Ethics in Government Act of 1978 (Public Law 95– 
521). 
‘‘(6) DIRECTOR AND STAFF.—Subject to such 
review as the Secretary deems necessary to assure 
the efficient administration of the Board, the chair 
and vice-chair of the Board may— 
‘‘(A) employ and fix the compensation of 
an Executive Director (subject to the approval 
of the Comptroller General) and such other per-
sonnel as may be necessary to carry out its du-
ties (without regard to the provisions of title 5, 
United States Code, governing appointments in 
the competitive service); 
‘‘(B) seek such assistance and support as 
may be required in the performance of its du-
ties from appropriate Federal departments and 
agencies; 
‘‘(C) enter into contracts or make other ar-
rangements, as may be necessary for the con-
duct of the work of the Board (without regard 
to section 3709 of the Revised Statutes (41 
U.S.C. 5)); 
‘‘(D) make advance, progress, and other 
payments which relate to the work of the 
Board; 
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‘‘(E) provide transportation and subsist-
ence for persons serving without compensation; 
and 
‘‘(F) prescribe such rules as it deems nec-
essary with respect to the internal organization 
and operation of the Board. 
‘‘(7) TERMS.—The members of the Board shall 
serve for the duration of the Board. Vacancies in the 
Board shall be filled as needed in a manner con-
sistent with the composition described in paragraph 
(2). 
‘‘(b) DEVELOPMENT
OF
HARMONIZED
STAND-
ARDS.— 
‘‘(1) IN
GENERAL.—In accordance with the 
process described in subsection (c), the Board shall 
identify and recommend nationally harmonized 
standards for each of the following process cat-
egories: 
‘‘(A) FORM FILING AND RATE FILING.— 
Form and rate filing standards shall be estab-
lished which promote speed to market and in-
clude the following defined areas for States that 
require such filings: 
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‘‘(i) Procedures for form and rate fil-
ing pursuant to a streamlined administra-
tive filing process. 
‘‘(ii) Timeframes for filings to be re-
viewed by a State if review is required be-
fore they are deemed approved. 
‘‘(iii) Timeframes for an eligible in-
surer to respond to State requests fol-
lowing its review. 
‘‘(iv) A process for an eligible insurer 
to self-certify. 
‘‘(v) State development of form and 
rate filing templates that include only non- 
preempted State law and Federal law re-
quirements for eligible insurers with timely 
updates. 
‘‘(vi) Procedures for the resubmission 
of forms and rates. 
‘‘(vii) Disapproval rationale of a form 
or rate filing based on material omissions 
or violations of non-preempted State law or 
Federal law with violations cited and ex-
plained. 
‘‘(viii) For States that may require a 
hearing, a rationale for hearings based on 
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violations of non-preempted State law or 
insurer requests. 
‘‘(B) MARKET CONDUCT REVIEW.—Market 
conduct review standards shall be developed 
which provide for the following: 
‘‘(i) Mandatory participation in na-
tional databases. 
‘‘(ii) The confidentiality of examina-
tion materials. 
‘‘(iii) The identification of the State 
agency with primary responsibility for ex-
aminations. 
‘‘(iv) Consultation and verification of 
complaint data with the eligible insurer 
prior to State actions. 
‘‘(v) Consistency of reporting require-
ments with the recordkeeping and adminis-
trative practices of the eligible insurer. 
‘‘(vi) Examinations that seek to cor-
rect material errors and harmful business 
practices rather than infrequent errors. 
‘‘(vii) Transparency and publishing of 
the State’s examination standards. 
‘‘(viii) Coordination of market conduct 
analysis. 
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‘‘(ix) Coordination and nonduplication 
between State examinations of the same el-
igible insurer. 
‘‘(x) Rationale and protocols to be 
met before a full examination is conducted. 
‘‘(xi) 
Requirements 
on 
examiners 
prior to beginning examinations such as 
budget planning and work plans. 
‘‘(xii) Consideration of methods to 
limit examiners’ fees such as caps, com-
petitive bidding, or other alternatives. 
‘‘(xiii) Reasonable fines and penalties 
for material errors and harmful business 
practices. 
‘‘(C) PROMPT PAYMENT OF CLAIMS.—The 
Board shall establish prompt payment stand-
ards for eligible insurers based on standards 
similar to those applicable to the Social Secu-
rity Act as set forth in section 1842(c)(2) of 
such Act (42 U.S.C. 1395u(c)(2)). Such prompt 
payment standards shall be consistent with the 
timing and notice requirements of the claims 
procedure rules to be specified under subpara-
graph (D), and shall include appropriate excep-
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tions such as for fraud, nonpayment of pre-
miums, or late submission of claims. 
‘‘(D) INTERNAL
REVIEW.—The Board 
shall establish standards for claims procedures 
for eligible insurers that are consistent with the 
requirements relating to initial claims for bene-
fits and appeals of claims for benefits under the 
Employee Retirement Income Security Act of 
1974 as set forth in section 503 of such Act 
(29 U.S.C. 1133) and the regulations there-
under. 
