[Congressional Bills 111th Congress]
[From the U.S. Government Publishing Office]
[H.R. 5889 Introduced in House (IH)]
111th CONGRESS
2d Session
H. R. 5889
To amend the Public Health Service Act and title XVIII of the Social
Security Act to increase the number of primary care physicians and
medical residents serving health professional shortage areas, and for
other purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
July 27, 2010
Mr. Young of Alaska introduced the following bill; which was referred
to the Committee on Energy and Commerce, and in addition to the
Committee on Ways and Means, for a period to be subsequently determined
by the Speaker, in each case for consideration of such provisions as
fall within the jurisdiction of the committee concerned
_______________________________________________________________________
A BILL
To amend the Public Health Service Act and title XVIII of the Social
Security Act to increase the number of primary care physicians and
medical residents serving health professional shortage areas, and for
other purposes.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. FINDINGS.
Congress finds the following:
(1) The average life expectancy in the United States has
increased to 80 years of age, causing an ever-increasing demand
for medical care.
(2) Medical school enrollment numbers have been virtually
stagnant for the last 25 years.
(3) During the last 20 years, median tuition and fees at
medical schools have increased by 229 percent (122 percent
adjusted for inflation) in private schools and by 479 percent
(256 percent adjusted for inflation) in public schools.
(4) The Association of American Medical Colleges, in its
Statement on the Physician Workforce, dated June, 2006, called
for an increase of 1,500 National Health Service Corps program
awards per year to help meet the need for physicians caring for
underserved populations and to help address rising medical
student indebtedness.
(5) The National Health Service Corps program has a proven
record of supplying physicians to underserved areas, and has
played an important role in expanding access for underserved
populations in rural and inner city communities.
(6) Continued expansion of the National Health Service
Corps program is strongly recommended.
(7) The growing debt incurred by graduating medical
students is likely to increase the interest and willingness of
graduates of United States medical schools to apply for
National Health Service Corps program funding and awards.
(8) One-third (250,000) of active physicians are over the
age of 55 and are likely to retire in the next ten years, while
the population will have increased by 24 percent. These
demographic changes will cause the population-to-physician
ratio to peak by the year 2020.
(9) In 2005, the Council on Graduate Medical Education
stated in a report to Congress that there will be a shortage of
not fewer than 90,000 full-time physicians by 2020.
(10) A continuing decline in the number of primary care
physicians will lead to increased shortages of health care
access in rural America.
(11) There is a declining ability to recruit qualified
medical students from rural and underserved areas, coupled with
greater difficulty on the part of community health centers and
other clinics to attract adequate personnel.
(12) Individuals in many geographic areas, especially rural
areas, lack adequate access to high quality preventive, primary
and specialty health care, contributing to significant health
disparities that impair America's public health and economic
productivity.
(13) A collaborative process is needed between hospitals
and non-hospital settings to maximize the potential of non-
hospital health care training.
SEC. 2. SCHOLARSHIPS FOR MEDICAL STUDENTS UNDER NATIONAL HEALTH SERVICE
CORPS SCHOLARSHIP PROGRAM.
Section 338H of the Public Health Service Act (42 U.S.C. 254q) is
amended by adding at the end the following:
``(d) Scholarships for Medical Students.--For contracts for
scholarships under this subpart to individuals who are accepted for
enrollment, or enrolled, in a course of study or program described in
section 338A(b)(1)(B) that leads to a degree in medicine or osteopathic
medicine, the Secretary shall, of the amounts appropriated under
subsection (a) for a fiscal year, obligate the greater of 10 percent or
such amount as necessary to fund ongoing activities related to such
contracts.''.
SEC. 3. CLARIFICATION OF ELIGIBILITY FOR MEDICARE GRADUATE MEDICAL
EDUCATION FUNDING OF A NONRURAL HOSPITAL THAT HAS A
TRAINING PROGRAM WITH AN INTEGRATED RURAL TRACK.
(a) In General.--Section 1886(h)(4)(H) of the Social Security Act
(42 U.S.C. 1395ww(h)(4)(H)), as amended by section 5506(a) of the
Patient Protection and Affordable Care Act (Public Law 111-148), is
amended--
(1) in clause (iv), by inserting ``(as defined in clause
(vii))'' after ``an integrated rural track''; and
(2) by adding at the end the following new clause:
``(vii) Definition of accredited training
program with an integrated rural track.--For
purposes of clause (iv), the term `accredited
training program with an integrated rural
track' means an accredited medical residency
training program located in an urban area which
offers a curriculum for all residents in the
program that includes the following
characteristics:
``(I) A minimum of 3 block months
of rural rotations. During such 3 block
months, the resident is in a rural area
for 4 weeks or a month.
``(II) A stated mission for
training rural physicians.
``(III) A minimum of 3 months of
obstetrical training, or an equivalent
longitudinal experience.
``(IV) A minimum of 4 months of
pediatric training that includes
neonatal, ambulatory, inpatient, and
emergency experiences through
rotations, or an equivalent
longitudinal experience.
``(V) A minimum of 2 months of
emergency medicine rotations, or an
equivalent longitudinal experience.''.
(b) Effective Date.--The amendments made by subsection (a) apply
with respect to--
(1) payments to hospitals under section 1886(h) of the
Social Security Act (42 U.S.C. 1395ww(h)) for cost reporting
periods beginning on or after January 1, 2011; and
(2) payments to hospitals under section 1886(d)(5)(B)(v) of
such Act (42 U.S.C. 1395ww(d)(5)(B)(v)) for discharges
occurring on or after January 1, 2011.
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