I 

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. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Primary Care Physi5 cian Reentry Act of 2015’’. 

6 SEC. 2. FINDINGS. 

7 Congress finds as follows: 

8 (1) According to the Association of American 

9 Medical Colleges— 


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1 (A) the shortage of primary care physi2 cians will reach 45,000 by the year 2020, as 

3 fewer than 20 percent of medical students 

4 choose to enter primary care medicine; and 

5 (B) the overall shortage of physicians in 

6 the United States is expected to surpass 

7 130,000 by 2025. 

8 (2) Medical schools in the United States train 

9 only approximately 18,000 new physicians every 

10 year. 

11 (3) The Department of Health and Human 

12 Services estimates that the United States needs at 

13 least 16,000 more primary care physicians. 

14 (4) According to a survey of 1,600 pediatricians 

15 over the age of 50 conducted by the Association of 

16 American Medical Colleges and the American Acad17 emy of Pediatrics, 22 percent of female pediatricians 

18 took extended leave (6 months or more) from medi19 cine, compared to only 6.5 percent of male pediatri20 cians. Seventy-one percent of the female pediatri21 cians who took extended leave did so to care for a 

22 child or family member. 

23 SEC. 3. REENTRY PROGRAM FOR PHYSICIANS. 

24 (a) ACTIVITIES OF THE SECRETARY.— 


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1 (1) ESTABLISHMENT OF DEMONSTRATION PRO2 GRAM.—The Secretary of Health and Human Serv3 ices (referred to in this section as the ‘‘Secretary’’) 

4 shall establish a demonstration program to assist the 

5 development of innovative programs that facilitate 

6 physician reentry into clinical practice to provide pri7 mary health services. Under such demonstration pro8 gram, the Secretary shall— 

9 (A) award one grant, on a competitive 

10 basis, to an eligible entity described in sub11 section (b) in each of the 10 regions served by 

12 a regional office of the Department of Health 

13 and Human Services to carry out physician re14 entry projects to assist reentering physicians 

15 participating in such projects through any of 

16 the activities described in subsection (d); and 

17 (B) in consultation with key stakeholders 

18 and subject to paragraph (2)(B), carry out the 

19 administrative activities described in paragraph 

20 (2)(A). 

21 (2) ADMINISTRATIVE ACTIVITIES.— 

22 (A) IN GENERAL.—For purposes of para23 graph (1)(B), the administrative activities de24 scribed in this subparagraph are the following: 


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1 (i) Conduct a national needs assess2 ment with regard to the supply of physi3 cians who provide primary health services, 

4 using, to the extent feasible, information 

5 collected for use in other similar completed 

6 or forthcoming studies, such as studies 

7 conducted by the Agency for Healthcare 

8 Research and Quality and the Health Re9 sources and Services Administration. 

10 (ii) Develop a database that contains 

11 a directory of programs that help physi12 cians reenter clinical practice. 

13 (iii) Disseminate evidence-based as14 sessments and evaluation tools as such as15 sessments and tools become available to 

16 measure the basic core competencies of 

17 physicians reentering clinical practice that 

18 are consistent with the guidelines pub19 lished by the Federation of State Medical 

20 Boards for such physicians. 

21 (iv) Assist State regulatory authorities 

22 and hospital credentialing committees to 

23 structure requirements for physicians to 

24 return to clinical practice in a manner that 


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1 ensures patient safety while addressing the 

2 burdens on such reentering physicians. 

3 (B) LIMITATION.—The Secretary shall use 

4 not more than 15 percent of the funds appro5 priated to carry out this section to carry out 

6 the activities described in subparagraph (A). 

7 (b) ELIGIBLE ENTITIES.—Entities eligible to receive 

8 a grant under this section are the following: 

9 (1) A State (as defined in section 2(f) of the 

10 Public Health Service Act, 42 U.S.C. 201(f)). 

11 (2) A hospital. 

12 (3) An academic medical center. 

13 (4) A medical school. 

14 (5) A health center (as defined in section 

15 330(a) of the Public Health Service Act (42 U.S.C. 

16 254b(a))). 

17 (6) A teaching health center. 

18 (7) A nonprofit organization with a dem19 onstrated history or expertise in providing physician 

20 education and with the ability to offer programs spe21 cifically targeted at reentering physicians. 

22 (c) APPLICATION.—In order to receive a grant under 

23 this section, an eligible entity shall submit to the Secretary 

24 an application at such time, in such manner, and con25 taining such information as the Secretary may require. 


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1 (d) USES OF FUNDS.—An eligible entity that receives 

2 funds under this section shall use such funds to carry out 

3 a physician reentry project to assist reentering physicians 

4 participating in the project through any of the following 

5 activities: 

6 (1) Training such reentering physicians to reen7 ter clinical practice. 

