal and the interest on the 
participant's loans payable to or for that participant. This proposed 
paragraph (c) would be in alignment with 38 U.S.C. 7694(c)(2).

17.530 Agreement and Obligated Service

    Proposed Sec.  17.530 would contain the requirements in the 
agreement that an applicant must sign and the terms of obligated 
services that are required as participants of the SELRP. As a condition 
of participating in the SELRP, and participant must agree, in writing, 
to the conditions stated in proposed paragraph (a). These conditions 
are a restatement of 38 U.S.C. 7696(a). We would state that a 
participant must obtain a license to practice medicine in a State; 
Successfully complete post-graduate training leading to eligibility for 
board certification in a medical specialty; Serve as a full-time 
clinical practice employee of VA for 12 months for every $40,000.00 
that the participant receives payment for the SELRP, however, the 
participant must serve for a period of no fewer than 24 months; and 
Except as provided in paragraph (b) of this section, begin obligated 
service as a full-time VA employee no later than 60 days after 
completing residency in the medical specialty described in Sec.  
17.527(a)(1).
    Section 303 of the VA MISSION Act of 2018 did not provide a 
provision for when the participant's obligated service would begin. We 
believe that establishing such provision via regulation would be 
helpful to the applicant in knowing the expectations of the SELRP up 
front. We would mirror proposed paragraph Sec.  17.530(b)(1) to Sec.  
17.646(a) by stating that a participant's obligated service will begin 
on the date

[[Page 70910]]

on which the participant begins full-time, permanent employment with VA 
in the field of medicine in a location determined by VA. Obligated 
service must be full-time, permanent employment and does not include 
any period of temporary or contractual employment.
    Proposed paragraph (b)(2) would restate 38 U.S.C. 7695 with minor 
edits. We would state that participants of the SELRP may select from a 
list of VA medical facilities provided by VA to serve the period of 
obligated service. In alignment with similar scholarship programs, we 
would add that VA reserves the right to make final decisions on the 
location and position of the obligated service. See 38 CFR 17.646(c). 
VA believes that is necessary to reserve the right to make final 
decisions on the location to achieve the intent of the VA Mission Act 
of 2018. VA must be able to have control over where it places the 
individuals to ensure VA beneficiaries' health care needs are met in 
locations that are within close proximity of the beneficiaries' 
residence.
    Proposed Sec.  17.530(c) would restate 38 U.S.C. 7696(b) with minor 
edits for clarity. We would state that if a participant receives an 
accredited fellowship in a medical specialty other than the medical 
specialty described in Sec.  17.527(a)(1), the participant may request, 
in writing, a delayed commencement of the period of obligated service 
until after the participant completes the fellowship. However, the 
period of obligated service will begin no later than 60 days after 
completion of such fellowship in the medical specialty described in 
Sec.  17.527(a)(1).

17.531 Failure To Comply With Terms and Conditions of Agreement

    Proposed Sec.  17.531 would state the consequences for failure to 
comply with the terms and conditions of the SELRP. This proposed 
section would mirror 38 U.S.C. 7696(c) with no edits. We would state 
that a participant of the SELRP who fails to satisfy the period of 
obligated service will owe the United States government an amount 
determined by the formula A = B x ((T - S) / T)), where: ``A'' is the 
amount the participant owes the United States government; ``B'' is the 
sum of all payments to or for the participant under the SELRP; ``T'' is 
the number of months in the period of obligated service of the 
participant; ``S'' is the number of whole months of such period of 
obligated service served by the participant. For example, if a 
participant agrees to a period of obligated service of 24 months, but 
only served 12 months and agreed to receive an amount of $80,000 for 24 
months of obligated service, the total amount owed would be calculated 
as follows: A = 80,000 x ((24 - 12) / 24)), total amount owed the 
Federal Government would be $40,000.

Effect of Rulemaking

    The Code of Federal Regulations, as proposed to be revised by this 
proposed rulemaking, would represent the exclusive legal authority on 
this subject. No contrary rules or procedures would be authorized. All 
VA guidance would be read to conform with this proposed rulemaking if 
possible or, if not possible, such guidance would be superseded by this 
rulemaking.