‘‘(2) RECOMMENDATIONS.—The Board shall 
recommend harmonized standards for each element 
of the categories described in subparagraph (A) 
through (D) of paragraph (1) within each such mar-
ket. Notwithstanding the previous sentence, the 
Board shall not recommend any harmonized stand-
ards that disrupt, expand, or duplicate the benefit, 
service, or provider mandate standards provided in 
the Benefit Choice Standards pursuant to section 
3122(a). 
‘‘(c) PROCESS
FOR
IDENTIFYING
HARMONIZED 
STANDARDS.— 
‘‘(1) IN
GENERAL.—The Board shall develop 
recommendations to harmonize inconsistent State in-
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tect health insurance consumers or promote 
speed to market or administrative efficiency. 
‘‘(E) The criteria specified in clauses (i) 
through (iii) of subsection (d)(2)(B). 
‘‘(d) RECOMMENDATIONS
AND CERTIFICATION
BY 
SECRETARY.— 
‘‘(1) RECOMMENDATIONS.—Not later than 18 
months after the date on which all members of the 
Board are selected under subsection (a), the Board 
shall recommend to the Secretary the certification of 
the harmonized standards identified pursuant to 
subsection (c). 
‘‘(2) CERTIFICATION.— 
‘‘(A) IN
GENERAL.—Not later than 120 
days after receipt of the Board’s recommenda-
tions under paragraph (1), the Secretary shall 
certify the recommended harmonized standards 
as provided for in subparagraph (B), and issue 
such standards in the form of an interim final 
regulation. 
‘‘(B) CERTIFICATION PROCESS.—The Sec-
retary shall establish a process for certifying 
the recommended harmonized standard, by cat-
egory, as recommended by the Board under this 
section. Such process shall— 
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‘‘(i) ensure that the certified stand-
ards for a particular process area achieve 
regulatory harmonization with respect to 
health plans on a national basis; 
‘‘(ii) ensure that the approved stand-
ards are the minimum necessary, with re-
gard to substance and quantity of require-
ments, to protect health insurance con-
sumers and maintain a competitive regu-
latory environment; and 
‘‘(iii) ensure that the approved stand-
ards will not limit the range of group 
health plan designs and insurance prod-
ucts, such as catastrophic coverage only 
plans, health savings accounts, and health 
maintenance organizations, that might oth-
erwise be available to consumers. 
‘‘(3) APPLICATION
AND
EFFECTIVE
DATE.— 
The standards certified by the Secretary under para-
graph (2) shall apply and become effective on the 
date that is 18 months after the date on which the 
Secretary certifies the harmonized standards. 
‘‘(e) TERMINATION.—The Board shall terminate and 
be dissolved after making the recommendations to the Sec-
retary pursuant to subsection (d)(1). 
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‘‘(f) ONGOING REVIEW.—Not earlier than 3 years 
after the termination of the Board under subsection (e), 
and not earlier than every 3 years thereafter, the Sec-
retary, in consultation with the National Association of In-
surance Commissioners and the entities and constituencies 
represented on the Board and the Advisory Panel, shall 
prepare and submit to the appropriate committees of Con-
gress a report that assesses the effect of the harmonized 
standards applied under this section on access, cost, and 
health insurance market functioning. The Secretary may, 
based on such report and applying the process established 
for certification under subsection (d)(2)(B), in consulta-
tion with the National Association of Insurance Commis-
sioners and the entities and constituencies represented on 
the Board and the Advisory Panel, update the harmonized 
standards through notice and comment rulemaking. 
‘‘(g) PUBLICATION.— 
‘‘(1) LISTING.—The Secretary shall maintain 
an up to date listing of all harmonized standards 
certified under this section on the Internet website 
of the Department of Health and Human Services. 
‘‘(2) SAMPLE CONTRACT LANGUAGE.—The Sec-
retary shall publish on the Internet website of the 
Department of Health and Human Services sample 
contract language that incorporates the harmonized 
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standards certified under this section, which may be 
used by insurers seeking to qualify as an eligible in-
surer. The types of harmonized standards that shall 
be included in sample contract language are the 
standards that are relevant to the contractual bar-
gain between the insurer and insured. 
‘‘(h) STATE ADOPTION AND ENFORCEMENT.—Not 
later than 18 months after the certification by the Sec-
retary of harmonized standards under this section, the 
States may adopt such harmonized standards (and become 
an adopting State) and, in which case, shall enforce the 
harmonized standards pursuant to State law. 
‘‘SEC. 3133. APPLICATION AND PREEMPTION. 
‘‘(a) SUPERCEDING OF STATE LAW.— 
‘‘(1) IN GENERAL.—The harmonized standards 
certified under this subtitle and applied as provided 
for in section 3133(d)(3), shall supersede any and 
all State laws of a nonadopting State insofar as such 
State laws relate to the areas of harmonized stand-
ards as applied to an eligible insurer, or health in-
surance coverage issued by a eligible insurer, includ-
ing with respect to coverage issued to a small busi-
ness health plan, in a nonadopting State. 
‘‘(2) NONADOPTING
STATES.—This subtitle 
shall supersede any and all State laws of a non-
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adopting State (whether enacted prior to or after the 
date of enactment of this title) insofar as they 
may— 
‘‘(A) prohibit an eligible insurer from of-
fering, marketing, or implementing health in-
surance coverage consistent with the har-
monized standards; or 
‘‘(B) have the effect of retaliating against 
or otherwise punishing in any respect an eligible 
insurer for offering, marketing, or imple-
menting health insurance coverage consistent 
with the harmonized standards under this sub-
title. 
