II 

118TH CONGRESS 

1ST SESSION S. 705 

To amend the Public Health Service Act to authorize a loan repayment 

program to encourage specialty medicine physicians to serve in rural 

communities experiencing a shortage of specialty medicine physicians, 

and for other purposes. 

IN THE SENATE OF THE UNITED STATES 

MARCH 8, 2023 

Ms. ROSEN (for herself and Mr. WICKER) introduced the following bill; which 

was read twice and referred to the Committee on Health, Education, 

Labor, and Pensions 

A BILL 

To amend the Public Health Service Act to authorize a 

loan repayment program to encourage specialty medicine 

physicians to serve in rural communities experiencing 

a shortage of specialty medicine physicians, and for other 

purposes. 

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 ‘‘Specialty Physicians 

5 Advancing Rural Care Act’’ or the ‘‘SPARC Act’’. 


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1 SEC. 2. SPECIALTY MEDICAL PRACTITIONERS WORKFORCE 

2 IN RURAL COMMUNITIES. 

3 Title VII of the Public Health Service Act (42 U.S.C. 

4 292 et seq.) is amended— 

5 (1) by redesignating part G (42 U.S.C. 795j et 

6 seq.) as part H; and 

7 (2) by inserting after part F (42 U.S.C. 295h) 

8 the following new part: 

9 ‘‘PART G—SPECIALTY MEDICINE WORKFORCE IN 

10 RURAL COMMUNITIES 

11 ‘‘SEC. 782. LOAN REPAYMENT PROGRAM. 

12 ‘‘(a) IN GENERAL.— 

13 ‘‘(1) PROGRAM FOR SPECIALTY MEDICINE PHY14 SICIANS.—The Secretary, acting through the Admin15 istrator of the Health Resources and Services Ad16 ministration, shall carry out a program under 

17 which— 

18 ‘‘(A) the Secretary enters into agreements 

19 with specialty medicine physicians to make pay20 ments in accordance with subsection (b) on the 

21 principal of and interest on any eligible loans 

22 described in subsection (c); and 

23 ‘‘(B) the specialty medicine physicians 

24 each agree to complete a period of obligated 

25 service described in subsection (d) as a specialty 

26 medicine physician in the United States in a 


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1 rural community experiencing a shortage of 

2 specialty medicine physicians. 

3 ‘‘(2) PROGRAM FOR NON-PHYSICIAN SPECIALTY

4 HEALTH CARE PROVIDERS.—The Secretary, acting 

5 through the Administrator of the Health Resources 

6 and Services Administration, may carry out a pro7 gram under which— 

8 ‘‘(A) the Secretary enters into agreements 

9 with non-physician specialty health care pro10 viders to make payments in accordance with 

11 subsection (b) on the principal of and interest 

12 on any eligible loans described in subsection (c); 

13 and 

14 ‘‘(B) the non-physician specialty health 

15 care providers each agree to complete a period 

16 of obligated service described in subsection (d) 

17 as a non-physician specialty health care pro18 vider in the United States in a rural community 

19 experiencing a shortage of such providers. 

20 ‘‘(b) PAYMENTS.—For each year of obligated service 

21 by a specialty medicine physician pursuant to an agree22 ment under subsection (a)(1) or by a non-physician spe23 cialty health care provider pursuant to an agreement 

24 under subsection (a)(2), the Secretary shall make a pay25 ment to such physician or provider as follows: 


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1 ‘‘(1) SERVICE IN SHORTAGE AREA.—The Sec2 retary shall pay— 

3 ‘‘(A) for each year of obligated service by 

4 a specialty medicine physician or non-physician 

5 specialty health care provider pursuant to an 

6 agreement under paragraph (1) or (2) of subsection (a), 1 7 ⁄6 of the principal of and interest 

8 on each eligible loan of the physician or pro9 vider which is outstanding on the date the phy10 sician or provider began service pursuant to the 

11 agreement; and 

12 ‘‘(B) for completion of the sixth and final 

13 year of such service, the remainder of such 

14 principal and interest. 

15 ‘‘(2) MAXIMUM AMOUNT.—The total amount of 

16 payments under this section to any specialty medi17 cine physician or non-physician specialty health care 

18 provider shall not exceed $250,000. 

19 ‘‘(c) ELIGIBLE LOANS.—The loans eligible for repay20 ment under this section are each of the following: 

21 ‘‘(1) Any loan for education in specialty medi22 cine or specialty health care. 

23 ‘‘(2) Any Federal Direct Stafford Loan, Fed24 eral Direct PLUS Loan, Federal Direct Unsub25 sidized Stafford Loan, or Federal Direct ConsolidaVerDate Sep 11 2014 01:32 Mar 16, 2023 Jkt 039200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\S705.IS S705

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1 tion Loan (as such terms are used in section 455 of 

2 the Higher Education Act of 1965). 