Paperwork Reduction Act

    The Paperwork Reduction Act of 1995 (44 U.S.C. 3507(d)) requires 
that VA consider the impact of paperwork and other information 
collection burdens imposed on the public. According to the 1995 
amendments to the Paperwork Reduction Act (5 CFR 1320.8(b)(2)(vi)), an 
agency may not collect or sponsor the collection of information, nor 
may it impose an information collection requirement unless it displays 
a currently valid Office of Management and Budget (OMB) control number. 
This proposed rule includes provisions constituting new collections of 
information under the Paperwork Reduction Act of 1995 that require 
approval by the OMB. Accordingly, under 44 U.S.C. 3507(d), VA has 
submitted a copy of this rulemaking action to OMB for review.
    OMB assigns control numbers to collections of information it 
approves. VA may not conduct or sponsor, and a person is not required 
to respond to, a collection of information unless it displays a 
currently valid OMB control number. Proposed Sec.  17.528 contains a 
collection of information under the Paperwork Reduction Act of 1995. If 
OMB does not approve the collection of information as requested, VA 
will immediately remove the provision containing a collection of 
information or take such other action as is directed by OMB.
    Comments on the collection of information contained in this 
proposed rule should be submitted to the Office of Management and 
Budget, Attention: Desk Officer for the Department of Veterans Affairs, 
Office of Information and Regulatory Affairs, Washington, DC 20503, 
with copies sent by mail or hand delivery to the Director, Office of 
Regulation Policy and Management (00REG), Department of Veterans 
Affairs, 810 Vermont Avenue NW, Room 1064, Washington, DC 20420; fax to 
(202) 273-9026; or through www.Regulations.gov. Comments should 
indicate that they are submitted in response to ``RIN 2900-AQ63--
Specialty Education Loan Repayment Program.''
    OMB is required to make a decision concerning the collections of 
information contained in this proposed rule between 30 and 60 days 
after publication of this document in the Federal Register. Therefore, 
a comment to OMB is best assured of having its full effect if OMB 
receives it within 30 days of publication. This does not affect the 
deadline for the public to comment on the proposed rule.
    VA considers comments by the public on proposed collections of 
information in--
     Evaluating whether the proposed collections of information 
are necessary for the proper performance of the functions of VA, 
including whether the information will have practical utility;
     Evaluating the accuracy of VA's estimate of the burden of 
the proposed collections of information, including the validity of the 
methodology and assumptions used;
     Enhancing the quality, usefulness, and clarity of the 
information to be collected; and
     Minimizing the burden of the collections of information on 
those who are to respond, including through the use of appropriate 
automated, electronic, mechanical, or other technological collection 
techniques or other forms of information technology, e.g., permitting 
electronic submission of responses.
    The collections of information contained in Sec.  17.528 are 
described immediately following this paragraph, under their respective 
titles. For the new proposed collection of information below, VA used 
general wage data from the Bureau of Labor Statistics (BLS) to estimate 
the respondents' costs associated with completing the information 
collection. According to the latest available BLS data, the mean hourly 
wage of full-time wage and salary workers was $101.63 based on the BLS 
wage code--``29-1069 All Occupations.'' This information was taken from 
the following website: https://www.bls.gov/oes/current/oes_nat.htm 
(March 2019).
    Title: Specialty Education Loan Repayment Program.
    OMB Control No.: 2900-xxxx (new).
    CFR provision: 38 CFR 17. 528.
    Summary of collection of information: The information required 
determines the eligibility or suitability of an applicant desiring to 
participate in the

[[Page 70911]]

SELRP under the provisions of 38 U.S.C. 7691 through 7697. The purpose 
of the SELRP would be to repay educational loans to individuals who 
pursued a program of study leading to a degree in medicine and who are 
seeking employment in VA. VA considers this program as a hiring 
incentive to meet the staffing needs for physicians in medical 
specialties for which VA determines that recruitment and retention of 
qualified personnel is difficult.
    Description of the need for information and proposed use of 
information: The information is needed to apply for the SELRP. VA will 
use this information to select qualified candidates to participate in 
this program.
    Description of likely respondents: Potential participants of the 
SELRP.
    Estimated number of respondents per month/year: 200 per year.
    Estimated frequency of responses per month/year: 1 time per year.
    Estimated average burden per response: 90 minutes.
    Estimated total annual reporting and recordkeeping burden: 80 
hours.
    Estimated cost to respondents per year: VA estimates the total cost 
to all respondents to be $8,130 per year. Legally, respondents may not 
pay a person or business for assistance in completing the information 
collection. Therefore, there are no expected overhead costs for 
completing the information collection.

