IIB 

110TH CONGRESS 

2D SESSION H. R. 2583 

IN THE SENATE OF THE UNITED STATES 

SEPTEMBER 25 (legislative day, SEPTEMBER 17), 2008 

Received 

OCTOBER 2 (legislative day, SEPTEMBER 17), 2008 

Read twice and referred to the Committee on Health, Education, Labor, and 

Pensions 

AN ACT 

To amend title VII of the Public Health Service Act to 

establish a loan program for eligible hospitals to establish 

residency training programs. 

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


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1 SECTION 1. SHORT TITLE. 

2 This Act may be cited as the ‘‘Physician Workforce 

3 Enhancement Act of 2008’’. 

4 SEC. 2. HOSPITAL RESIDENCY LOAN PROGRAM. 

5 Subpart 2 of part E of title VII of the Public Health 

6 Service Act is amended by adding at the end the following 

7 new section: 

8 ‘‘SEC. 771. HOSPITAL RESIDENCY LOAN PROGRAM. 

9 ‘‘(a) ESTABLISHMENT.—Not later than October 1, 

10 2010, the Secretary, acting through the Administrator of 

11 the Health Resources and Services Administration, shall 

12 establish a hospital residency loan program that provides 

13 loans to eligible hospitals to establish a residency training 

14 program. 

15 ‘‘(b) APPLICATION.—No loan may be provided under 

16 this section to an eligible hospital except pursuant to an 

17 application that is submitted and approved in a time, man18 ner, and form specified by the Administrator of the Health 

19 Resources and Services Administration. A loan under this 

20 section shall be on such terms and conditions and meet 

21 such requirements as the Administrator determines appro22 priate, in accordance with the provisions of this section. 

23 ‘‘(c) ELIGIBILITY; PREFERENCE FOR RURAL

24 AREAS.— 

25 ‘‘(1) ELIGIBLE HOSPITAL DEFINED.—For pur26 poses of this section, an ‘eligible hospital’ means, 


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1 with respect to a loan under this section, a public or 

2 non-profit hospital that, as of the date of the sub3 mission of an application under subsection (b), 

4 meets, to the satisfaction of the Administrator of the 

5 Health Resources and Services Administration, each 

6 of the following criteria: 

7 ‘‘(A) The hospital does not operate a resi8 dency training program and has not previously 

9 operated such a program. 

10 ‘‘(B) The hospital has secured initial ac11 creditation by the American Council for Grad12 uate Medical Education or the American Osteo13 pathic Association. 

14 ‘‘(C) The hospital provides assurances to 

15 the satisfaction of the Administrator of the 

16 Health Resources and Services Administration 

17 that such loan shall be used, consistent with 

18 subsection (d), only for the purposes of estab19 lishing and conducting an allopathic or osteo20 pathic physician residency training program in 

21 at least one of the following, or a combination 

22 of the following: 

23 ‘‘(i) Family medicine. 

24 ‘‘(ii) Internal medicine. 

25 ‘‘(iii) Obstetrics or gynecology. 


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1 ‘‘(iv) Behavioral or Mental health. 

2 ‘‘(v) Pediatrics. 

3 ‘‘(D) The hospital enters into an agree4 ment with the Administrator that certifies the 

5 hospital will provide for the repayment of the 

6 loan in accordance with subsection (e). 

7 ‘‘(2) PREFERENCE FOR RURAL AREAS.—In 

8 making loans under this section, the Administrator 

9 of the Health Resources and Services Administration 

10 shall create guidelines that give preference to rural 

11 areas (as such term is defined in section 

12 1886(d)(2)(D) of the Social Security Act). 

13 ‘‘(d) PERMISSIBLE USES OF LOAN FUNDS.—A loan 

14 provided under this section shall be used, with respect to 

15 a residency training program, only for costs directly at16 tributable to the residency training program, except as 

17 otherwise provided by the Administrator of the Health Re18 sources and Services Administration. 

