LOAN REPAYMENT PROGRAM.

SEC. 202. LOAN REPAYMENT PROGRAM. (a) Provision of Primary Health Services.— (1) In general.—Section 338B(a) of the Public Health Service Act (42 U.S.C. 2541–1(a)) is amended by striking “Corps Loan” and all that follows and inserting the following: “Corps Loan Repayment Program to assure, with respect to the provision of primary health services pursuant to section 331(a)(2)— “(1) an adequate supply of physicians, dentists, certified nurse midwives, certified nurse practitioners, and physician assistants; and “(2) if needed by the Corps, an adequate supply of other health professionals (including mental health professionals).”. (2) Loan repayment contract.—Section 338B(f)(1)(B)(iv) of the Public Health Service Act (42 U.S.C. 2541(f)(1)(B)(iv)) is amended by inserting “as a provider of primary health services” before “in a health manpower shortage area”. 104 STAT. 3024 (b) Eligibility.— (1) In general.— (A) Section 338B(b)(1) of the Public Health Service Act (42 U.S.C. 2541–1(b)(1) is amended to read as follows: “(1) (A) must have a degree in medicine, osteopathic medicine, dentistry, or other health profession, or be certified as a nurse midwife, nurse practioner, or physician assistant; “(B) be enrolled in an approved graduate training program in medicine, osteopathic medicine, dentistry, or other health profession; or “(C) be enrolled as a full-time student— “(i) in an accredited (as determined by the Secretary) educational institution in a State; and “(ii) in the final year of a course of a study or program, offered by such institution and approved by the Secretary, leading to a degree in medicine, osteopathic medicine, dentistry, or other health profession;”. (B) Section 338B(f)(1)(B) of the Public Health Service Act (42 U.S.C. 2541-l((f)(1)(B)) is amended in clauses (ii) and (iii) by striking “(b)(1)(A)” each place such term appears and inserting “(b)(1)(C)”. (2) Time for submission of contract.— (A) Section 338B(b) of the Public Health Service Act (42 U.S.C. 2541-l(b)) is amended— (i) by adding “and” after the semicolon at the end of paragraph (2); and (ii) by striking paragraphs (3) and (4), and by inserting after paragraph (2) the following: “(3) submit to the Secretary an application for a contract described in subsection (f) (relating to the payment by the Secretary of the educational loans of the individual in consideration of the individual serving for a period of obligated service).”. (B) Section 338B(e) of the Public Health Service Act (42 U.S.C. 2541—1(e)) is amended by striking “only” and all that follows and inserting the following: “only upon the Secretary and the individual entering into a written contract described in subsection (f).”. (c) Incentives for Recruitment and Retention.— Section 3388(c) of the Public Health Service Act (42 U.S.C. 2541–1(c)) is amended by adding at the end the following new paragraph: “(4) Recruitment and retention.— “(A) The Secretary shall distribute to health professions schools materials providing information on the Loan Repayment Program and shall encourage the schools to disseminate the materials to the students of the schools. “(B) (i) In the case of any health professional whose period of obligated service under the Loan Repayment Program is nearing completion, the Secretary shall encourage the individual to remain in a health manpower shortage area and to continue providing primary health services. “(ii) During the period in which a health professional is planning and making the transition to private practice from obligated service under the Loan Repayment Program, the Secretary may provide assistance to the professional regarding such transition if the professional is104 STAT. 3025 remaining in a health manpower shortage area and is continuing to provide primary health services. “(C) In the case of entities to which participants in the Loan Repayment Program are assigned under section 333, the Secretary shall encourage the entities to provide options with respect to assisting the participants in remaining in the health manpower shortage areas involved, and in continuing to provide primary health services, after the period of obligated service under the Loan Repayment Program is completed. The options with respect to which the Secretary provides such encouragement may include options regarding the sharing of a single employment position in the health professions by 2 or more health professionals, and options regarding the recruitment of couples where both of the individuals are health professionals.”. (d) Priority in Making Awards.—Section 338B(d) of the Public Health Service Act (42 U.S.C. 2541–1(d)) is amended to read as follows: “(d) (1) Subject to section 333A, in providing contracts under the Loan Repayment Program— “(A) the Secretary shall consider the extent of the demonstrated interest of the applicants for the contracts in providing primary health services; and “(B) may consider such other factors regarding the applicants as the Secretary determines to be relevant to selecting qualified individuals to participate in such Program. “(2) In providing contracts under the Loan Repayment Program, the Secretary shall give priority— “(A) to any application for such a contract submitted by an individual whose training is in a health profession or specialty determined by the Secretary to be needed by the Corps; “(B) to any application for such a contract submitted by an individual who has (and whose spouse, if any, has) characteristics that increase the probability that the individual will continue to serve in a health manpower shortage area after the period of obligated service pursuant to subsection (f) is completed; and “(C) subject to subparagraph (B), to any application for such a contract submitted by an individual who is from a disadvantaged background.”