I
106TH CONGRESS
1ST SESSION
H. R. 385
To amend the Internal Revenue Code of 1986 to provide a tax credit to
primary health providers who establish practices in health professional
shortage areas.
IN THE HOUSE OF REPRESENTATIVES
JANUARY 19, 1999
Ms. KILPATRICK
(for herself, Mrs. CLAYTON, Mr. DELAHUNT, Mr.
FALEOMAVAEGA, Mr. FROST, Mr. HASTINGS of Florida, Mrs. HOOLEY of
Oregon, Ms. LEE, Mr. LEWIS
of Georgia, Mr. MCINTYRE, Ms.
MILLENDER-MCDONALD, Mr. PASTOR, Mr. PAUL, Mr. RUSH, Mr. SAND-
ERS, Mr. SANDLIN, Ms. STABENOW, and Mr. STUPAK) introduced the fol-
lowing bill; which was referred to the Committee on Ways and Means
A BILL
To amend the Internal Revenue Code of 1986 to provide
a tax credit to primary health providers who establish
practices in health professional shortage areas.
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 ‘‘Health Care Access
Improvement Act’’.
SEC. 2. NONREFUNDABLE CREDIT FOR CERTAIN PRIMARY
HEALTH 
SERVICES 
PROVIDERS 
SERVING
HEALTH PROFESSIONAL SHORTAGE AREAS.
(a) IN GENERAL.—Subpart A of part IV of sub-
chapter A of chapter 1 of the Internal Revenue Code of
1986 (relating to nonrefundable personal credits) is
amended by inserting after section 25A the following new
section:
‘‘SEC. 25B. PRIMARY HEALTH SERVICES PROVIDERS SERV-
ING 
HEALTH 
PROFESSIONAL 
SHORTAGE
AREAS.
‘‘(a) ALLOWANCE
OF CREDIT.—In the case of a
qualified primary health services provider, there is allowed
as a credit against the tax imposed by this chapter for
any taxable year in a mandatory service period an amount
equal to the product of—
‘‘(1) the lesser of—
‘‘(A) the number of months of such period
occurring in such taxable year, or
‘‘(B) 60 months, reduced by the number of
months taken into account under this para-
graph with respect to such provider for all pre-
ceding taxable years (whether or not in the
same mandatory service period), multiplied by
‘‘(2) $1,000.
‘‘(b) QUALIFIED PRIMARY HEALTH SERVICES PRO-
VIDER.—For purposes of this section, the term ‘qualified
primary health services provider’ means any physician who
for any month during a mandatory service period is cer-
tified by the Bureau to be a primary health services pro-
vider who—
‘‘(1) is providing primary health services—
‘‘(A) full time, and
‘‘(B) to individuals at least 80 percent of
whom reside in a health professional shortage
area,
‘‘(2) is not receiving during such year a scholar-
ship under the National Health Service Corps Schol-
arship Program or the Indian health professions
scholarship program or a loan repayment under the
National Health Service Corps Loan Repayment
Program or the Indian Health Service Loan Repay-
ment Program,
‘‘(3) is not fulfilling service obligations under
such Programs, and
‘‘(4) has not defaulted on such obligations.
‘‘(c) MANDATORY SERVICE PERIOD.—For purposes
of this section, the term ‘mandatory service period’ means
the period of 60 consecutive calendar months beginning
with the first month the taxpayer is a qualified primary
health services provider. In the case of an individual who
is such a provider on the date of enactment of the Health
Care Access Improvement Act, such term means the pe-
riod of 60 consecutive calendar months beginning with the
first month after such date.
‘‘(d) OTHER DEFINITIONS AND SPECIAL RULES.—
For purposes of this section—
‘‘(1) BUREAU.—The term ‘Bureau’ means the
Bureau of Health Care Delivery and Assistance,
Health Resources and Services Administration of the
United States Public Health Service.
‘‘(2) PHYSICIAN.—The term ‘physician’ has the
meaning given to such term by section 1861(r) of
the Social Security Act.
‘‘(3) PRIMARY HEALTH SERVICES PROVIDER.—
The term ‘primary health services provider’ means a
provider of basic health services (as described in sec-
tion 330(b)(1)(A)(i) of the Public Health Service
Act).
‘‘(4) 
HEALTH
PROFESSIONAL
SHORTAGE
AREA.—The term ‘health professional shortage area’
means a health professional shortage area (as de-
fined in section 332(a)(1) of the Public Health Serv-
ice Act).
‘‘(e) RECAPTURE OF CREDIT.—
‘‘(B) CESSATION
OF
DESIGNATION.—The
cessation of the designation of any area as a
rural health professional shortage area after the
beginning of the mandatory service period for
any taxpayer shall not constitute a recapture
event.
‘‘(C) SECRETARIAL
WAIVER.—The Sec-
retary may waive any recapture event caused by
extraordinary circumstances.
‘‘(4) NO CREDITS AGAINST TAX.—Any increase
in tax under this subsection shall not be treated as
a tax imposed by this chapter for purposes of deter-
mining the amount of any credit under subpart A,
B, or D of this part.’’.
(b) CLERICAL AMENDMENT.—The table of sections
for subpart A of part IV of subchapter A of chapter 1
of the Internal Revenue Code of 1986 is amended by in-
serting after the item relating to section 25A the following
new item:
‘‘Sec. 25B. Primary health services providers serving health pro-
fessional shortage areas.’’.
(c) EFFECTIVE DATE.—The amendments made by
this section shall apply to taxable years beginning after
December 31, 1998.
Æ