What This Bill Does
This bill creates a loan repayment program for doctors and certain other health care providers who agree to work in rural areas that don't have enough specialty medicine doctors. The federal government would pay back part of their student loans in exchange for a commitment to work in these underserved communities for six years.
Who It Affects
- Specialty medicine physicians (doctors in medical specialties)
- Non-physician specialty health care providers (licensed health professionals who are not doctors and provide specialized care)
- The Health Resources and Services Administration (the agency that would run the program)
- Rural communities experiencing shortages of specialty doctors
Key Provisions
- The Secretary of Health and Human Services must carry out a loan repayment program for specialty medicine physicians who agree to work in rural shortage areas for six years (Sec. 782(a)(1))
- The Secretary may also run a similar program for non-physician specialty health care providers under the same conditions (Sec. 782(a)(2))
- For each year of work in a shortage area, the government repays 1/6 of a participant's eligible loan principal and interest, with the remaining balance paid after completing the sixth year (Sec. 782(b)(1))
- Total loan repayment to any one person cannot exceed $250,000 (Sec. 782(b)(2))
- Participants cannot receive loan repayment from this program and another federal loan forgiveness program for the same service (Sec. 782(e))
- No more than 15 percent of yearly funding can go to non-physician specialty health care providers, and these providers cannot use other federal health care loan forgiveness programs (Sec. 782(g))
What Changes
If this bill becomes law, the federal government will create a new loan repayment program that specialty medicine doctors and certain other health care providers can join. Participants who commit to working six years in rural areas with doctor shortages will have their student loans partially or fully repaid by the government. The Health Resources and Services Administration will manage this program and must report to Congress every two years through fiscal year 2031 about where doctors are practicing and whether the program is improving access to specialty care in rural areas.
Important Definitions
- Specialty medicine physician: A doctor practicing in specialties listed in a specific Health Resources and Services Administration report, or in hospice and palliative medicine, geriatric medicine, or another specialty where the Secretary determines there is a significant shortage and limited patient access (Sec. 782(j)(2))
- Non-physician specialty health care provider: A licensed health professional who is not a doctor and provides patient care other than primary care (basic medical services) (Sec. 782(j)(1))
- Rural community experiencing a shortage: Not specified in bill text
Effective Date
Not specified in bill text
II
118TH CONGRESS
1ST SESSION
S. 705
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 SENATE OF THE UNITED STATES
MARCH 8, 2023
Ms. ROSEN (for herself and Mr. WICKER) introduced the following bill; which
was read twice and referred to the Committee on Health, Education,
Labor, and Pensions
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-
1
tives of the United States of America in Congress assembled,
2
SECTION 1. SHORT TITLE.
3
This Act may be cited as the ‘‘Specialty Physicians
4
Advancing Rural Care Act’’ or the ‘‘SPARC Act’’.
5
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•S 705 IS
SEC. 2. SPECIALTY MEDICAL PRACTITIONERS WORKFORCE
1
IN RURAL COMMUNITIES.
2
Title VII of the Public Health Service Act (42 U.S.C.
3
292 et seq.) is amended—
4
(1) by redesignating part G (42 U.S.C. 795j et
5
seq.) as part H; and
6
(2) by inserting after part F (42 U.S.C. 295h)
7
the following new part:
8
‘‘PART G—SPECIALTY MEDICINE WORKFORCE IN
9
RURAL COMMUNITIES
10
‘‘SEC. 782. LOAN REPAYMENT PROGRAM.
11
‘‘(a) IN GENERAL.—
12
‘‘(1) PROGRAM FOR SPECIALTY MEDICINE PHY-
13
SICIANS.—The Secretary, acting through the Admin-
14
istrator of the Health Resources and Services Ad-
15
ministration, shall carry out a program under
16
which—
17
‘‘(A) the Secretary enters into agreements
18
with specialty medicine physicians to make pay-
19
ments in accordance with subsection (b) on the
20
principal of and interest on any eligible loans
21
described in subsection (c); and
22
‘‘(B) the specialty medicine physicians
23
each agree to complete a period of obligated
24
service described in subsection (d) as a specialty
25
medicine physician in the United States in a
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•S 705 IS
rural community experiencing a shortage of
1
specialty medicine physicians.
2
‘‘(2) PROGRAM FOR NON-PHYSICIAN SPECIALTY
3
HEALTH CARE PROVIDERS.—The Secretary, acting
4
through the Administrator of the Health Resources
5
and Services Administration, may carry out a pro-
6
gram under which—
7
‘‘(A) the Secretary enters into agreements
8
with non-physician specialty health care pro-
9
viders to make payments in accordance with
10
subsection (b) on the principal of and interest
11
on any eligible loans described in subsection (c);
12
and
13
‘‘(B) the non-physician specialty health
14
care providers each agree to complete a period
15
of obligated service described in subsection (d)
16
as a non-physician specialty health care pro-
17
vider in the United States in a rural community
18
experiencing a shortage of such providers.
19
‘‘(b) PAYMENTS.—For each year of obligated service
20
by a specialty medicine physician pursuant to an agree-
21
ment under subsection (a)(1) or by a non-physician spe-
22
cialty health care provider pursuant to an agreement
23
under subsection (a)(2), the Secretary shall make a pay-
24
ment to such physician or provider as follows:
25
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•S 705 IS
‘‘(1) SERVICE IN SHORTAGE AREA.—The Sec-
1
retary shall pay—
2
‘‘(A) for each year of obligated service by
3
a specialty medicine physician or non-physician
4
specialty health care provider pursuant to an
5
agreement under paragraph (1) or (2) of sub-
6
section (a), 1⁄6 of the principal of and interest
7
on each eligible loan of the physician or pro-
8
vider which is outstanding on the date the phy-
9
sician or provider began service pursuant to the
10
agreement; and
11
‘‘(B) for completion of the sixth and final
12
year of such service, the remainder of such
13
principal and interest.