‘‘(b) SAVINGS CLAUSE AND CONSTRUCTION.— 
‘‘(1) NONAPPLICATION TO ADOPTING STATES.— 
Subsection (a) shall not apply with respect to adopt-
ing States. 
‘‘(2) NONAPPLICATION
TO
CERTAIN
INSUR-
ERS.—Subsection (a) shall not apply with respect to 
insurers that do not qualify as eligible insurers who 
offer health insurance coverage in a nonadopting 
State. 
‘‘(3) NONAPPLICATION WHERE OBTAINING RE-
LIEF UNDER STATE LAW.—Subsection (a)(1) shall 
not supercede any State law of a nonadopting State 
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to the extent necessary to permit individuals or the 
insurance department of the State (or other State 
agency) to obtain relief under State law to require 
an eligible insurer to comply with the harmonized 
standards under this subtitle. 
‘‘(4) NO EFFECT ON PREEMPTION.—In no case 
shall this subtitle be construed to limit or affect in 
any manner the preemptive scope of sections 502 
and 514 of the Employee Retirement Income Secu-
rity Act of 1974. In no case shall this subtitle be 
construed to create any cause of action under Fed-
eral or State law or enlarge or affect any remedy 
available under the Employee Retirement Income 
Security Act of 1974. 
‘‘(c) EFFECTIVE DATE.—This section shall apply be-
ginning on the date that is 18 months after the date on 
harmonized standards are certified by the Secretary under 
this subtitle. 
‘‘SEC. 3134. CIVIL ACTIONS AND JURISDICTION. 
‘‘(a) IN GENERAL.—The district courts of the United 
States shall have exclusive jurisdiction over civil actions 
involving the interpretation of this subtitle. 
‘‘(b) ACTIONS.—An eligible insurer may bring an ac-
tion in the district courts of the United States for injunc-
tive or other equitable relief against any officials or agents 
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ment, prior to the end of the 60-day period begin-
ning on the date on which such petition is filed with 
the Court, unless all parties to such proceeding 
agree to an extension of such period. 
‘‘(e) STANDARD OF REVIEW.—A court in an action 
filed under this section, shall render a judgment based on 
a review of the merits of all questions presented in such 
action and shall not defer to any conduct or action, or 
proposed conduct or action, of a nonadopting State. 
‘‘SEC. 3135. AUTHORIZATION OF APPROPRIATIONS; RULE 
OF CONSTRUCTION. 
‘‘(a) AUTHORIZATION OF APPROPRIATIONS.—There 
are authorized to be appropriated such sums as may be 
necessary to carry out this subtitle. 
‘‘(b) HEALTH SAVINGS ACCOUNTS.—Nothing in this 
subtitle shall be construed to create any mandates for cov-
erage of any benefits below the deductible levels set for 
any health savings account-qualified health plan pursuant 
to section 223 of the Internal Revenue Code of 1986.’’. 
TITLE III—TAX-RELATED 
HEALTH INCENTIVES 
SEC. 301. SECA TAX DEDUCTION FOR HEALTH INSURANCE 
COSTS. 
(a) IN GENERAL.—Subsection (l) of section 162 of 
the Internal Revenue Code of 1986 (relating to special 
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rules for health insurance costs of self-employed individ-
uals) is amended by striking paragraph (4) and by redes-
ignating paragraph (5) as paragraph (4). 
(b) EFFECTIVE DATE.—The amendment made by 
this section shall apply to taxable years beginning after 
December 31, 2009. 
SEC. 302. DEDUCTION FOR QUALIFIED HEALTH INSURANCE 
COSTS OF INDIVIDUALS. 
(a) IN GENERAL.—Part VII of subchapter B of chap-
ter 1 of the Internal Revenue Code of 1986 (relating to 
additional itemized deductions for individuals) is amended 
by redesignating section 224 as section 225 and by insert-
ing after section 223 the following new section: 
‘‘SEC. 224. COSTS OF QUALIFIED HEALTH INSURANCE. 
‘‘(a) IN GENERAL.—In the case of an individual, 
there shall be allowed as a deduction an amount equal to 
the amount paid during the taxable year for coverage for 
the taxpayer, his spouse, and dependents under qualified 
health insurance. 
‘‘(b) QUALIFIED HEALTH INSURANCE.—For pur-
poses of this section, the term ‘qualified health insurance’ 
means insurance which constitutes medical care, other 
than insurance substantially all of the coverage of which 
is of excepted benefits described in section 9832(c). 
‘‘(c) SPECIAL RULES.— 
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100 
‘‘(1) COORDINATION
WITH
MEDICAL
DEDUC-
TION, ETC.—Any amount paid by a taxpayer for in-
surance to which subsection (a) applies shall not be 
taken into account in computing the amount allow-
able to the taxpayer as a deduction under section 
162(l) or 213(a). Any amount taken into account in 
determining the credit allowed under section 35 shall 
not be taken into account for purposes of this sec-
tion. 
