Sec. 137601. Establishing Rural and Underserved Pathway to Practice Training Programs for Post-Baccalaureate Students and Medical Students
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Title XVIII of the Social Security Act ( 42 U.S.C. 1395 et seq. ) is amended by adding at the end the following new section: Not later than October 1, 2023, the Secretary shall, subject to the succeeding provisions of this section, carry out the Rural and Underserved Pathway to Practice Training Program for Post-Baccalaureate and Medical Students (in this section, referred to as the Program ) under which the Secretary awards Pathway to Practice medical scholarship vouchers to qualifying students described in subsection
(b)for the purpose of increasing the number of physicians practicing in rural and underserved communities. For purposes of this section, a qualifying student described in this subsection is an individual who— attests he or she— is or will be a first-generation student of a 4-year college, graduate school, or professional school; was a Pell Grant recipient; or lived in a medically underserved area, rural area, or health professional shortage area for a period of 4 or more years prior to attending an undergraduate program; has accepted enrollment in— a post-baccalaureate program that is not more than 2 years and intends to enroll in a qualifying medical school within 2 years after completion of such program; or a qualifying medical school; will practice medicine in a health professional shortage area, medically underserved area, public hospital, rural area, or as required under subsection (d)(5); and submits an application and a signed copy of the agreement described under subsection (c). To be eligible to receive a Pathway to Practice medical scholarship voucher under this section, a qualifying student described in subsection
(b)shall submit to the Secretary an application at such time, in such manner, and containing such information as the Secretary may require. As a part of the application described in paragraph (1), the Secretary shall include a notice of the items which are required to be agreed to under subsection (d)(4) for the purpose of notifying the qualifying student of the terms of the Rural and Underserved Pathway to Practice Training Program. On an annual basis, the Secretary may award a Pathway to Practice medical scholarship voucher under the Program to not more than 1,000 qualifying students described in subsection (b). In determining whether to award a Pathway to Practice medical scholarship voucher under the Program to qualifying students described in subsection (b), the Secretary shall prioritize applications from any such student who attests that he or she— was a participant in the Health Resources and Services Administration Health Careers Opportunity Program or an Area Health Education Center scholar; is a disadvantaged student (as defined by the National Health Service Corps of the Health Resources & Services Administration of the Department of Health and Human Services); or attended a historically black college or other minority serving institution (as defined in section 1067q of title 20, United States Code). Each Pathway to Practice medical scholarship voucher awarded to a qualifying student pursuant to paragraph
(1)shall be so awarded to such a student on an annual basis for each year of enrollment in a post-baccalaureate program and a qualifying medical school (as appropriate). Subject to paragraph (5), each Pathway to Practice medical scholarship voucher awarded under the Program shall include amounts for— tuition; academic fees (as determined by the qualifying medical school); required textbooks and equipment; a monthly stipend equal to the amount provided for individuals under the health professions scholarship and financial assistance program described in section 2121(c) of title 10, United States Code; and any other educational expenses normally incurred by students at the post-baccalaureate program or qualifying medical school (as appropriate). No amounts under paragraph
(4)may be provided a qualifying student awarded a Pathway to Practice medical scholarship voucher under the Program, unless the qualifying student submits to the Secretary an agreement to— complete a post-baccalaureate program that is not more than 2 years (if applicable pursuant to the option under subsection (b)(2)(A)); graduate from a qualifying medical school; complete a residency program in an approved residency training program (as defined in section 1886(h)(5)(A)); complete an initial residency period or the period of board eligibility; practice medicine for at least the number of years of the Pathway to Practice medical scholarship voucher awarded under paragraph
(2)after a residency program in a health professional shortage area, a medically underserved area, a public hospital, or a rural area, and during such period annually submit documentation with respect to whether the qualifying student practices medicine in such an area and where; for the purpose of determining compliance with subparagraph (E), not later than 180 days after the date on which qualifying student completes a residency program, provide to the Secretary information with respect to where the qualifying student is practicing medicine following the period described in such subparagraph; except in the case of a waiver for hardship pursuant to section 1892(f)(3), be liable to the United States pursuant to section 1892 for any amounts received under this Program that is determined a past-due obligation under subsection (b)(3) of such section in the case qualifying student fails to complete all of the requirements of this agreement under this subsection; and for the purpose of determining the amount of Pathway to Practice medical scholarship vouchers paid or incurred by a qualifying medical school or any provider of a post-baccalaureate program referred to in subsection (b)(2)(A) for the costs of tuition under paragraph (4)(A), consent to any personally identifying information being shared with the Secretary of the Treasury. Each annual award of an amount of Pathway to Practice medical scholarship voucher under paragraph