. (e) Contents of Contract.—Section 338B(f)(2) of the Public Health Service Act (42 U.S.C. 2541–1(f)(2)) is amended by inserting before the semicolon the following: “, including extensions resulting in an aggregate period of obligated service in excess of 4 years.” (f) Payments.— (1) Clarification regarding undergraduate loans.—Section 338B(g)(1) of the Public Health Service Act (42 U.S.C. 2541–1(g)(1) is amended in the matter preceding subparagraph (A) by striking “loans received by the individual for—” and inserting the following: “loans received by the individual regarding the undergraduate or graduate education of the individual (or both), which loans were made for—” (2) Annual amount of repayments.— Section 338B(g)(2) of the Public Health Service Act (42 U.S.C. 2541–1(g)(2)) is amended— (A) in subparagraph (A)— 104 STAT. 3026 (i) by striking “Except” and all that follows through “for each” and inserting “For each”; (ii) by striking “$20,000” and inserting “$35,000”; and and (iii) by adding at the end the following new sentence: “In making a determination of the amount to pay for a year of such service by an individual, the Secretary shall consider the extent to which each such determination— “(i) affects the ability of the Secretary to maximize the number of contracts that can be provided under the Loan Repayment Program from the amounts appropriated for such contracts; “(ii) provides an incentive to serve in health man-power shortage areas with the greatest such shortages; and “(iii) provides an incentive with respect to the health professional involved remaining in a health manpower shortage area, and continuing to provide primary health services, after the completion of the period of obligated service under the Loan Repayment Program.”; and (B) by striking subparagraph (B) and redesignating subparagraph (C) as subparagraph (B). (g) Tax Liability.— (1) In general.—Section 338B(g)(3) of the Public Health Service Act (42 U.S.C. 2541-l(g)(3)) is amended to read as follows: “(3) Tax liability.— For the purpose of providing reimbursements for tax liability resulting from payments under paragraph (2) on behalf of an individual— “(A) the Secretary shall, in addition to such payments, make payments to the individual in an amount equal to 39 percent of the total amount of loan repayments made for the taxable year involved; and “(B) may make such additional payments as the Secretary determines to be appropriate with respect to such purpose.”. (2) Applicability of amendment.—The amendment made by paragraph (1) shall apply only with respect to contracts under section 338B of the Public Health Service Act (relating to service in the National Health Service Corps) that are entered into on or after the effective date of this Act. (h) Reports to Congress.—Section 338B(i) of the Public Health Service Act (42 U.S.C. 2541—1(i)) is amended to read as follows: “(i) Reports.—Not later than March 1 of each year, the Secretary shall submit to the Congress a report providing, with respect to the preceding fiscal year— “(1) the total amount of loan payments made under the Loan Repayment Program; “(2) the number of applications filed under this section; “(3) the number, and type of health profession training, of individuals receiving loan repayments under such Program; “(4) the educational institution at which such individuals received their training; “(5) the total amount of the indebtedness of such individuals for educational loans as of the date on which the individuals become participants in such Program; 104 STAT. 3027 “(6) the number of years of obligated service specified for such individuals in the initial contracts under subsection (f), and, in the case of individuals whose period of such service has been completed, the total number of years for which the individuals served in the Corps (including any extensions made for purposes of paragraph (2) of such subsection); “(7) (A) the number, and type of health professions training, of such individuals who have breached the contract under subsection (f) through any of the actions specified in subsection (a) or (b) of section 338E; and “(B) with respect to such individuals— “(i) the educational institutions with respect to which payments have been made or were to be made under the contract; “(ii) the amounts for which the individuals are liable to the United States under section 338E; “(iii) the extent of payment by the individuals of such amounts; and “(iv) if known, the basis for the decision of the individuals to breach the contract under subsection (f); and “(8) the effectiveness of the Secretary in recruiting health professionals to participate in the Loan Repayment Program, and in encouraging and assisting such professionals with respect to providing primary health services to health manpower shortage areas after the completion of the period of obligated service under such Program.”.