‘‘(2) DEDUCTION NOT ALLOWED FOR SELF-EM-
PLOYMENT
TAX
PURPOSES.—The deduction allow-
able by reason of this section shall not be taken into 
account in determining an individual’s net earnings 
from self-employment (within the meaning of section 
1402(a)) for purposes of chapter 2.’’. 
(b) DEDUCTION
ALLOWED
IN
COMPUTING
AD-
JUSTED GROSS INCOME.—Subsection (a) of section 62 of 
such Code is amended by inserting before the last sentence 
the following new paragraph: 
‘‘(22) COSTS
OF
QUALIFIED
HEALTH
INSUR-
ANCE.—The deduction allowed by section 224.’’. 
(c) CLERICAL AMENDMENT.—The table of sections 
for part VII of subchapter B of chapter 1 of such Code 
is amended by redesignating the item relating to section 
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101 
224 as an item relating to section 225 and inserting before 
such item the following new item: 
‘‘Sec. 224. Costs of qualified health insurance.’’. 
(d) EFFECTIVE DATE.—The amendments made by 
this section shall apply to taxable years beginning after 
December 31, 2009. 
TITLE IV—INCREASING ACCESS 
TO VA HEALTH CARE 
SEC. 401. REQUIREMENT FOR PAYMENTS TO FACILITIES 
OTHER THAN THE DEPARTMENT OF VET-
ERANS 
AFFAIRS 
FOR 
COVERED 
HEALTH 
SERVICES. 
(a) REQUIREMENT TO AUTHORIZE RECEIPT OF COV-
ERED HEALTH SERVICES AT NON-DEPARTMENT FACILI-
TIES PURSUANT
TO CONTRACTS WITH SUCH FACILI-
TIES.—Subsection (a) of section 1703 of title 38, United 
States Code, is amended to read as follows: 
‘‘(a) An enrolled veteran may elect to receive covered 
health services through a non-Department facility. Such 
an election shall be made by submission to the Secretary 
of an application in accordance with such regulations as 
the Secretary prescribes. The Secretary shall authorize 
such services to be furnished to such veteran pursuant to 
contracting with such a facility to furnish such services 
to such a veteran, as authorized in section 1710 of this 
title.’’. 
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102 
(b) DESCRIPTIONS OF COVERED HEALTH SERVICES 
AND ENROLLED VETERANS.—Such section is further 
amended by adding at the end the following new sub-
section: 
‘‘(e) For purposes of subsection (a)— 
‘‘(1) a covered health service is any hospital 
care, medical service, rehabilitative service, or pre-
ventative health service for which the veteran de-
scribed in such subsection is eligible under this title; 
and 
‘‘(2) an enrolled veteran is a veteran who is en-
rolled in the system of patient enrollment established 
under section 1705(a) of this title.’’. 
(c) EFFECTIVE DATE.—The Secretary of Veterans 
Affairs shall implement the amendments made by sub-
sections (a) and (b) in order for enrolled veterans de-
scribed in section 1703(e)(2) of title 38, United States 
Code, as added by subsection (b), to receive covered health 
services in accordance with section 1703(a) of such title, 
as amended by subsection (a), not later than 180 days 
after the date of the enactment of this Act. 
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103 
SEC. 402. AUTHORITY OF DEPARTMENT OF VETERANS AF-
FAIRS PHARMACIES TO DISPENSE MEDICA-
TIONS TO VETERANS ON PRESCRIPTIONS 
WRITTEN BY PRIVATE PRACTITIONERS. 
Section 1712 of title 38, United States Code, is 
amended by adding at the end the following new sub-
section: 
‘‘(f) Subject to section 1722A of this title, the Sec-
retary shall furnish to a veteran, through a Department 
health care facility, such drugs and medicines as may be 
ordered on prescription of a duly licensed physician in the 
treatment of any illness or injury of the veteran provided 
pursuant to the authority to contract with a non-Depart-
ment facility for such treatment under section 1703 of this 
title.’’. 
TITLE V—NURSING SHORTAGE 
SEC. 501. CHILD CARE ASSISTANCE FOR INDIVIDUALS PUR-
SUING ADVANCED NURSING DEGREES. 
Part E of title VIII of the Public Health Service Act 
(42 U.S.C. 297a et seq.) is amended— 
(1) by redesignating section 810 (relating to a 
prohibition against discrimination by schools) as sec-
tion 846B; and 
(2) by adding at the end the following: 
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104 
‘‘SEC. 846C. CHILD CARE ASSISTANCE FOR INDIVIDUALS 
PURSUING ADVANCED NURSING DEGREES. 
‘‘(a) IN GENERAL.—The Secretary may carry out a 
program of entering into contracts with eligible individuals 
under which— 
‘‘(1) the Secretary agrees to provide child care 
vouchers to the eligible individual for each month 
during which the individual is a student in an ad-
vanced nursing degree program; and 
‘‘(2) the eligible individual agrees to serve, at 
the completion of such program, as a faculty mem-
ber at a school of nursing for a period of 4 years. 
‘‘(b) VOUCHERS.—Vouchers provided to an eligible 
individual under this section— 
‘‘(1) shall be for child care expenses; and 
‘‘(2) shall be for not more than $500 per 
month. 