14
‘‘(2) MAXIMUM AMOUNT.—The total amount of
15
payments under this section to any specialty medi-
16
cine physician or non-physician specialty health care
17
provider shall not exceed $250,000.
18
‘‘(c) ELIGIBLE LOANS.—The loans eligible for repay-
19
ment under this section are each of the following:
20
‘‘(1) Any loan for education in specialty medi-
21
cine or specialty health care.
22
‘‘(2) Any Federal Direct Stafford Loan, Fed-
23
eral Direct PLUS Loan, Federal Direct Unsub-
24
sidized Stafford Loan, or Federal Direct Consolida-
25
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•S 705 IS
tion Loan (as such terms are used in section 455 of
1
the Higher Education Act of 1965).
2
‘‘(3) Any Federal Perkins Loan under part E
3
of title I of the Higher Education Act of 1965.
4
‘‘(4) Any other Federal loan as determined ap-
5
propriate by the Secretary.
6
‘‘(d) PERIOD OF OBLIGATED SERVICE.—Any spe-
7
cialty medicine physician or non-physician specialty health
8
care provider receiving payments under this section as re-
9
quired by an agreement under paragraph (1) or (2) of sub-
10
section (a) shall agree to a 6-year commitment to full-time
11
employment, with no more than 1 year passing between
12
any 2 years of covered employment, as a specialty medi-
13
cine physician or non-physician specialty health care pro-
14
vider, as applicable, in the United States in a rural com-
15
munity experiencing a shortage of specialty medicine phy-
16
sicians or non-physician specialty health care providers, as
17
applicable.
18
‘‘(e) INELIGIBILITY FOR DOUBLE BENEFITS.—No
19
borrower may, for the same service, receive a reduction
20
of loan obligations or a loan repayment under both—
21
‘‘(1) this section; and
22
‘‘(2) any federally supported loan forgiveness
23
program, including under section 338B, 338I, or
24
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•S 705 IS
846 of this Act, or section 428J, 428L, 455(m), or
1
460 of the Higher Education Act of 1965.
2
‘‘(f) BREACH.—
3
‘‘(1) LIQUIDATED
DAMAGES
FORMULA.—The
4
Secretary may establish a liquidated damages for-
5
mula to be used in the event of a breach of an
6
agreement entered into under paragraph (1) or (2)
7
of subsection (a).
8
‘‘(2) LIMITATION.—The failure by a specialty
9
medicine physician or a non-physician specialty
10
health care provider to complete the full period of
11
service obligated pursuant to such an agreement,
12
taken alone, shall not constitute a breach of the
13
agreement, so long as the physician or provider com-
14
pleted in good faith the years of service for which
15
payments were made to the physician or provider
16
under this section.
17
‘‘(g) SPECIAL RULES
FOR NON-PHYSICIAN SPE-
18
CIALTY HEALTH CARE PROVIDERS.—Non-physician spe-
19
cialty health care providers participating in the program
20
under this section are not eligible for other Federal loan
21
forgiveness programs specific to health care providers. Not
22
more than 15 percent of amounts made available to carry
23
out this section for a fiscal year may be allocated to
24
awards to non-physician specialty health care providers.
25
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•S 705 IS
‘‘(h) REPORTS
TO CONGRESS.—Not later than 5
1
years after the date of enactment of this section, and not
2
less than every other year thereafter through fiscal year
3
2031, the Secretary shall report to Congress on—
4
‘‘(1) the practice location of special medicine
5
physicians and non-physician specialty health care
6
providers participating, or who have participated, in
7
the loan repayment program under this section; and
8
‘‘(2) the impact of the loan repayment program
9
under this section on the availability of specialty
10
medicine or specialty health care services in the
11
United States in rural communities experiencing a
12
shortage of specialty medicine physicians or non-
13
physician specialty health care providers.
14
‘‘(i) DATA UPDATES.—The Administrator of the
15
Health Resources and Services Administration shall up-
16
date publicly available data on the supply of specialty med-
17
icine physicians and non-physician specialty health care
18
providers, as appropriate.
19
‘‘(j) DEFINITIONS.—In this section:
20
‘‘(1) NON-PHYSICIAN SPECIALTY HEALTH CARE
21
PROVIDER.—The
term
‘non-physician
specialty
22
health care provider’ means a health professional
23
other than a physician who is licensed to provide pa-
24
tient care other than primary care services.
25
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•S 705 IS
‘‘(2) SPECIALTY
MEDICINE
PHYSICIAN.—The
1
term ‘specialty medicine physician’ means a physi-
2
cian practicing in—
3
‘‘(A) a specialty identified in the report of
4
the Health Resources and Services Administra-
5
tion, titled ‘Projecting the Supply of Non-Pri-
6
mary Care Specialty and Subspecialty Clini-
7
cians: 2010–2025’;
8
‘‘(B) hospice and palliative medicine;
9
‘‘(C) geriatric medicine; or
10
‘‘(D) another medical specialty, if the Sec-
11
retary determines that there is evidence dem-
12
onstrating a significant shortage of providers in
13
the medical specialty and limited patient access
14
to care.
15
‘‘(k) AUTHORIZATION
OF
APPROPRIATIONS.—To
16
carry out this section, there are authorized to be appro-
17
priated such sums as may be necessary for fiscal years
18
2023 through 2032.’’.
19
Æ
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