IB 
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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Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Physician Workforce 
Enhancement Act of 2008’’. 
SEC. 2. HOSPITAL RESIDENCY LOAN PROGRAM. 
Subpart 2 of part E of title VII of the Public Health 
Service Act is amended by adding at the end the following 
new section: 
‘‘SEC. 771. HOSPITAL RESIDENCY LOAN PROGRAM. 
‘‘(a) ESTABLISHMENT.—Not later than October 1, 
2010, the Secretary, acting through the Administrator of 
the Health Resources and Services Administration, shall es-
tablish a hospital residency loan program that provides 
loans to eligible hospitals to establish a residency training 
program. 
‘‘(b) APPLICATION.—No loan may be provided under 
this section to an eligible hospital except pursuant to an 
application that is submitted and approved in a time, man-
ner, and form specified by the Administrator of the Health 
Resources and Services Administration. A loan under this 
section shall be on such terms and conditions and meet such 
requirements as the Administrator determines appropriate, 
in accordance with the provisions of this section. 
‘‘(c) ELIGIBILITY; PREFERENCE FOR RURAL AREAS.— 
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‘‘(1) ELIGIBLE HOSPITAL DEFINED.—For pur-
poses of this section, an ‘eligible hospital’ means, with 
respect to a loan under this section, a public or non- 
profit hospital that, as of the date of the submission 
of an application under subsection (b), meets, to the 
satisfaction of the Administrator of the Health Re-
sources and Services Administration, each of the fol-
lowing criteria: 
‘‘(A) The hospital does not operate a resi-
dency training program and has not previously 
operated such a program. 
‘‘(B) The hospital has secured initial ac-
creditation by the American Council for Grad-
uate Medical Education or the American Osteo-
pathic Association. 
‘‘(C) The hospital provides assurances to the 
satisfaction of the Administrator of the Health 
Resources and Services Administration that such 
loan shall be used, consistent with subsection (d), 
only for the purposes of establishing and con-
ducting an allopathic or osteopathic physician 
residency training program in at least one of the 
following, or a combination of the following: 
‘‘(i) Family medicine. 
‘‘(ii) Internal medicine. 
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‘‘(iii) Obstetrics or gynecology. 
‘‘(iv) Behavioral or Mental health. 
‘‘(v) Pediatrics. 
‘‘(D) The hospital enters into an agreement 
with the Administrator that certifies the hospital 
will provide for the repayment of the loan in ac-
cordance with subsection (e). 
‘‘(2) PREFERENCE FOR RURAL AREAS.—In mak-
ing loans under this section, the Administrator of the 
Health Resources and Services Administration shall 
create guidelines that give preference to rural areas 
(as such term is defined in section 1886(d)(2)(D) of 
the Social Security Act). 
‘‘(d) PERMISSIBLE USES OF LOAN FUNDS.—A loan 
provided under this section shall be used, with respect to 
a residency training program, only for costs directly attrib-
utable to the residency training program, except as other-
wise provided by the Administrator of the Health Resources 
and Services Administration. 
‘‘(e) REPAYMENT OF LOANS.— 
‘‘(1) REPAYMENT PLANS.—For purposes of sub-
section (c)(1)(D), a repayment plan for an eligible 
hospital is in accordance with this subsection if it 
provides for the repayment of the loan amount in in-
stallments, in accordance with a schedule that is 
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agreed to by the Administrator of the Health Re-
sources and Services Administration and the hospital 
and that is in accordance with paragraphs (2), (3), 
and (4). 
‘‘(2) COMMENCEMENT OF REPAYMENT.—Repay-
ment by an eligible hospital of a loan under this sec-
tion shall commence not later than the date that is 
18 months after the date on which the loan amount 
is disbursed to such hospital. 
‘‘(3) REPAYMENT PERIOD.—A loan made under 
this section shall be fully repaid not later than the 
date that is 24 months after the date on which the re-
payment is required to commence. 
‘‘(4) LOAN
PAYABLE
IN
FULL
IF
RESIDENCY 
TRAINING PROGRAM CANCELED.—In the case that an 
eligible hospital borrows a loan under this section, 
with respect to a residency training program, and 
terminates such program before the date on which 
such loan has been fully repaid in accordance with a 
plan under paragraph (1), such loan shall be payable 
by the hospital not later than 45 days after the date 
of such termination. 
‘‘(f) NO INTEREST CHARGED.—The Administrator of 
the Health Resources and Services Administration may not 
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charge or collect interest on any loan made under this sec-
tion. 
‘‘(g) LIMITATION ON TOTAL AMOUNT OF LOAN.—The 
cumulative annual dollar amount of a loan made to an eli-
gible hospital under this section may not exceed $250,000. 
‘‘(h) PENALTIES.—The Administrator of the Health 
Resources and Services Administration shall establish pen-
alties to which an eligible hospital receiving a loan under 
this section would be subject if such hospital is in violation 
of any of the criteria described in subsection (c)(1). Such 
penalties shall include the charge or collection of interest, 
at a rate to be determined by the Administrator of the 
Health Resources and Services Administration. Except as 
otherwise provided, penalties collected under this subsection 
shall be paid to the Administrator of the Health Resources 
and Services Administration and shall, subject to appro-
priation Acts, be available until expended for the purpose 
of enforcing the provisions of this section. 
‘‘(i) REPORTS.—Not later than January 1, 2012, and 
annually thereafter (before January 2, 2014), the Adminis-
trator of the Health Resources and Services Administration 
shall submit to Congress a report on the efficacy of the pro-
gram under this section in increasing the number of resi-
dents practicing in each medical specialty described in sub-
section (c)(1)(C) during such year and the extent to which 
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the program resulted in an increase in the number of avail-
able practitioners in each of such medical specialties that 
serve medically underserved populations. 
‘‘(j) FUNDING.— 
‘‘(1) AUTHORIZATION OF APPROPRIATIONS.—For 
the purpose of providing amounts for loans under this 
section, there are authorized to be appropriated such 
sums as may be necessary to provide— 
‘‘(A) $8,000,000 in loans for fiscal year 
2010; 
‘‘(B) $8,400,000 in loans for fiscal year 
2011; 
‘‘(C) $8,820,000 in loans for fiscal year 
2012; 
‘‘(D) $9,261,000 in loans for fiscal year 
2013; and 
‘‘(E) $9,724,050 in loans for fiscal year 
2014. 
‘‘(2) 
AVAILABILITY.—Amounts 
appropriated 
under paragraph (1) shall remain available until ex-
pended. 
‘‘(k) TERMINATION OF PROGRAM.—No loan may be 
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 
Act to establish a loan program for eligible hos-
pitals to establish residency training programs. 
SEPTEMBER 23, 2008 
Reported with an amendment, committed to the Com-
mittee of the Whole House on the State of the Union, 
and ordered to be printed 
VerDate Aug 31 2005 
02:41 Sep 24, 2008
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