8 (2) Paying credentialing fees and other fees 

9 that are necessary for such reentering physicians to 

10 reenter clinical practice. 

11 (3) Paying the salaries of such reentering phy12 sicians who are so eligible to reenter clinical practice 

13 during the period for which such physicians provide 

14 primary health services at a center described in sub15 section (e)(1). 

16 (4) Providing loan repayment assistance and 

17 other financial assistance, including scholarships and 

18 grants for education and training, to such reentering 

19 physicians. 

20 (e) REQUIREMENTS OF REENTRY PHYSICIANS TO

21 PARTICIPATE IN PROJECTS.—To be eligible to participate 

22 in a physician reentry project carried out by an eligible 

23 entity under this section, a reentering physician shall pro24 vide assurances satisfactory to the Secretary that the phy25 sician will comply with the following: 


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1 (1) SERVICE LOCATIONS.—The reentering phy2 sician shall provide primary health services at— 

3 (A) a health center (as defined in section 

4 330(a) of the Public Health Service Act (42 

5 U.S.C. 254b(a))); 

6 (B) a Veterans Administration Medical 

7 Center if the Secretary of Veterans Affairs cer8 tifies that there is a shortage of physicians at 

9 such medical center; or 

10 (C) a school-based health center (as de11 fined in section 2110(c)(9) of the Social Secu12 rity Act (42 U.S.C. 1397jj(c)(9))). 

13 (2) LENGTH OF SERVICE.—The reentering phy14 sician shall provide such services at such a center, 

15 consistent with paragraph (1), for not less than 2 

16 years. 

17 (f) LIABILITY PROTECTIONS.—For purposes of sec18 tion 224 of the Public Health Service Act (42 U.S.C. 233), 

19 a reentering physician participating in a physician reentry 

20 project under this section shall be deemed to be an em21 ployee of the Public Health Service working within the 

22 scope of such employment with respect to primary health 

23 services provided by such reentering physician at a center 

24 described in subsection (e)(1) under the terms of such par25 ticipation in such project. The remedy against the United 


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1 States for a physician described in paragraph (2) who is 

2 deemed to be an employee of the Public Health Service 

3 pursuant to the previous sentence shall be exclusive of any 

4 other civil action or proceeding to the same extent as the 

5 remedy against the United States is exclusive pursuant to 

6 subsection (a) of such section. 

7 (g) ANNUAL REVIEW AND REPORT.—For any year 

8 during which the demonstration program under this sec9 tion is carried out, the Secretary shall conduct a review 

10 and comprehensive evaluation of such program and shall 

11 prepare and submit to Congress a report assessing such 

12 program, including an assessment of the performance of 

13 the reentering physicians who participate in physician re14 entry projects under such program. 

15 (h) REENTERING PHYSICIANS.— 

16 (1) DEFINITION.—Subject to paragraph (2), for 

17 purposes of this section, the term ‘‘reentering physi18 cian’’ means an individual— 

19 (A) who is a physician (as defined in sec20 tion 1861(r)(1) of the Social Security Act, 42 

21 U.S.C. 1395x(r)(1)); 

22 (B) who received training in primary care 

23 or primary health services, including family 

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1 rics and gynecology, dentistry, and mental 

2 health. 

3 (C) who was previously (and may currently 

4 be) legally authorized to practice medicine and 

5 surgery by a State; 

6 (D) who previously engaged in the clinical 

7 practice of medicine, but who is not currently 

8 engaged in the clinical practice of medicine and 

9 has not been engaged in such practice for a pe10 riod of 2 years or such longer period deter11 mined to be sufficient by the Secretary; and 

12 (E) who provides assurances satisfactory 

13 to the Secretary and the respective State licens14 ing board that the individual will return to clin15 ical practice in the discipline in which such indi16 vidual was trained or certified, including, if ap17 plicable, by regaining necessary training and 

18 certification for legal authorization to practice 

19 medicine and surgery by a State. 

20 (2) EXCLUSIONS.—For purposes of this section, 

21 the term ‘‘reentering physician’’ does not include an 

22 individual if— 

23 (A) such individual has failed to complete 

24 an obligation to provide health care services 

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1 cluding any period of obligated service under 

2 subpart III of part D of title III of the Public 

3 Health Service Act (42 U.S.C. 254l et seq.)); or 

4 (B) the individual has a debt due to the 

5 United States. 

6 (i) PRIMARY HEALTH SERVICES DEFINED.—For 

7 purposes of this section, the term ‘‘primary health serv8 ices’’ has the meaning given such term in section 

9 331(a)(3) of the Public Health Service Act (42 U.S.C. 

10 254d(a)(3)). 

11 (j) AUTHORIZATION OF APPROPRIATIONS.—There is 

12 authorized to be appropriated to carry out this section 

13 such sums as may be necessary for fiscal year 2016. 

Æ 


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