I 

111TH CONGRESS 

1ST SESSION H. R. 1185 

To amend the Public Health Service Act to provide for a competitive loan 

repayment program for primary care physicians who commit to volunteering part-time at community health centers. 

IN THE HOUSE OF REPRESENTATIVES 

FEBRUARY 25, 2009 

Ms. CASTOR of Florida introduced the following bill; which was referred to the 

Committee on Energy and Commerce 

A BILL 

To amend the Public Health Service Act to provide for 

a competitive loan repayment program for primary care 

physicians who commit to volunteering part-time at community health centers. 

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 Volun5 teer Incentive Act of 2009’’. 

6 SEC. 2. PRIMARY CARE LOAN REPAYMENT PROGRAM. 

7 Part C of title VII of the Public Health Service Act 

8 is amended by adding at the end the following new section: 


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1 ‘‘SEC. 749. PRIMARY CARE LOAN REPAYMENT PROGRAM. 

2 ‘‘(a) PURPOSE.—It is the purpose of this section to 

3 alleviate critical shortages of primary care physicians. 

4 ‘‘(b) LOAN REPAYMENTS.—The Secretary shall es5 tablish a loan repayment program of entering into con6 tracts (under terms and conditions specified by the Sec7 retary and consistent with this section) with eligible indi8 viduals under which, subject to subsection (i)(2)— 

9 ‘‘(1) the individual agrees to serve without pay 

10 for at least 4 hours each week for a period of 5 con11 secutive years— 

12 ‘‘(A) as a primary care physician; and 

13 ‘‘(B) at a health center, as defined in sec14 tion 330, designated by the Secretary (as of the 

15 date of the application of the individual for a 

16 contract under this section) as serving an area 

17 with a shortage of primary care physicians; and 

18 ‘‘(2) the Secretary agrees to pay, for each year 

19 of such service, not more than $5,000 of the prin20 cipal and interest of the graduate educational loans 

21 of the individual. 

22 ‘‘(c) ELIGIBILITY.—To be eligible to participate in 

23 the loan repayment program under this section, an indi24 vidual must— 

25 ‘‘(1) have a degree in medicine or osteopathic 

26 medicine; 


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1 ‘‘(2)(A) have completed an accredited graduate 

2 medical residency training program in primary care 

3 medicine; or 

4 ‘‘(B) be enrolled in such a residency training 

5 program; and 

6 ‘‘(3) submit to the Secretary an application, in 

7 such form, manner, and time as specified by the 

8 Secretary, for a contract under this section. 

9 ‘‘(d) APPLICATION, CONTRACT, AND INFORMATION

10 REQUIREMENTS.—The provisions of section 338B(c) 

11 shall, except as inconsistent with this section, apply to the 

12 loan repayment program under this section in the same 

13 manner and to the same extent as such provisions apply 

14 to the National Health Service Corps Loan Repayment 

15 Program under section 338B, except that each reference 

16 to a health professional shortage area shall be deemed a 

17 reference to a community health center described in sub18 section (b)(1)(B). 

19 ‘‘(e) PRIORITY.—In providing contracts under the 

20 loan repayment program under this section, the Secretary 

21 shall give priority to individuals who agree to serve in com22 munity health centers described in subsection (b)(1)(B) 

23 that are located in areas that the Secretary, as of the date 

24 of the individual’s application for a contract under this 


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1 section, has designated under section 332 as health profes2 sional shortage areas. 

3 ‘‘(f) APPROVAL REQUIRED FOR PARTICIPATION.—An 

4 individual becomes a participant in the loan repayment 

5 program under this section only upon the Secretary and 

6 the individual entering into a written contract under this 

7 section. 

