I 
119TH CONGRESS 
1ST SESSION H. R. 4681 
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 HOUSE OF REPRESENTATIVES 
JULY 23, 2025 
Mr. JOYCE of Pennsylvania (for himself and Ms. ROSS) introduced the 
following bill; which was referred to the Committee on Energy and Commerce 
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. 
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 ‘‘Specialty Physicians 
Advancing Rural Care Act’’ or the ‘‘SPARC Act’’. 
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SEC. 2. SPECIALTY MEDICAL PRACTITIONERS WORKFORCE 
IN RURAL COMMUNITIES. 
Title VII of the Public Health Service Act (42 U.S.C. 
292 et seq.) is amended— 
(1) by redesignating part G (42 U.S.C. 795j et 
seq.) as part H; and 
(2) by inserting after part F (42 U.S.C. 295h) 
the following new part: 
‘‘PART G—SPECIALTY MEDICINE WORKFORCE IN 
RURAL COMMUNITIES 
‘‘SEC. 782. LOAN REPAYMENT PROGRAM. 
‘‘(a) IN GENERAL.— 
‘‘(1) PROGRAM FOR SPECIALTY MEDICINE PHY-
SICIANS.—The Secretary, acting through the Admin-
istrator of the Health Resources and Services Ad-
ministration, shall carry out a program under 
which— 
‘‘(A) the Secretary enters into agreements 
with specialty medicine physicians to make pay-
ments in accordance with subsection (b) on the 
principal of and interest on any eligible loans 
described in subsection (c); and 
‘‘(B) the specialty medicine physicians 
each agree to complete a period of obligated 
service described in subsection (d) as a specialty 
medicine physician in the United States in a 
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rural community experiencing a shortage of 
specialty medicine physicians. 
‘‘(2) PROGRAM FOR NON-PHYSICIAN SPECIALTY 
HEALTH CARE PROVIDERS.—The Secretary, acting 
through the Administrator of the Health Resources 
and Services Administration, may carry out a pro-
gram under which— 
‘‘(A) the Secretary enters into agreements 
with non-physician specialty health care pro-
viders to make payments in accordance with 
subsection (b) on the principal of and interest 
on any eligible loans described in subsection (c); 
and 
‘‘(B) the non-physician specialty health 
care providers each agree to complete a period 
of obligated service described in subsection (d) 
as a non-physician specialty health care pro-
vider in the United States in a rural community 
experiencing a shortage of such providers. 
‘‘(b) PAYMENTS.—For each year of obligated service 
by a specialty medicine physician pursuant to an agree-
ment under subsection (a)(1) or by a non-physician spe-
cialty health care provider pursuant to an agreement 
under subsection (a)(2), the Secretary shall make a pay-
ment to such physician or provider as follows: 
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‘‘(1) SERVICE IN SHORTAGE AREA.—The Sec-
retary shall pay— 
‘‘(A) for each year of obligated service by 
a specialty medicine physician or non-physician 
specialty health care provider pursuant to an 
agreement under paragraph (1) or (2) of sub-
section (a), 1⁄6 of the principal of and interest 
on each eligible loan of the physician or pro-
vider which is outstanding on the date the phy-
sician or provider began service pursuant to the 
agreement; and 
‘‘(B) for completion of the sixth and final 
year of such service, the remainder of such 
principal and interest. 
‘‘(2) MAXIMUM AMOUNT.—The total amount of 
payments under this section to any specialty medi-
cine physician or non-physician specialty health care 
provider shall not exceed $250,000. 
‘‘(c) ELIGIBLE LOANS.—The loans eligible for repay-
ment under this section are each of the following: 
‘‘(1) Any loan for education in specialty medi-
cine or specialty health care. 
‘‘(2) Any Federal Direct Stafford Loan, Fed-
eral Direct PLUS Loan, Federal Direct Unsub-
sidized Stafford Loan, or Federal Direct Consolida-
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tion Loan (as such terms are used in section 455 of 
the Higher Education Act of 1965). 
