SPARC Act

I 118TH CONGRESS 1ST SESSION H. R. 2761 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 APRIL 20, 2023 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- 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 VerDate Sep 11 2014 22:11 Apr 26, 2023 Jkt 039200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H2761.IH H2761 kjohnson on DSK79L0C42PROD with BILLS 2 •HR 2761 IH 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 26 VerDate Sep 11 2014 22:11 Apr 26, 2023 Jkt 039200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H2761.IH H2761 kjohnson on DSK79L0C42PROD with BILLS 3 •HR 2761 IH 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 VerDate Sep 11 2014 22:11 Apr 26, 2023 Jkt 039200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H2761.IH H2761 kjohnson on DSK79L0C42PROD with BILLS 4 •HR 2761 IH ‘‘(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 VerDate Sep 11 2014 22:11 Apr 26, 2023 Jkt 039200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H2761.IH H2761 kjohnson on DSK79L0C42PROD with BILLS 5 •HR 2761 IH 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 VerDate Sep 11 2014 22:11 Apr 26, 2023 Jkt 039200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H2761.IH H2761 kjohnson on DSK79L0C42PROD with BILLS 6 •HR 2761 IH 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 VerDate Sep 11 2014 22:11 Apr 26, 2023 Jkt 039200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H2761.IH H2761 kjohnson on DSK79L0C42PROD with BILLS 7 •HR 2761 IH ‘‘(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 VerDate Sep 11 2014 22:11 Apr 26, 2023 Jkt 039200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\H2761.IH H2761 kjohnson on DSK79L0C42PROD with BILLS 8 •HR 2761 IH ‘‘(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 VerDate Sep 11 2014 22:11 Apr 26, 2023 Jkt 039200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6301 E:\BILLS\H2761.IH H2761 kjohnson on DSK79L0C42PROD with BILLS