Regulatory Flexibility Act

    The Secretary hereby certifies that this proposed rule would not 
have a significant economic impact on a substantial number of small 
entities as they are defined in the Regulatory Flexibility Act, 5 
U.S.C. 601-612. The provisions associated with this rulemaking are not 
processed by any other entities outside of VA. Therefore, pursuant to 5 
U.S.C. 605(b), this rulemaking would be exempt from the initial and 
final regulatory flexibility analysis requirements of 5 U.S.C. 603 and 
604.

Executive Orders 12866, 13563 and 13771

    Executive Orders 12866 and 13563 direct agencies to assess the 
costs and benefits of available regulatory alternatives and, when 
regulation is necessary, to select regulatory approaches that maximize 
net benefits (including potential economic, environmental, public 
health and safety effects, and other advantages; distributive impacts; 
and equity). Executive Order 13563 (Improving Regulation and Regulatory 
Review) emphasizes the importance of quantifying both costs and 
benefits, reducing costs, harmonizing rules, and promoting flexibility.
    The Office of Management and Budget has designated this rule is not 
a significant regulatory action under Executive Order 12866. VA's 
impact analysis can be found as a supporting document at http://
www.regulations.gov, usually within 48 hours after the rulemaking 
document is published. Additionally, a copy of the rulemaking and its 
impact analysis are available on VA's website at http://www.va.gov/orpm 
by following the link for VA Regulations Published from FY 2004 through 
FYTD.
    This proposed rule is not expected to be an E.O. 13771 regulatory 
action because this proposed rule is not significant under E.O. 12866.

Unfunded Mandates

    The Unfunded Mandates Reform Act of 1995 requires, at 2 U.S.C. 
1532, that agencies prepare an assessment of anticipated costs and 
benefits before issuing any rule that may result in the expenditure by 
State, local, and tribal governments, in the aggregate, or by the 
private sector, of $100 million or more (adjusted annually for 
inflation) in any one year. This proposed rule would have no such 
effect on State, local, and tribal governments, or on the private 
sector.

Catalog of Federal Domestic Assistance

    There are no Catalog of Federal Domestic Assistance numbers and 
titles for this rule.

List of Subjects in 38 CFR Part 17

    Administrative practice and procedure, Health care, Health 
facilities, Health professions, Health records, Medical and dental 
schools, Scholarships and fellowships, Veterans.

Signing Authority

    The Secretary of Veterans Affairs, or designee, approved this 
document and authorized the undersigned to sign and submit the document 
to the Office of the Federal Register for publication electronically as 
an official document of the Department of Veterans Affairs. Pamela 
Powers, Chief of Staff, Department of Veterans Affairs, approved this 
document on November 5, 2019, for publication.

Consuela Benjamin,
Regulation Development Coordinator, Office of Regulation Policy & 
Management, Office of the Secretary, Department of Veterans Affairs.

    For the reasons set forth in the preamble, we propose to amend 38 
CFR part 17 as follows:

PART 17--MEDICAL

0
1. The authority citation for part 17 is amended to read as follows:

    Authority:  38 U.S.C. 501, and as noted in specific sections.
* * * * *
    Sections 17.525 through 17.531 are also issued under 38 U.S.C. 
7691 through 7697.
* * * * *
0
2. Adding an undesignated center heading immediately following Sec.  
17.511 and new Sec. Sec.  17.525 through 17.531 to read as follows.

Specialty Education Loan Repayment Program

17.525 Purpose.
17.526 Definitions.
17.527 Eligibility.
17.528 Application.
17.529 Award procedures.
17.530 Agreement and obligated service.
17.531 Failure to comply with terms and conditions of agreement.


Sec.  17.525  Purpose.

    The purpose of Sec. Sec.  17.525 through 17.531 is to establish the 
Specialty Education Loan Repayment Program (SELRP). The SELRP an 
incentive program for certain individuals to meet VA's need for 
physicians in medical specialties for which VA determines that 
recruitment and retention of qualified personnel is difficult. 
Assistance under the SELRP may be in addition to other assistance 
available to individuals under the Educational Assistance Program under 
38 U.S.C. 7601.


Sec.  17.526  Definitions.