‘‘(c) DEFINITION.—In this section, the term ‘eligible 
individual’ means an individual who is enrolled or accepted 
for enrollment as a full-time student in an advanced nurs-
ing degree program. 
‘‘(d) AUTHORIZATION
OF
APPROPRIATIONS.—To 
carry out this section, there are authorized to be appro-
priated such sums as may be necessary for each of fiscal 
years 2010 through 2014.’’. 
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105 
SEC. 502. NURSE FACULTY PROGRAM. 
Title VII of the Higher Education Act of 1965 (20 
U.S.C. 1133 et seq.) is amended by adding at the end 
the following new part: 
‘‘PART E—NURSE FACULTY PROJECT 
‘‘SEC. 771. PURPOSES. 
‘‘The purposes of this part are to create a program— 
‘‘(1) to provide scholarships to qualified nurses 
in pursuit of an advanced degree with the goal of be-
coming faculty members in an accredited nursing 
program; and 
‘‘(2) to provide grants to partnerships between 
accredited schools of nursing and hospitals or health 
facilities to fund release time for qualified nurse em-
ployees, so that those employees can earn a salary 
while obtaining an advanced degree in nursing with 
the goal of becoming nurse faculty. 
‘‘SEC. 772. ASSISTANCE AUTHORIZED. 
‘‘(a) COMPETITIVE GRANTS AUTHORIZED.—The Sec-
retary may, on a competitive basis, award grants to, and 
enter into contracts and cooperative agreements with, 
partnerships composed of an accredited school of nursing 
at an institution of higher education and a hospital or 
health facility to establish projects to enable such hospital 
or health facility to retain its staff of experienced nurses 
while providing a mechanism to have these individuals be-
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106 
come, through an accelerated nursing education program, 
faculty members of an accredited school of nursing. 
‘‘(b) DURATION; EVALUATION
AND
DISSEMINA-
TION.— 
‘‘(1) DURATION.—Grants under this part shall 
be awarded for a period of 3 to 5 years. 
‘‘(2) MANDATORY EVALUATION AND DISSEMI-
NATION.—Grants under this part shall be primarily 
used for evaluation, and dissemination to other insti-
tutions of higher education, of the information ob-
tained through the activities described in section 
771(2). 
‘‘(c) CONSIDERATIONS
IN MAKING AWARDS.—In 
awarding grants and entering into contracts and coopera-
tive agreements under this section, the Secretary shall 
consider the following: 
‘‘(1) GEOGRAPHIC
DISTRIBUTION.—Providing 
an equitable geographic distribution of such grants. 
‘‘(2) RURAL AND URBAN AREAS.—Distributing 
such grants to urban and rural areas. 
‘‘(3) RANGE AND TYPE OF INSTITUTION.—En-
suring that the activities to be assisted are developed 
for a range of types and sizes of institutions of high-
er education. 
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107 
‘‘(4) PRIOR
EXPERIENCE
OR
EXCEPTIONAL 
PROGRAMS.—Institutions of higher education with 
demonstrated prior experience in providing advanced 
nursing education programs to prepare nurses inter-
ested in pursuing a faculty role. 
‘‘(d) USES OF FUNDS.—Funds made available by 
grant, contract, or cooperative agreement under this part 
may be used— 
‘‘(1) to develop a new national demonstration 
initiative to align nursing education with the emerg-
ing challenges of health care delivery; and 
‘‘(2) for any one or more of the following inno-
vations in educational programs: 
‘‘(A) to develop a clinical simulation lab-
oratory in a hospital, health facility, or accred-
ited school of nursing; 
‘‘(B) to purchase distance learning tech-
nologies; 
‘‘(C) to fund release time for qualified 
nurses enrolled in the graduate nursing pro-
gram; 
‘‘(D) to provide for faculty salaries; and 
‘‘(E) to collect and analyze data on edu-
cational outcomes. 
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108 
‘‘SEC. 773. APPLICATIONS. 
‘‘Each partnership desiring to receive a grant, con-
tract, or cooperative agreement under this part shall sub-
mit an application to the Secretary at such time, in such 
manner, and accompanied by such information as the Sec-
retary may require. Each application shall include assur-
ances that— 
‘‘(1) the individuals enrolled in the program will 
be qualified nurses in pursuit of a master’s or doc-
toral degree in nursing and have a contractual obli-
gation with the hospital or health facility that is in 
partnership with the institution of higher education; 
‘‘(2) the hospital or health facility of employ-
ment would be the clinical site for the accredited 
school of nursing program; 
‘‘(3) individuals will also maintain their employ-
ment on a part-time basis to the hospital or health 
facility that allowed them to participate in the pro-
gram, and will receive an income from the hospital 
or health facility, as a part-time employee, and re-
lease times or flexible schedules to accommodate 
their class schedule; and 
‘‘(4) upon completion of the program, individ-
uals agree to teach for 2 years in an accredited 
school of nursing for each year of support the indi-
vidual received under this program. 
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109 
‘‘SEC. 774. AUTHORIZATION OF APPROPRIATIONS. 