‘‘(3) Any Federal Perkins Loan under part E 
of title I of the Higher Education Act of 1965. 
‘‘(4) Any other Federal loan as determined ap-
propriate by the Secretary. 
‘‘(d) PERIOD OF OBLIGATED SERVICE.—Any spe-
cialty medicine physician or non-physician specialty health 
care provider receiving payments under this section as re-
quired by an agreement under paragraph (1) or (2) of sub-
section (a) shall agree to a 6-year commitment to full-time 
employment, with no more than 1 year passing between 
any 2 years of covered employment, as a specialty medi-
cine physician or non-physician specialty health care pro-
vider, as applicable, in the United States in a rural com-
munity experiencing a shortage of specialty medicine phy-
sicians or non-physician specialty health care providers, as 
applicable. 
‘‘(e) INELIGIBILITY FOR DOUBLE BENEFITS.—No 
borrower may, for the same service, receive a reduction 
of loan obligations or a loan repayment under both— 
‘‘(1) this section; and 
‘‘(2) any federally supported loan forgiveness 
program, including under section 338B, 338I, or 
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846 of this Act, or section 428J, 428L, 455(m), or 
460 of the Higher Education Act of 1965. 
‘‘(f) BREACH.— 
‘‘(1) LIQUIDATED
DAMAGES
FORMULA.—The 
Secretary may establish a liquidated damages for-
mula to be used in the event of a breach of an 
agreement entered into under paragraph (1) or (2) 
of subsection (a). 
‘‘(2) LIMITATION.—The failure by a specialty 
medicine physician or a non-physician specialty 
health care provider to complete the full period of 
service obligated pursuant to such an agreement, 
taken alone, shall not constitute a breach of the 
agreement, so long as the physician or provider com-
pleted in good faith the years of service for which 
payments were made to the physician or provider 
under this section. 
‘‘(g) SPECIAL RULES
FOR NON-PHYSICIAN SPE-
CIALTY HEALTH CARE PROVIDERS.—Non-physician spe-
cialty health care providers participating in the program 
under this section are not eligible for other Federal loan 
forgiveness programs specific to health care providers. Not 
more than 15 percent of amounts made available to carry 
out this section for a fiscal year may be allocated to 
awards to non-physician specialty health care providers. 
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‘‘(h) REPORTS
TO CONGRESS.—Not later than 5 
years after the date of enactment of this section, and not 
less than every other year thereafter through fiscal year 
2033, the Secretary shall report to Congress on— 
‘‘(1) the practice location of special medicine 
physicians and non-physician specialty health care 
providers participating, or who have participated, in 
the loan repayment program under this section; and 
‘‘(2) the impact of the loan repayment program 
under this section on the availability of specialty 
medicine or specialty health care services in the 
United States in rural communities experiencing a 
shortage of specialty medicine physicians or non- 
physician specialty health care providers. 
‘‘(i) DATA UPDATES.—The Administrator of the 
Health Resources and Services Administration shall up-
date publicly available data on the supply of specialty med-
icine physicians and non-physician specialty health care 
providers, as appropriate. 
‘‘(j) DEFINITIONS.—In this section: 
‘‘(1) NON-PHYSICIAN SPECIALTY HEALTH CARE 
PROVIDER.—The 
term 
‘non-physician 
specialty 
health care provider’ means a health professional 
other than a physician who is licensed to provide pa-
tient care other than primary care services. 
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‘‘(2) SPECIALTY
MEDICINE
PHYSICIAN.—The 
term ‘specialty medicine physician’ means a physi-
cian practicing in an area of medicine other than 
primary care. 
‘‘(k) AUTHORIZATION
OF
APPROPRIATIONS.—To 
carry out this section, there are authorized to be appro-
priated such sums as may be necessary for fiscal years 
2025 through 2034.’’. 
Æ 
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