(2)shall be made with respect to a specific qualifying medical school or post-baccalaureate program that is not more than 2 years and such school or program shall (as a condition of, and prior to, such award being made with respect to such school or program)— submit to the Secretary such information as the Secretary may require to determine the amount of such award on the basis of the costs of the costs of the items specified under paragraph
(4)(except for subparagraph (D)) with respect to such school or program, and enter into an agreement with the Secretary under which such school or provider will verify (in such manner as the Secretary may provide) that amounts paid by such school or provider to the qualifying student are used for such costs. In this section: The team health professional shortage area has the meaning given such term in subparagraphs
(A)or
(B)of section 332(a)(1) of the Public Health Service Act. The term initial residency period has the meaning given such term in section 1886(h)(5)(F). The term medically underserved area means an area designated pursuant to section 330(b)(3)(A) of the Public Health Service Act. The term Pell Grant recipient has the meaning given such term in section 322(3) of the Higher Education Act of 1965. The term period of board eligibility has the meaning given such term in section 1886(h)(5)(G). The term qualifying medical school means a school of medicine accredited by the Liaison Committee on Medical Education of the American Medical Association and the Association of American Medical Colleges (or approved by such Committee as meeting the standards necessary for such accreditation) or a school of osteopathy accredited by the American Osteopathic Association, or approved by such Association as meeting the standards necessary for such accreditation which— for each academic year, enrolls at least 10 qualifying students who are in enrolled in such a school; requires qualifying students to enroll in didactic coursework and clinical experience applicable to practicing medicine in health professional shortage areas, medically underserved areas, or rural areas, including— clinical rotations in such areas in applicable specialties (as applicable and as available); coursework or training experiences focused on medical issues prevalent in such areas and cultural and structural competency; and is located in a State (as defined in section 210(h)). The term rural area has the meaning given such term in section 1886(d)(2)(D). Any person who knowingly and willfully obtains by fraud, false statement, or forgery, or fails to refund any funds, assets, or property provided under this section or attempts to so obtain by fraud, false statement or forgery, or fail to refund any funds, assets, or property, received pursuant to this section shall be fined not more than $20,000 or imprisoned for not more than 5 years, or both. . Section 1892 of the Social Security Act ( 42 U.S.C. 1395ccc ) is amended— in subsection (a)(1)(A)— by striking , or the and inserting , the ; and by inserting or the Rural and Underserved Pathway to Practice Training Program for Post- Baccalaureate and Medical Students under section 1899C before , owes a past-due obligation ; in subsection (b)— in paragraph (1), by striking at the end or ; in paragraph (2), by striking the period at the end and inserting ; or ; and by adding the end the following new paragraph: subject to subsection (f), owed by an individual to the United States by breach of an agreement under section 1899C(c) and which payment has not been paid by the individual for any amounts received under the Rural and Underserved Pathway to Practice Training Program for Post-Baccalaureate and Medical Students (and accrued interest determined in accordance with subsection (f)(4)) in the case such individual fails to complete the requirements of such agreement. ; and by adding at the end the following new subsection: The Secretary— shall require payment to the United States for any amount of damages that the United States is entitled to recover under subsection (b)(3), within the 5-year period beginning on the date an eligible individual fails to complete the requirements of such agreement under section 1899C(d)(5) (or such longer period beginning on such date as specified by the Secretary), and any such amounts not paid within such period shall be subject to collection through deductions in Medicare payments pursuant to subsection (e); may allow payments described in paragraph
(1)to be paid in installments over such 5-year period, which shall accrue interest in an amount determined pursuant to paragraph (5); may waive the requirement for an individual to pay a past-due obligation under subsection (b)(3) in the case of hardship (as determined by the Secretary); may not disclose any past-due obligation under subsection (b)(3) that is owed to the United States to any credit reporting agency that the United States entitled to be recovered the United States under this section; and shall make a final determination of whether the amount of payment under section 1899C made to a qualifying student (as described in subsection
(b)of such section) was in excess of or less than the amount of payment that is due, and payment of such excess or deficit is not made (or effected by offset) within 90 days of the date of the determination, and interest shall accrue on the balance of such excess or deficit not paid or offset (to the extent that the balance is owed by or owing to the provider) at a rate determined in accordance with the regulations of the Secretary of the Treasury applicable to charges for late payments. .