    The following definitions apply to Sec. Sec.  17.525 through 
17.530.
    Educational loan means a loan, government or commercial, made for 
educational purposes by institutions that are subject to examination 
and supervision in their capacity as lending institutions by an agency 
of the United States or of the state in which the lender has its 
principal place of business. Loans must be for the actual costs paid 
for tuition, and other reasonable educational expenses such as living 
expenses, fees, books, supplies, educational equipment and materials, 
and laboratory expenses. Loans must be

[[Page 70912]]

obtained from a government entity, a private financial institution, a 
school, or any other authorized entity stated in this definition. The 
following loans do not qualify for the SELRP:
    (1) Loans obtained from family members, relatives, or friends;
    (2) Loans made prior to, or after, the individual's qualifying 
education;
    (3) Any portion of a consolidated loan that is not specifically 
identified with the education and purposes for which the SELRP may be 
authorized, such as home or auto loans merged with educational loans;
    (4) Loans for which an individual incurred a service obligation for 
repayment or agreed to service for future cancellation;
    (5) Credit card debt;
    (6) Parent Plus Loans;
    (7) Loans that have been paid in full;
    (8) Loans that are in default, delinquent, not in a current payment 
status, or have been assumed by a collection agency;
    (9) Loans not obtained from a bank, credit union, savings and loan 
association, not-for-profit organization, insurance company, school, 
and other financial or credit institution which is subject to 
examination and supervision in its capacity as a lending institution by 
an agency of the United States or of the state in which the lender has 
its principal place of business;
    (10) Loans for which supporting documentation is not available;
    (11) Loans that have been consolidated with loans of other 
individuals, such as spouses, children, friends, or other family 
member; or
    (12) Home equity loans or other non-educational loans.
    SELRP means the Specialty Education Loan Repayment Program 
established in Sec. Sec.  17.525 through 17.530.
    State means a State as defined in 38 U.S.C. 101(20), or a political 
subdivision of such a State.
    VA means the Department of Veterans Affairs.


Sec.  17.527  Eligibility.

    (a) General. An individual must meet the following requirements to 
be eligible to participate in the SELRP.
    (1) Will be eligible for appointment under 38 U.S.C. 7401 to work 
as a physician in a medical specialty for which VA determines that 
recruitment or retention of qualified personnel is difficult. In 
determining staffing needs, VA will consider the anticipated needs of 
VA for a period of two to six years in the future. VA will publish 
these vacancies in a notice in the Federal Register on a yearly basis 
until vacancies are filled.
    (2) Owes any amount of principal or interest for an educational 
loan where the proceeds were used by or on behalf of the individual to 
pay costs relating to a course of medical education or training that 
leads to employment as a physician and;
    (3) Is:
    (i) Recently graduated from an accredited medical or osteopathic 
school and matched to an accredited residency program in a medical 
specialty designated by VA; or
    (ii) A physician in training with more than 2 years remaining in 
such training.
    (b) Applicants without a residency match. An applicant may apply 
for the SELRP before receiving a residency match during the applicant's 
senior year of medical or osteopathic school. Once the applicant is 
matched with a residency specialty stated in Sec.  17.525 and upon 
selection of the SELRP, VA must offer the applicant participation in 
the SELRP no later than 28 days after
    (1) The applicant is matched with the residency; and
    (2) VA has published the residency in a Notice in the Federal 
Register. Such notices are published on a yearly basis until vacancies 
are filled.
    (c) Preferences. VA will give preference to eligible participants 
who:
    (1) Are, or will be, participating in residency programs in health 
care facilities that are:
    (i) Located in rural areas;
    (ii) Operated by Indian tribes, tribal organizations, or the Indian 
Health Services; or
    (iii) Are affiliated with underserved health care facilities of VA.
    (2) Veterans.


Sec.  17.528  Application.