8 ‘‘(g) PAYMENTS.— 

9 ‘‘(1) IN GENERAL.—A loan repayment provided 

10 for an individual under a written contract under this 

11 section shall consist of payment, in accordance with 

12 paragraph (2), on behalf of the individual of the 

13 principal, interest, and related expenses on govern14 ment and commercial loans received by the indi15 vidual regarding the graduate education of the indi16 vidual, which loans were made for— 

17 ‘‘(A) tuition expenses; 

18 ‘‘(B) all other reasonable educational ex19 penses, including fees, books, and laboratory ex20 penses, incurred by the individual; or 

21 ‘‘(C) reasonable living expenses as deter22 mined by the Secretary. 

23 ‘‘(2) PAYMENTS FOR YEARS SERVED.— 

24 ‘‘(A) IN GENERAL.—For each year of serv25 ice described in subsection (b)(1) that an indiVerDate Nov 24 2008 21:47 Feb 26, 2009 Jkt 079200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H1185.IH H1185

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1 vidual contracts to serve under this section the 

2 Secretary may pay not more than $5,000 on be3 half of the individual for loans described in 

4 paragraph (1). In making a determination of 

5 the amount to pay for a year of such service by 

6 an individual, the Secretary shall consider the 

7 extent to which each such determination— 

8 ‘‘(i) affects the ability of the Secretary 

9 to maximize the number of contracts that 

10 can be provided under the loan repayment 

11 program under this section from the 

12 amounts appropriated for such contracts; 

13 ‘‘(ii) provides an incentive to serve in 

14 community health centers with the greatest 

15 shortage of primary care physicians; and 

16 ‘‘(iii) provides an incentive with re17 spect to the individual involved remaining 

18 in an area with a shortage of primary care 

19 physicians, and continuing to provide 

20 health services in primary care medicine, 

21 after the completion of the period of serv22 ice described in subsection (b)(1). 

23 ‘‘(B) REPAYMENT SCHEDULE.—Any ar24 rangement made by the Secretary for the mak25 ing of loan repayments in accordance with this 


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1 subsection shall provide that any repayments 

2 for a year of service described in subsection 

3 (b)(1) shall be made no later than the end of 

4 the fiscal year in which the individual completes 

5 such year of service. 

6 ‘‘(3) TAX LIABILITY.—For the purpose of pro7 viding reimbursements for tax liability resulting 

8 from payments under paragraph (2) on behalf of an 

9 individual— 

10 ‘‘(A) the Secretary shall, in addition to 

11 such payments, make payments to the indi12 vidual in an amount equal to 39 percent of the 

13 total amount of loan repayments made for the 

14 taxable year involved; and 

15 ‘‘(B) may make such additional payments 

16 as the Secretary determines to be appropriate 

17 with respect to such purpose. 

18 ‘‘(4) PAYMENT SCHEDULE.—The Secretary 

19 may enter into an agreement with the holder of any 

20 loan for which payments are made under the loan 

21 repayment program under this section to establish a 

22 schedule for the making of such payments. 

23 ‘‘(h) BREACH OF CONTRACT.—The provisions of sec24 tion 338E shall apply to an individual who breaches a con25 tract under this section in the same manner and to the 


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1 same extent as such provisions apply to an individual who 

2 breaches a contract under section 338B. 

3 ‘‘(i) DEFINITIONS.—For purposes of this section: 

4 ‘‘(1) PRIMARY CARE MEDICINE.—The term ‘pri5 mary care medicine’ shall include family medicine, 

6 general pediatrics, and general internal medicine. 

7 ‘‘(2) PRIMARY CARE PHYSICIAN.—The term 

8 ‘primary care physician’ means a physician special9 izing in primary care medicine. 

10 ‘‘(j) AUTHORIZATION OF APPROPRIATIONS.— 

11 ‘‘(1) IN GENERAL.—To carry out this section, 

12 there is authorized to be appropriated such sums as 

13 are necessary for each of the fiscal years 2009 

14 through 2013. 

15 ‘‘(2) CONTINGENCY.—Any financial obligation 

16 of the United States arising out of a contract en17 tered into under this section and any obligation of 

18 the individual that is conditioned thereon, is contin19 gent on funds being appropriated for loan repay20 ments under paragraph (1).’’. 

Æ 


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