‘‘There are authorized to be appropriated for this 
part not more than $10,000,000 for fiscal year 2009 and 
such sums as may be necessary for each of the 4 suc-
ceeding fiscal years. 
‘‘SEC. 775. DEFINITION. 
‘‘For purposes of this part, the term ‘health facility’ 
means an Indian Health Service health service center, a 
Native Hawaiian health center, a hospital, a federally 
qualified health center, a rural health clinic, a nursing 
home, a home health agency, a hospice program, a public 
health clinic, a State or local department of public health, 
a skilled nursing facility, or ambulatory surgical center.’’. 
SEC. 503. NURSE FACULTY LOAN REPAYMENT PROGRAM. 
Part E of title VIII of the Public Health Service Act 
(42 U.S.C. 297a et seq.) is amended by inserting after 
section 846C, as added by section 501, the following new 
section: 
‘‘SEC. 846D. NURSE FACULTY LOAN REPAYMENT PROGRAM. 
‘‘(a) 
ESTABLISHMENT.—The 
Secretary, 
acting 
through the Administrator of the Health Resources and 
Services Administration, may enter into an agreement 
with eligible individuals for the repayment of education 
loans, in accordance with this section, to increase the num-
ber of qualified nursing faculty. 
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110 
‘‘(b) AGREEMENTS.—Each agreement entered into 
under subsection (a) shall require that the eligible indi-
vidual shall serve as a full-time member of the faculty of 
an accredited school of nursing for a total period, in the 
aggregate, of at least four years during the six-year period 
beginning on the later of— 
‘‘(1) the date on which the individual receives 
a master’s or doctorate nursing degree from an ac-
credited school of nursing; or 
‘‘(2) the date on which the individual enters 
into an agreement under subsection (a). 
‘‘(c) AGREEMENT PROVISIONS.—Agreements entered 
into pursuant to subsection (a) shall be entered into on 
such terms and conditions as the Secretary may deter-
mine, except that— 
‘‘(1) not more than ten months after the date 
on which the six-year period described under sub-
section (b) begins, but in no case before the indi-
vidual starts as a full-time member of the faculty of 
an accredited school of nursing, the Secretary shall 
begin making payments, for and on behalf of that 
individual, on the outstanding principal of, and in-
terest on, any loan of that individual obtained to pay 
for such degree; 
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111 
‘‘(2) for an individual who has completed a 
master’s degree in nursing— 
‘‘(A) payments may not exceed $10,000 
per calendar year; and 
‘‘(B) total payments may not exceed 
$40,000; and 
‘‘(3) for an individual who has completed a doc-
torate degree in nursing— 
‘‘(A) payments may not exceed $20,000 
per calendar year; and 
‘‘(B) total payments may not exceed 
$80,000. 
‘‘(d) BREACH OF AGREEMENT.— 
‘‘(1) IN GENERAL.—In the case of any agree-
ment made under subsection (a), the individual is 
liable to the Federal Government for the total 
amount paid by the Secretary under such agree-
ment, and for interest on such amount at the max-
imum legal prevailing rate, if the individual fails to 
meet the agreement terms required under subsection 
(b). 
‘‘(2) WAIVER OR SUSPENSION OF LIABILITY.— 
In the case of an individual making an agreement 
for purposes of paragraph (1), the Secretary shall 
provide for the waiver or suspension of liability 
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112 
under such paragraph if compliance by the indi-
vidual with the agreement involved is impossible or 
would involve extreme hardship to the individual or 
if enforcement of the agreement with respect to the 
individual would be unconscionable. 
‘‘(3) DATE CERTAIN FOR RECOVERY.—Subject 
to paragraph (2), any amount that the Federal Gov-
ernment is entitled to recover under paragraph (1) 
shall be paid to the United States not later than the 
expiration of the 3-year period beginning on the date 
the United States becomes so entitled. 
‘‘(4) AVAILABILITY.—Amounts recovered under 
paragraph (1) shall be available to the Secretary for 
making loan repayments under this section and shall 
remain available for such purpose until expended. 
‘‘(e) ELIGIBLE INDIVIDUAL DEFINED.—For pur-
poses of this section, the term ‘eligible individual’ means 
an individual who— 
‘‘(1) is a United States citizen, national, or law-
ful permanent resident; 
‘‘(2) holds an unencumbered license as a reg-
istered nurse; and 
‘‘(3) has either already completed a master’s or 
doctorate nursing program at an accredited school of 
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113 
nursing or is currently enrolled on a full-time or 
part-time basis in such a program. 
‘‘(f) AUTHORIZATION OF APPROPRIATIONS.—There 
are authorized to be appropriated to the Secretary such 
sums as may be necessary for each of fiscal years 2010 
through 2014 to carry out this Act. Such sums shall re-
main available until expended.’’. 
SEC. 504. PROGRAMS TO INCREASE THE NUMBER OF 
NURSES WITHIN THE ARMED FORCES. 
(a) IN GENERAL.—The Secretary of Defense may 
provide for the carrying out of each of the programs de-
scribed in subsections (b) through (f). 