    (a) General. A complete application for the SELRP consists of a 
completed application form, letters of reference, and personal 
statement.
    (b) References. The applicant must provide the following letters of 
reference and sign a release of information form for VA to contact such 
references. The letters of reference should include the following:
    (1) One letter of reference from the Program Director of the core 
program in which the applicant is training, which indicates that the 
applicant is in good to excellent standing, or, for individuals who 
have yet to initiate training, a letter of reference from a faculty 
member or dean;
    (2) One or more letters of reference from faculty members under 
which the applicant trained; and
    (3) One letter of reference from a peer colleague who is familiar 
with the practice and character of the applicant.
    (c) Personal statement. The personal statement must include the 
following documentation:
    (1) A cover letter that provides the following information:
    (i) Why the applicant is interested in VA employment;
    (ii) The applicant's interest in working at a particular medical 
specialty and underserved area;
    (iii) Likely career goals, including career goals in VA; and
    (iv) A brief summary of past employment or training and 
accomplishments, including any particular clinical areas of interest 
(e.g., substance abuse).
    (2) The following information must be provided on a VA form or 
online collection system and is subject to VA verification:
    (i) A summary of the applicant's educational debt, which includes 
the total debt amount and when the debt was acquired. The health 
professional debt covered the loan must be specific to education that 
was required, used, and qualified the applicant for appointment as a 
physician.
    (ii) The name of the lending agency that provided the educational 
loan.
    (3) A full curriculum vitae.
    (The Office of Management and Budget has approved the information 
collection requirements in this section under control number XXXX-
XXXX.)


Sec.  17.529  Award procedures.

    (a) Repayment amount. (1) VA may pay no more than $40,000 in 
educational loan repayment for each year of obligated service for a 
period not to exceed four years for a total payment of $160,000.00.
    (2) An educational loan repayment may not exceed the actual amount 
of principal and interest on an educational loan or loans.
    (b) Payment. VA will pay the participant, or the lending 
institution on behalf of the participant, directly for the principal 
and interest on the participant's educational loans. Payments will be 
made monthly or annually for each applicable service period, depending 
on the terms of the agreement. Participants must provide VA 
documentation that shows the amounts that were credited or posted by 
the lending institution to a participant's educational loan during an 
obligated service period. VA will issue payments after the participant 
commences the period of obligated service. Payments are exempt from 
Federal taxation.
    (c) Waiver of maximum amount of payment. VA may waive the 
limitations under paragraph (a)(1) of this section to participants of 
the SELRP if VA

[[Page 70913]]

determines that there is a shortage of qualified employees due to 
either the location of where the participant will serve the period of 
obligated service or the requirements of the position that the 
participant will hold in VA. However, the waiver may not exceed the 
actual amount of the principal and the interest on the participant's 
loans payable to or for that participant.


Sec.  17.530  Agreement and obligated service.

    (a) General. In addition to any requirements under section 5379(c) 
of title 5, a participant in the SELRP must agree, in writing, to the 
following:
    (1) Obtain a license to practice medicine in a State;
    (2) Successfully complete post-graduate training leading to 
eligibility for board certification in a medical specialty;
    (3) Serve as a full-time clinical practice employee of VA for 12 
months for every $40,000.00 that the participant receives payment 
through the SELRP, however, the participant must serve for a period of 
no fewer than 24 months; and
    (4) Except as provided in paragraph (b) of this section, begin 
obligated service as a full-time VA employee no later than 60 days 
after completing residency in the medical specialty described in Sec.  
17.527(a)(1).
    (b) Obligated service. (1) General provision. A participant's 
obligated service will begin on the date on which the participant 
begins full-time, permanent employment with VA in the qualifying field 
of medicine in a location determined by VA. Obligated service must be 
full-time, permanent employment and does not include any period of 
temporary or contractual employment.
    (2) Location and position of obligated service. VA will provide 
SELRP participants a list of qualifying medical facility locations. A 
participant may select a service location from that list. However, VA 
reserves the right to make final decisions on the location and position 
of the obligated service.
    (c) Exception to commencement of obligated service. If a 
participant receives an accredited fellowship in a medical specialty 
other than the specialty described in Sec.  17.27(a)(1), the 
participant may request, in writing, a delayed commencement of the 
period of obligated service until after the participant completes the 
fellowship. However, the period of obligated service will begin no 
later than 60 days after completion of such fellowship in the medical 
specialty described in Sec.  17.527(a)(1).


Sec.  17.531  Failure to comply with terms and conditions of agreement.

    A participant of the SELRP who fails to satisfy the period of 
obligated service will owe the United States government an amount 
determined by the formula A = B x ((T-S) / T)), where:
    (a) ``A'' is the amount the participant owes the United States 
government.
    (b) ``B'' is the sum of all payments to or for the participant 
under the SELRP.
    (c) ``T'' is the number of months in the period of obligated 
service of the participant.
    (d) ``S'' is the number of whole months of such period of obligated 
service served by the participant.

[FR Doc. 2019-27511 Filed 12-23-19; 8:45 am]
BILLING CODE 8320-01-P