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Union Calendar No. 568 

110TH CONGRESS 

2D SESSION H. R. 2583 

[Report No. 110–872] 

To amend title VII of the Public Health Service Act to establish a loan 

program for eligible hospitals to establish residency training programs. 

IN THE HOUSE OF REPRESENTATIVES 

JUNE 6, 2007 

Mr. BURGESS (for himself and Mr. MATHESON) introduced the following bill; 

which was referred to the Committee on Energy and Commerce 

SEPTEMBER 23, 2008 

Additional sponsors: Ms. GRANGER, Mr. SMITH of Texas, Mr. LATOURETTE, 

Mrs. EMERSON, Mr. GILCHREST, Mr. PLATTS, Mr. CASTLE, Mr. 

GINGREY, Mr. BOREN, Mr. KIND, Ms. JACKSON-LEE of Texas, Mr. 

PEARCE, Mr. AKIN, Mr. GORDON of Tennessee, Mr. GOHMERT, Mr. POE, 

Ms. HIRONO, Mr. SNYDER, Mr. GONZALEZ, Mr. BRALEY of Iowa, Mr. 

MCCOTTER, and Mr. HOLDEN

SEPTEMBER 23, 2008 

Reported with an amendment, committed to the Committee of the Whole 

House on the State of the Union, and ordered to be printed 

[Strike out all after the enacting clause and insert the part printed in italic] 

[For text of introduced bill, see copy of bill as introduced on June 6, 2007] 

A BILL 

To amend title VII of the Public Health Service Act to 

establish a loan program for eligible hospitals to establish 

residency training programs. 


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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 ‘‘Physician Workforce 

5 Enhancement Act of 2008’’. 

6 SEC. 2. HOSPITAL RESIDENCY LOAN PROGRAM. 

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

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

9 new section: 

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

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

12 2010, the Secretary, acting through the Administrator of 

13 the Health Resources and Services Administration, shall es14 tablish a hospital residency loan program that provides 

15 loans to eligible hospitals to establish a residency training 

16 program. 

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

18 this section to an eligible hospital except pursuant to an 

19 application that is submitted and approved in a time, man20 ner, and form specified by the Administrator of the Health 

21 Resources and Services Administration. A loan under this 

22 section shall be on such terms and conditions and meet such 

23 requirements as the Administrator determines appropriate, 

24 in accordance with the provisions of this section. 

25 ‘‘(c) ELIGIBILITY; PREFERENCE FOR RURAL AREAS.— 


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1 ‘‘(1) ELIGIBLE HOSPITAL DEFINED.—For pur2 poses of this section, an ‘eligible hospital’ means, with 

3 respect to a loan under this section, a public or non4 profit hospital that, as of the date of the submission 

5 of an application under subsection (b), meets, to the 

6 satisfaction of the Administrator of the Health Re7 sources and Services Administration, each of the fol8 lowing criteria: 

9 ‘‘(A) The hospital does not operate a resi10 dency training program and has not previously 

11 operated such a program. 

12 ‘‘(B) The hospital has secured initial ac13 creditation by the American Council for Grad14 uate Medical Education or the American Osteo15 pathic Association. 

16 ‘‘(C) The hospital provides assurances to the 

17 satisfaction of the Administrator of the Health 

18 Resources and Services Administration that such 

19 loan shall be used, consistent with subsection (d), 

20 only for the purposes of establishing and con21 ducting an allopathic or osteopathic physician 

22 residency training program in at least one of the 

23 following, or a combination of the following: 

24 ‘‘(i) Family medicine. 

25 ‘‘(ii) Internal medicine. 


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1 ‘‘(iii) Obstetrics or gynecology. 

2 ‘‘(iv) Behavioral or Mental health. 

3 ‘‘(v) Pediatrics. 

4 ‘‘(D) The hospital enters into an agreement 

5 with the Administrator that certifies the hospital 

6 will provide for the repayment of the loan in ac7 cordance with subsection (e). 

8 ‘‘(2) PREFERENCE FOR RURAL AREAS.—In mak9 ing loans under this section, the Administrator of the 

10 Health Resources and Services Administration shall 

11 create guidelines that give preference to rural areas 

12 (as such term is defined in section 1886(d)(2)(D) of 

13 the Social Security Act). 

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

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

16 a residency training program, only for costs directly attrib17 utable to the residency training program, except as other18 wise provided by the Administrator of the Health Resources 

19 and Services Administration. 

20 ‘‘(e) REPAYMENT OF LOANS.— 

21 ‘‘(1) REPAYMENT PLANS.—For purposes of sub22 section (c)(1)(D), a repayment plan for an eligible 

23 hospital is in accordance with this subsection if it 

24 provides for the repayment of the loan amount in in25 stallments, in accordance with a schedule that is 


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1 agreed to by the Administrator of the Health Re2 sources and Services Administration and the hospital 

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

4 and (4). 

5 ‘‘(2) COMMENCEMENT OF REPAYMENT.—Repay6 ment by an eligible hospital of a loan under this sec7 tion shall commence not later than the date that is 

8 18 months after the date on which the loan amount 

9 is disbursed to such hospital. 

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

11 this section shall be fully repaid not later than the 

12 date that is 24 months after the date on which the re13 payment is required to commence. 

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

15 TRAINING PROGRAM CANCELED.—In the case that an 

16 eligible hospital borrows a loan under this section, 

17 with respect to a residency training program, and 

18 terminates such program before the date on which 

19 such loan has been fully repaid in accordance with a 

20 plan under paragraph (1), such loan shall be payable 

21 by the hospital not later than 45 days after the date 

22 of such termination. 

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

24 the Health Resources and Services Administration may not 


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1 charge or collect interest on any loan made under this sec2 tion. 

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

4 cumulative annual dollar amount of a loan made to an eli5 gible hospital under this section may not exceed $250,000. 

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

7 Resources and Services Administration shall establish pen8 alties to which an eligible hospital receiving a loan under 

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

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

11 penalties shall include the charge or collection of interest, 

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

13 Health Resources and Services Administration. Except as 

14 otherwise provided, penalties collected under this subsection 

15 shall be paid to the Administrator of the Health Resources 

16 and Services Administration and shall, subject to appro17 priation Acts, be available until expended for the purpose 

18 of enforcing the provisions of this section. 

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

20 annually thereafter (before January 2, 2014), the Adminis21 trator of the Health Resources and Services Administration 

22 shall submit to Congress a report on the efficacy of the pro23 gram under this section in increasing the number of resi24 dents practicing in each medical specialty described in sub25 section (c)(1)(C) during such year and the extent to which 


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1 the program resulted in an increase in the number of avail2 able practitioners in each of such medical specialties that 

3 serve medically underserved populations. 

4 ‘‘(j) FUNDING.— 

5 ‘‘(1) AUTHORIZATION OF APPROPRIATIONS.—For 

6 the purpose of providing amounts for loans under this 

7 section, there are authorized to be appropriated such 

8 sums as may be necessary to provide— 

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

10 2010; 

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

12 2011; 

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

14 2012; 

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

16 2013; and 

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

18 2014. 

19 ‘‘(2) AVAILABILITY.—Amounts appropriated 

20 under paragraph (1) shall remain available until ex21 pended. 

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

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


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Union Calendar No. 568 

110TH CONGRESS 

2D SESSION H. R. 2583 

[Report No. 110–872] 

A BILL 

To amend title VII of the Public Health Service 

pitals to establish residency training programs. Act to establish a loan program for eligible hosSEPTEMBER 23, 2008 

Reported with an amendment, committed to the Comand ordered to be printed mittee of the Whole House on the State of the Union, 


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