PRINTER'S NO. 4634
No. 2975 Session of 2004
INTRODUCED BY B. SMITH, NOVEMBER 9, 2004
REFERRED TO COMMITTEE ON PROFESSIONAL LICENSURE,
NOVEMBER 9, 2004
AN ACT
1 Establishing a State loan repayment program for certain health
2 professionals; and conferring powers and imposing duties on
3 the Department of Health.
4 The General Assembly of the Commonwealth of Pennsylvania
5 hereby enacts as follows:
6 TABLE OF CONTENTS
7 Chapter 1. Preliminary Provisions
8 Section 101. Short title.
9 Section 102. Definitions.
10 Chapter 3. Loan Repayment Program
11 Section 301. Program establishment and purpose.
12 Section 302. Program administration and eligibility.
13 Section 303. Eligible loan repayment sites.
14 Section 304. Eligible health professionals and providers.
15 Section 305. Obligations of participants.
16 Chapter 5. Administration and Enforcement
17 Section 501. Responsibilities of department.
18 SEction 502. Procedure for loan repayment.
1 Section 503. Failure to complete obligated service.
2 Section 504. Suspension or waiver of obligation.
3 Chapter 11. Miscellaneous Provisions
4 Section 1101. Funding.
5 Section 1102. Effective date.
6 CHAPTER 1
7 PRELIMINARY PROVISIONS
8 Section 101. Short title.
9 This act shall be known and may be cited as the Health
10 Professional Loan Repayment Act.
11 Section 102. Definitions.
12 The following words and phrases when used in this act shall
13 have the meanings given to them in this section unless the
14 context clearly indicates otherwise:
15 "Department." The Department of Health of the Commonwealth.
16 "Health professional shortage area." An area designated as
17 such by the Secretary of Health and Human Services as provided
18 under 42 CFR Pt. 5 (relating to designation of health
19 professional(s) shortage areas).
20 "Program." The National Health Services Corps State loan
21 repayment program established under section 301.
22 "Qualifying educational loans." Government and commercial
23 loans for actual costs paid for tuition, reasonable education
24 expenses and reasonable living expenses related to the graduate
25 or undergraduate education of a health care professional.
26 CHAPTER 3
27 LOAN REPAYMENT PROGRAM
28 Section 301. Program establishment and purpose.
29 The department shall establish a National Health Services
30 Corps State loan repayment program authorized by section 3381 of
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1 the Public Health Service Act (58 Stat. 682, 42 U.S.C. § 254q-
2 1). The purpose of the program is to assist communities with the
3 recruitment and retention of health professionals in federally
4 designated health professional shortage areas.
5 Section 302. Program administration and eligibility.
6 (a) Duties of department.--The department shall administer
7 the program. The department shall:
8 (1) Ensure that Federal funds are used in accordance
9 with program requirements established by the Federal National
10 Health Services Corps.
11 (2) Notify potentially eligible loan repayment sites
12 about the program.
13 (3) Develop and disseminate application materials to
14 sites.
15 (4) Review and rank applications using the scoring
16 criteria approved by the Department of Health and Human
17 Services as part of the department's program application.
18 (5) Select sites that qualify for loan repayment based
19 upon the availability of Federal and State funding.
20 (6) Carry out other activities necessary to implement
21 and administer this act.
22 (7) Verify the eligibility of program participants.
23 (8) Sign a contract with each participant that specifies
24 the obligations of the participant and the Commonwealth.
25 (9) Arrange for loan repayment of qualifying educational
26 loans for program participants.
27 (10) Monitor the obligated service of program
28 participants.
29 (11) Waive or suspend service or payment obligations of
30 participants in appropriate situations.
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1 (12) Place participants who fail to meet their
2 obligations in default.
3 (13) Enforce penalties for default.
4 Section 303. Eligible loan repayment sites.
5 Nonprofit private and public entities located in and
6 providing health care services in federally designated primary
7 care health professional shortage areas are eligible to apply
8 for the program. The department shall develop a list of health
9 professional shortage areas in this Commonwealth in greatest
10 need of health care professionals and shall select loan
11 repayment sites from that list. The department shall ensure, to
12 the greatest extent possible, that the geographic distribution
13 of sites within this Commonwealth reflects the percentage of the
14 population living in rural and urban health professional
15 shortage areas.
16 Section 304. Eligible health professionals and providers.
17 (a) Eligible health professionals.--To be eligible to apply
18 to the department for the program, health professionals must:
19 (1) Be citizens or nationals of the United States.
20 (2) Not have any unserved obligations for service to a
21 Federal, State or local government or other entity.
22 (3) Have a current and unrestricted Pennsylvania license
23 to practice.