3 ‘‘(3) Any Federal Perkins Loan under part E 

4 of title I of the Higher Education Act of 1965. 

5 ‘‘(4) Any other Federal loan as determined ap6 propriate by the Secretary. 

7 ‘‘(d) PERIOD OF OBLIGATED SERVICE.—Any spe8 cialty medicine physician or non-physician specialty health 

9 care provider receiving payments under this section as re10 quired by an agreement under paragraph (1) or (2) of sub11 section (a) shall agree to a 6-year commitment to full-time 

12 employment, with no more than 1 year passing between 

13 any 2 years of covered employment, as a specialty medi14 cine physician or non-physician specialty health care pro15 vider, as applicable, in the United States in a rural com16 munity experiencing a shortage of specialty medicine phy17 sicians or non-physician specialty health care providers, as 

18 applicable. 

19 ‘‘(e) INELIGIBILITY FOR DOUBLE BENEFITS.—No 

20 borrower may, for the same service, receive a reduction 

21 of loan obligations or a loan repayment under both— 

22 ‘‘(1) this section; and 

23 ‘‘(2) any federally supported loan forgiveness 

24 program, including under section 338B, 338I, or 


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1 846 of this Act, or section 428J, 428L, 455(m), or 

2 460 of the Higher Education Act of 1965. 

3 ‘‘(f) BREACH.— 

4 ‘‘(1) LIQUIDATED DAMAGES FORMULA.—The 

5 Secretary may establish a liquidated damages for6 mula to be used in the event of a breach of an 

7 agreement entered into under paragraph (1) or (2) 

8 of subsection (a). 

9 ‘‘(2) LIMITATION.—The failure by a specialty 

10 medicine physician or a non-physician specialty 

11 health care provider to complete the full period of 

12 service obligated pursuant to such an agreement, 

13 taken alone, shall not constitute a breach of the 

14 agreement, so long as the physician or provider com15 pleted in good faith the years of service for which 

16 payments were made to the physician or provider 

17 under this section. 

18 ‘‘(g) SPECIAL RULES FOR NON-PHYSICIAN SPE19 CIALTY HEALTH CARE PROVIDERS.—Non-physician spe20 cialty health care providers participating in the program 

21 under this section are not eligible for other Federal loan 

22 forgiveness programs specific to health care providers. Not 

23 more than 15 percent of amounts made available to carry 

24 out this section for a fiscal year may be allocated to 

25 awards to non-physician specialty health care providers. 


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1 ‘‘(h) REPORTS TO CONGRESS.—Not later than 5 

2 years after the date of enactment of this section, and not 

3 less than every other year thereafter through fiscal year 

4 2031, the Secretary shall report to Congress on— 

5 ‘‘(1) the practice location of special medicine 

6 physicians and non-physician specialty health care 

7 providers participating, or who have participated, in 

8 the loan repayment program under this section; and 

9 ‘‘(2) the impact of the loan repayment program 

10 under this section on the availability of specialty 

11 medicine or specialty health care services in the 

12 United States in rural communities experiencing a 

13 shortage of specialty medicine physicians or non14 physician specialty health care providers. 

15 ‘‘(i) DATA UPDATES.—The Administrator of the 

16 Health Resources and Services Administration shall up17 date publicly available data on the supply of specialty med18 icine physicians and non-physician specialty health care 

19 providers, as appropriate. 

20 ‘‘(j) DEFINITIONS.—In this section: 

21 ‘‘(1) NON-PHYSICIAN SPECIALTY HEALTH CARE

22 PROVIDER.—The term ‘non-physician specialty 

23 health care provider’ means a health professional 

24 other than a physician who is licensed to provide pa25 tient care other than primary care services. 


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1 ‘‘(2) SPECIALTY MEDICINE PHYSICIAN.—The 

2 term ‘specialty medicine physician’ means a physi3 cian practicing in— 

4 ‘‘(A) a specialty identified in the report of 

5 the Health Resources and Services Administra6 tion, titled ‘Projecting the Supply of Non-Pri7 mary Care Specialty and Subspecialty Clini8 cians: 2010–2025’; 

9 ‘‘(B) hospice and palliative medicine; 

10 ‘‘(C) geriatric medicine; or 

11 ‘‘(D) another medical specialty, if the Sec12 retary determines that there is evidence dem13 onstrating a significant shortage of providers in 

14 the medical specialty and limited patient access 

15 to care. 

16 ‘‘(k) AUTHORIZATION OF APPROPRIATIONS.—To 

17 carry out this section, there are authorized to be appro18 priated such sums as may be necessary for fiscal years 

19 2023 through 2032.’’. 

Æ 


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