Hospital Mortgage Insurance Act of 2003
PL 108-91 (H.R.659), enacted 10/03/2003

117 STAT. 1158
PUBLIC LAW 108–91—OCT. 3, 2003
Public Law 108–91
108th Congress
An Act
To amend section 242 of the National Housing Act regarding the requirements
for mortgage insurance under such Act for hospitals.
Be it enacted by the Senate and House of Representatives of
the United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ‘‘Hospital Mortgage Insurance
Act of 2003’’.
SEC. 2. STANDARDS FOR DETERMINING NEED AND FEASIBILITY FOR
HOSPITALS.
(a) IN
GENERAL.—Paragraph (4) of section 242(d) of the
National Housing Act (12 U.S.C. 1715z–7) is amended to read
as follows:
‘‘(4)(A) The Secretary shall require satisfactory evidence that
the hospital will be located in a State or political subdivision of
a State with reasonable minimum standards of licensure and
methods of operation for hospitals and satisfactory assurance that
such standards will be applied and enforced with respect to the
hospital.
‘‘(B) The Secretary shall establish the means for determining
need and feasibility for the hospital, if the State does not have
an official procedure for determining need for hospitals. If the
State has an official procedure for determining need for hospitals,
the Secretary shall require that such procedure be followed before
the application for insurance is submitted, and the application
shall document that need has also been established under that
procedure.’’.
(b) EFFECTIVE DATE.—
(1) IN GENERAL.—The amendment made by subsection (a)
shall take effect and apply as of the date of the enactment
of this Act.
(2) EFFECT OF REGULATORY AUTHORITY.—Any authority of
the Secretary of Housing and Urban Development to issue
regulations to carry out the amendment made by subsection
(a) may not be construed to affect the effectiveness or applica-
bility of such amendment under paragraph (1) of this sub-
section.
SEC. 3. EXEMPTION FOR CRITICAL ACCESS HOSPITALS.
(a) IN GENERAL.—Section 242 of the National Housing Act
(12 U.S.C. 1715z–7) is amended—
(1) in subsection (b)(1)(B), by inserting ‘‘, unless the facility
is a critical access hospital (as that term is defined in section
Applicability.
12 USC 1715z–7
note.
12 USC 1701
note.
Hospital
Mortgage
Insurance Act of
2003.
Oct. 3, 2003
[H.R. 659]
VerDate 11-MAY-2000
10:15 Aug 27, 2004
Jkt 019194
PO 00000
Frm 00110
Fmt 6580
Sfmt 6581
D:\STATUTES\2003\19194PT2.001
APPS10
PsN: 19194PT2
117 STAT. 1159
PUBLIC LAW 108–91—OCT. 3, 2003
LEGISLATIVE HISTORY—H.R. 659:
HOUSE REPORTS: No. 108–27 (Comm. on Financial Services).
CONGRESSIONAL RECORD, Vol. 149 (2003):
Mar. 12, considered and passed House.
Sept. 2, considered and passed Senate, amended.
Sept. 17, House concurred in Senate amendment.
1861(mm)(1) 
of 
the 
Social 
Security 
Act 
(42 
U.S.C.
1395x(mm)(1)))’’ after ‘‘tuberculosis’’; and
(2) by adding at the end the following:
‘‘(i) TERMINATION OF EXEMPTION FOR CRITICAL ACCESS HOS-
PITALS.—
‘‘(1) IN GENERAL.—The exemption for critical access hos-
pitals under subsection (b)(1)(B) shall have no effect after July
31, 2006.
‘‘(2) REPORT TO CONGRESS.—Not later than 3 years after
July 31, 2003, the Secretary shall submit a report to Congress
detailing the effects of the exemption of critical access hospitals
from the provisions of subsection (b)(1)(B) on—
‘‘(A) the provision of mortgage insurance to hospitals
under this section; and
‘‘(B) the General Insurance Fund established under
section 519.’’.
SEC. 4. STUDY OF BARRIERS TO RECEIPT OF INSURED MORTGAGES
BY FEDERALLY QUALIFIED HEALTH CENTERS.
(a) IN GENERAL.—The Secretary of Housing and Urban Develop-
ment shall conduct a study on the barriers to the receipt of mortgage
insurance by federally qualified health centers (as defined in section
1905(l)(2)(B) of the Social Security Act (42 U.S.C. 1396d(l)(2)(B)))
under section 1101 of the National Housing Act (12 U.S.C. 1749aaa),
or other programs under that Act.
(b) REPORT.—Not later than 6 months after the date of enact-
ment of this Act, the Secretary of Housing and Urban Development
shall submit a report regarding any appropriate legislative and
regulatory changes needed to enable federally qualified health cen-
ters to access mortgage insurance under section 1101 of the National
Housing Act (12 U.S.C. 1749aaa), or other programs under that
Act to—
(1) the Committee on Banking, Housing, and Urban Affairs
of the Senate; and
(2) the Committee on Financial Services of the House of
Representatives.
Approved October 3, 2003.
Deadline.
Deadline.
VerDate 11-MAY-2000
10:15 Aug 27, 2004
Jkt 019194
PO 00000
Frm 00111
Fmt 6580
Sfmt 6580
D:\STATUTES\2003\19194PT2.001
APPS10
PsN: 19194PT2