(b) SERVICE OF NURSE OFFICERS AS FACULTY IN 
EXCHANGE FOR COMMITMENT TO ADDITIONAL SERVICE 
IN THE ARMED FORCES.— 
(1) IN GENERAL.—One of the programs under 
this section may be a program in which covered com-
missioned officers with a graduate degree in nursing 
or a related field who are in the nurse corps of the 
Armed Force concerned serve a tour of duty of two 
years as a full-time faculty member of an accredited 
school of nursing. 
(2) COVERED OFFICERS.—A commissioned offi-
cer of the nurse corps of the Armed Forces de-
scribed in this paragraph is a nurse officer on active 
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114 
duty who has served for more than nine years on ac-
tive duty in the Armed Forces as an officer of the 
nurse corps at the time of the commencement of the 
tour of duty described in paragraph (1). 
(3) BENEFITS
AND
PRIVILEGES.—An officer 
serving on the faculty of an accredited school or 
nursing under this subsection shall be accorded all 
the benefits, privileges, and responsibilities (other 
than compensation and compensation-related bene-
fits) of any other comparably situated individual 
serving a full-time faculty member of such school. 
(4) AGREEMENT FOR ADDITIONAL SERVICE.— 
Each officer who serves a tour of duty on the faculty 
of a school of nursing under this subsection shall 
enter into an agreement with the Secretary to serve 
upon the completion of such tour of duty for a pe-
riod of four years for such tour of duty as a member 
of the nurse corps of the Armed Force concerned. 
Any service agreed to by an officer under this para-
graph is in addition to any other service required of 
the officer under law. 
(c) SERVICE OF NURSE OFFICERS AS FACULTY IN 
EXCHANGE
FOR SCHOLARSHIPS
FOR NURSE OFFICER 
CANDIDATES.— 
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115 
(1) IN GENERAL.—One of the programs under 
this section may be a program in which commis-
sioned officers with a graduate degree in nursing or 
a related field who are in the nurse corps of the 
Armed Force concerned serve while on active duty a 
tour of duty of two years as a full-time faculty mem-
ber of an accredited school of nursing. 
(2) BENEFITS
AND
PRIVILEGES.—An officer 
serving on the faculty of an accredited school of 
nursing under this subsection shall be accorded all 
the benefits, privileges, and responsibilities (other 
than compensation and compensation-related bene-
fits) of any other comparably situated individual 
serving as a full-time faculty member of such school. 
(3) SCHOLARSHIPS FOR NURSE OFFICER CAN-
DIDATES.—(A) Each accredited school of nursing at 
which an officer serves on the faculty under this 
subsection shall provide scholarships to individuals 
undertaking an educational program at such school 
leading to a degree in nursing who agree, upon com-
pletion of such program, to accept a commission as 
an officer in the nurse corps of the Armed Forces. 
(B) The total amount of funds made available 
for scholarships by an accredited school of nursing 
under subparagraph (A) for each officer serving on 
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116 
the faculty of that school under this subsection shall 
be not less than the amount equal to an entry-level 
full-time faculty member of that school for each year 
that such officer so serves on the faculty of that 
school. 
(C) The total number of scholarships provided 
by an accredited school of nursing under subpara-
graph (A) for each officer serving on the faculty of 
that school under this subsection shall be such num-
ber as the Secretary of Defense shall specify for pur-
poses of this subsection. 
(d) SCHOLARSHIPS FOR CERTAIN NURSE OFFICERS 
FOR EDUCATION AS NURSES.— 
(1) IN GENERAL.—One of the programs under 
this section may be a program in which the Sec-
retary provides scholarships to commissioned officers 
of the nurse corps of the Armed Force concerned de-
scribed in paragraph (2) who enter into an agree-
ment described in paragraph (4) for the participa-
tion of such officers in an educational program of an 
accredited school of nursing leading to a graduate 
degree in nursing. 
(2) COVERED
NURSE
OFFICERS.—A commis-
sioned officer of the nurse corps of the Armed 
Forces described in this paragraph is a nurse officer 
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117 
who has served not less than 20 years on active duty 
in the Armed Forces and is otherwise eligible for re-
tirement from the Armed Forces. 
(3) SCOPE OF SCHOLARSHIPS.—Amounts in a 
scholarship provided a nurse officer under this sub-
section may be utilized by the officer to pay the 
costs of tuition, fees, and other educational expenses 
of the officer in participating in an educational pro-
gram described in paragraph (1). 
(4) AGREEMENT.—An agreement of a nurse of-
ficer described in this paragraph is the agreement of 
the officer— 
(A) to participate in an educational pro-
gram described in paragraph (1); and 
(B) upon graduation from such educational 
program— 
(i) to serve not less than two years as 
a full-time faculty member of an accredited 
school of nursing; and 
(ii) to undertake such activities as the 
Secretary considers appropriate to encour-
age current and prospective nurses to pur-
sue service in the nurse corps of the 
Armed Forces. 
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118 
(e) TRANSITION ASSISTANCE FOR RETIRING NURSE 
OFFICERS QUALIFIED AS FACULTY.— 
(1) IN GENERAL.—One of the programs under 
this section may be a program in which the Sec-
retary provides to commissioned officers of the nurse 
corps of the Armed Force concerned described in 
paragraph (2) the assistance described in paragraph 
(3) to assist such officers in obtaining and fulfilling 
positions as full-time faculty members of an accred-
ited school of nursing after retirement from the 
Armed Forces. 