19 ‘‘(e) REPAYMENT OF LOANS.— 

20 ‘‘(1) REPAYMENT PLANS.—For purposes of 

21 subsection (c)(1)(D), a repayment plan for an eligi22 ble hospital is in accordance with this subsection if 

23 it provides for the repayment of the loan amount in 

24 installments, in accordance with a schedule that is 

25 agreed to by the Administrator of the Health ReVerDate Aug 31 2005 04:15 Oct 03, 2008 Jkt 079200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H2583.RFS H2583

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1 sources and Services Administration and the hospital 

2 and that is in accordance with paragraphs (2), (3), 

3 and (4). 

4 ‘‘(2) COMMENCEMENT OF REPAYMENT.—Re5 payment by an eligible hospital of a loan under this 

6 section shall commence not later than the date that 

7 is 18 months after the date on which the loan 

8 amount is disbursed to such hospital. 

9 ‘‘(3) REPAYMENT PERIOD.—A loan made under 

10 this section shall be fully repaid not later than the 

11 date that is 24 months after the date on which the 

12 repayment is required to commence. 

13 ‘‘(4) LOAN PAYABLE IN FULL IF RESIDENCY

14 TRAINING PROGRAM CANCELED.—In the case that 

15 an eligible hospital borrows a loan under this sec16 tion, with respect to a residency training program, 

17 and terminates such program before the date on 

18 which such loan has been fully repaid in accordance 

19 with a plan under paragraph (1), such loan shall be 

20 payable by the hospital not later than 45 days after 

21 the date of such termination. 

22 ‘‘(f) NO INTEREST CHARGED.—The Administrator of 

23 the Health Resources and Services Administration may 

24 not charge or collect interest on any loan made under this 

25 section. 


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1 ‘‘(g) LIMITATION ON TOTAL AMOUNT OF LOAN.— 

2 The cumulative annual dollar amount of a loan made to 

3 an eligible hospital under this section may not exceed 

4 $250,000. 

5 ‘‘(h) PENALTIES.—The Administrator of the Health 

6 Resources and Services Administration shall establish pen7 alties to which an eligible hospital receiving a loan under 

8 this section would be subject if such hospital is in violation 

9 of any of the criteria described in subsection (c)(1). Such 

10 penalties shall include the charge or collection of interest, 

11 at a rate to be determined by the Administrator of the 

12 Health Resources and Services Administration. Except as 

13 otherwise provided, penalties collected under this sub14 section shall be paid to the Administrator of the Health 

15 Resources and Services Administration and shall, subject 

16 to appropriation Acts, be available until expended for the 

17 purpose of enforcing the provisions of this section. 

18 ‘‘(i) REPORTS.—Not later than January 1, 2012, and 

19 annually thereafter (before January 2, 2014), the Admin20 istrator of the Health Resources and Services Administra21 tion shall submit to Congress a report on the efficacy of 

22 the program under this section in increasing the number 

23 of residents practicing in each medical specialty described 

24 in subsection (c)(1)(C) during such year and the extent 

25 to which the program resulted in an increase in the numVerDate Aug 31 2005 04:15 Oct 03, 2008 Jkt 079200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H2583.RFS H2583

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1 ber of available practitioners in each of such medical spe2 cialties that serve medically underserved populations. 

3 ‘‘(j) FUNDING.— 

4 ‘‘(1) AUTHORIZATION OF APPROPRIATIONS.— 

5 For the purpose of providing amounts for loans 

6 under this section, there are authorized to be appro7 priated such sums as may be necessary to provide— 

8 ‘‘(A) $8,000,000 in loans for fiscal year 

9 2010; 

10 ‘‘(B) $8,400,000 in loans for fiscal year 

11 2011; 

12 ‘‘(C) $8,820,000 in loans for fiscal year 

13 2012; 

14 ‘‘(D) $9,261,000 in loans for fiscal year 

15 2013; and 

16 ‘‘(E) $9,724,050 in loans for fiscal year 

17 2014. 

18 ‘‘(2) AVAILABILITY.—Amounts appropriated 

19 under paragraph (1) shall remain available until ex20 pended. 


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1 ‘‘(k) TERMINATION OF PROGRAM.—No loan may be 

2 made under this section after December 31, 2013.’’. 

Passed the House of Representatives September 23, 

2008. 

Attest: LORRAINE C. MILLER, 

Clerk. 


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