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

Summary: Physician Workforce Enhancement Act of 2009 - Amends the Public Health Service Act to require the Secretary of Health and Human Services, acting through the Administrator of the Health Resources and Services Administration, to establish a loan program that provides loans to eligible hospitals to establish residency training programs. Requires that such program be an allopathic or osteopathic physician residency training program in family medicine, internal medicine, emergency medicine, obstetrics or gynecology, general surgery, preventive medicine, pediatrics, and behavioral and mental health. Requires the Administrator to give preference to hospitals in a rural area or an urban area that is not a large urban area.

SECTION 1. SHORT TITLE.

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

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, 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.''.