24 (4) Be ready to begin full-time clinical practice upon
25 signing a contract for obligated service.
26 (b) Eligible providers.--Eligible providers are those
27 specified by the Federal Bureau of Health Professions in the
28 policy information notice for the State's current Federal grant
29 application. A health professional selected for participation is
30 not eligible for loan repayment until the health professional
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1 has an employment agreement or contract with an eligible loan
2 repayment site and has signed a contract for obligated service
3 with the department.
4 Section 305. Obligations of participants.
5 (a) Contract required.--Before starting the period of
6 obligated service, a participant must sign a contract with the
7 department that specifies the obligations of the participant and
8 the department.
9 (b) Obligated service.--A participant shall agree in the
10 contract to fulfill the period of obligated service by providing
11 primary health care services in full-time clinical practice. The
12 service must be provided in a nonprofit private or public entity
13 that is located in and providing services to a federally
14 designated health professional shortage area and that has been
15 designated as an eligible site by the department under the
16 program.
17 (c) Length of service.--Participants must agree to provide
18 obligated service for a minimum of two years. A participant may
19 extend a contract to provide obligated service for a third and
20 fourth year, subject to approval by the department and the
21 availability of Federal and State funding.
22 (d) Affidavit of service required.--Before receiving loan
23 repayment, annually thereafter, and as requested by the
24 department, a participant shall submit an affidavit to the
25 department stating that the participant is providing the
26 obligated service and which is signed by a representative of the
27 organizational entity in which the service is provided.
28 Participants must provide written notice to the department
29 within 30 days of:
30 (1) A change in name or address.
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1 (2) A decision not to fulfill a service obligation.
2 (3) Cessation of clinical practice.
3 (e) Tax responsibility.--The participant is responsible for
4 reporting on Federal income tax returns any amount paid by the
5 State on designated loans, if required to do so under Federal
6 law.
7 (f) Nondiscrimination requirements.--Participants are
8 prohibited from charging a higher rate for professional services
9 than the usual and customary rate prevailing in the area where
10 the services are provided. If a patient is unable to pay this
11 charge, a participant shall charge the patient a reduced rate or
12 not charge the patient. Participants must agree not to
13 discriminate on the basis of ability to pay or status as a
14 Medicare or medical assistance enrollee. Participants must agree
15 to accept assignment under the Medicare program and to serve as
16 an enrolled provider under medical assistance.
17 CHAPTER 5
18 ADMINISTRATION AND ENFORCEMENT
19 Section 501. Responsibilities of department.
20 Subject to the availability of Federal and State funds for
21 the program, the department shall pay all or part of the
22 qualifying education loans up to $30,000 annually for each
23 primary care physician participant that fulfills the required
24 service obligation.
25 Section 502. Procedure for loan repayment.
26 Program participants, at the time of signing a contract,
27 shall designate the qualifying loan or loans for which the
28 department is to make payments. The participant shall submit to
29 the department proof that all payments made by the department
30 have been applied toward the designated qualifying educational
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1 loans. The department shall make payments in accordance with the
2 terms and conditions of the State loan repayment grant agreement
3 or contract, in an amount not to exceed $30,000 when annualized.
4 If the amount paid by the department is less than $30,000 during
5 a 12-month period, the department shall pay during the twelfth
6 month an additional amount towards a loan or loans designated by
7 the participant, to bring the total paid to $30,000. The total
8 amount paid by the department must not exceed the amount of
9 principal and accrued interest of the designated loans.
10 Section 503. Failure to complete obligated service.
11 A program participant who fails to complete the required
12 years of obligated service shall repay the amount paid, as well
13 as a financial penalty specified by the Federal Bureau of Health
14 Professions in the policy information notice for the State's
15 current Federal grant application. The department shall report
16 to the appropriate health-related licensing board a participant
17 who fails to complete the service obligation and fails to repay
18 the amount paid or fails to pay any financial penalty owed under
19 this section.
20 Section 504. Suspension or waiver of obligation.
21 Payment or service obligations cancel in the event of a
22 participant's death. The department may waive or suspend payment
23 or service obligations in case of total and permanent disability
24 or long-term temporary disability lasting for more than two
25 years. The department shall evaluate all other requests for
26 suspension or waivers on a case-by-case basis.
27 CHAPTER 11
28 MISCELLANEOUS PROVISIONS
29 Section 1101. Funding.
30 Program loan repayments shall be made only to the extent that
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1 funds are available for that purpose and are sufficient to cover
2 administration of the program.
3 Section 1102. Effective date.
4 This act shall take effect in 60 days.
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