(2) COVERED
NURSE
OFFICERS.—A commis-
sioned officer of the nurse corps of the Armed 
Forces described in this paragraph is a nurse officer 
who— 
(A) has served an aggregate of at least 20 
years on active duty or in reserve active status 
in the Armed Forces; 
(B) is eligible for retirement from the 
Armed Forces; and 
(C) possesses a doctoral or master degree 
in nursing or a related field which qualifies the 
nurse officer to discharge the position of nurse 
instructor at an accredited school of nursing. 
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119 
(3) ASSISTANCE.—The assistance described in 
this paragraph is assistance as follows: 
(A) Career placement assistance. 
(B) Continuing education. 
(C) Stipends (in an amount specified by 
the Secretary). 
(4) AGREEMENT.—A nurse officer provided as-
sistance under this subsection shall enter into an 
agreement with the Secretary to serve as a full-time 
faculty member of an accredited school of nursing 
for such period as the Secretary shall provide in the 
agreement. 
(f) BENEFITS FOR RETIRED NURSE OFFICERS AC-
CEPTING APPOINTMENT AS FACULTY.— 
(1) IN GENERAL.—One of the programs under 
this section may be a program in which the Sec-
retary provides to any individual described in para-
graph (2) the benefits specified in paragraph (3). 
(2) COVERED INDIVIDUALS.—An individual de-
scribed in this paragraph is an individual who— 
(A) is retired from the Armed Forces after 
service as a commissioned officer in the nurse 
corps of the Armed Forces; 
(B) holds a graduate degree in nursing; 
and 
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120 
(C) serves as a full-time faculty member of 
an accredited school of nursing. 
(3) BENEFITS.—The benefits specified in this 
paragraph shall include the following: 
(A) Payment of retired or retirement pay 
without reduction based on receipt of pay or 
other compensation from the institution of 
higher education concerned. 
(B) Payment by the institution of higher 
education concerned of a salary and other com-
pensation to which other similarly situated fac-
ulty members of the institution of higher edu-
cation would be entitled. 
(C) If the amount of pay and other com-
pensation payable by the institution of higher 
education concerned for service as an associate 
full-time faculty member is less than the basic 
pay to which the individual was entitled imme-
diately before retirement from the Armed 
Forces, payment of an amount equal to the dif-
ference between such basic pay and such pay-
ment and other compensation. 
(g) ADMINISTRATION
AND
DURATION
OF
PRO-
GRAMS.— 
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121 
(1) IN GENERAL.—The Secretary shall establish 
requirements and procedures for the administration 
of the programs authorized by this section. Such re-
quirements and procedures shall include procedures 
for selecting participating schools of nursing. 
(2) DURATION.—Any program carried out 
under this section shall continue for not less than 
two years. 
(3) ASSESSMENT.—Not later than two years 
after commencing any program under this section, 
the Secretary shall assess the results of such pro-
gram and determine whether or not to continue such 
program. The assessment of any program shall be 
based on measurable criteria, information concerning 
results, and such other matters as the Secretary 
considers appropriate. 
(4) CONTINUATION.—The Secretary may con-
tinue carrying out any program under this section 
that the Secretary determines, pursuant to an as-
sessment under paragraph (3), to continue to carry 
out. In continuing to carry out a program, the Sec-
retary may modify the terms of the program within 
the scope of this section. The continuation of any 
program may include its expansion to include addi-
tional participating schools of nursing. 
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122 
(h) DEFINITIONS.—In this section, the terms ‘‘school 
of nursing’’ and ‘‘accredited’’ have the meaning given 
those terms in section 801 of the Public Health Service 
Act (42 U.S.C. 296). 
TITLE 
VI—RESERVE 
COMPO-
NENTS 
OF 
THE 
ARMED 
FORCES 
SEC. 601. EFFECTIVE DATE OF ACTIVE DUTY FOR PUR-
POSES OF ENTITLEMENT TO ACTIVE DUTY 
HEALTH CARE OF MEMBERS OF THE RE-
SERVE 
COMPONENTS 
OF 
THE 
ARMED 
FORCES RECEIVING ALERT ORDER ANTICI-
PATING A CALL OR ORDER TO ACTIVE DUTY 
IN SUPPORT OF A CONTINGENCY OPER-
ATION. 
Subsection (d) of section 1074 of title 10, United 
States Code, is amended to read as follows: 
‘‘(d)(1) For purposes of this chapter, a member of 
a reserve component of the Armed Forces shall be treated 
as a member of the Armed Forces on active duty as fol-
lows: 
‘‘(A) On the date of the issuance of the alert 
order for the member’s unit in anticipation of the 
mobilization of the unit for service for a period of 
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123 
more than 30 days in support of a contingency oper-
ation. 
‘‘(B) On the date of the issuance of the order 
providing for the assignment or attachment of the 
member to a unit subject to an alert order described 
in paragraph (1). 
‘‘(2) If the alert order for a member’s unit (or the 
unit to which the member is assigned or attached) is re-
scinded, the member shall cease to be treated on active 
duty for purposes of this chapter as of the date of the 
issuance of the order rescinding such alert order.’’. 
Æ 
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