PRIA, Government Policy, Made Personal

Summary

Schools that run the student loan program must make students who get those loans promise to start and finish a primary health care residency within 4 years after they graduate. Students must also agree to work in primary health care for 10 years (counting their residency) or until the loan is paid off, whichever comes first. The rule does not apply if the student’s first loan was made before July 1, 1993, or if the loan came from certain “exempt” federal or school contributions tied to funds under section 292t(f). Money that came from appropriations before October 1, 1990 is not exempt. If a student breaks the promise, the loan’s interest rate goes up by 2 percentage points above the rate they would have paid. The Secretary must allow a partial or full waiver or a pause if following the promise is impossible, would cause extreme hardship, or would be unfair. If a student leaves school before graduating and does not return or go to another medical or osteopathic school, the obligation is waived; if they later return, the obligation is paused for the time they were not attending. Waivers do not let a student avoid repaying loans under section 292r. Each school must meet one of three targets every year ending June 30, 1997 and every June 30 after that for graduates who finished about 4 years earlier: either at least 50% are in primary care training or practicing primary care; or at least 25% and at least 5 percentage points higher than the prior year; or the school is at or above the 75th percentile among similar schools. The Secretary will check compliance within 90 days after the year ends, using a report the school must send. If a school fails, it must pay the Secretary a share of its loan fund income: 10% for the year ending June 30, 1997; 20% for the year ending June 30, 1998; and 30% for later years. Payments can come from the loan fund, but income from exempt contributions must be excluded and cannot be used to pay. Money collected will be used to add federal capital to loan funds of schools that meet the targets, and those payments will not be treated as exempt contributions. Schools must submit annual reports with statistics about graduates from about 4 years earlier. Exempt contributions means certain federal or school contributions described above. Income means principal and interest payments on fund loans and other earnings. Primary health care means family medicine, general internal medicine, general pediatrics, preventive medicine, or osteopathic general practice. Congress believes repaid loan funds should only be used to run this program and not sent to the Treasury or used for other things.

Title 42, §292s

The Public Health and Welfare, Source: USLM XML via OLRC

(a)Requirements for students

(1)In general

(A)to enter and complete a residency training program in primary health care not later than 4 years after the date on which the student graduates from such school; and

(B)to practice in such care for 10 years (including residency training in primary health care) or through the date on which the loan is repaid in full, whichever occurs first.

(2)Inapplicability to certain students

(A)The requirement established in paragraph (1) regarding the student loan fund of a school does not apply to a student if—

(i)the first loan to the student from such fund is made before July 1, 1993; or

(ii)the loan is made from—

(I)a Federal capital contribution under section 292q of this title that is made from amounts appropriated under section 292t(f) of this title (in this section referred to as an “exempt Federal capital contribution”); or

(II)a school contribution made under section 292q of this title pursuant to such a Federal capital contribution (in this section referred to as an “exempt school contribution”).

(B)A Federal capital contribution under section 292q of this title may not be construed as being an exempt Federal capital contribution if the contribution was made from amounts appropriated before October 1, 1990. A school contribution under section 292q of this title may not be construed as being an exempt school contribution if the contribution was made pursuant to a Federal capital contribution under such section that was made from amounts appropriated before such date.

(3)Noncompliance by student

Each agreement entered into with a student pursuant to paragraph (1) shall provide that, if the student fails to comply with such agreement, the loan involved will begin to accrue interest at a rate of 2 percent per year greater than the rate at which the student would pay if compliant in such year.

(4)Waivers

(A)With respect to the obligation of an individual under an agreement made under paragraph (1) as a student, the Secretary shall provide for the partial or total waiver or suspension of the obligation whenever compliance by the individual is impossible, or would involve extreme hardship to the individual, and if enforcement of the obligation with respect to the individual would be unconscionable.

(B)For purposes of subparagraph (A), the obligation of an individual shall be waived if—

(i)the status of the individual as a student of the school involved is terminated before graduation from the school, whether voluntarily or involuntarily; and

(ii)the individual does not, after such termination, resume attendance at the school or begin attendance at any other school of medicine or osteopathic medicine.

(C)If an individual resumes or begins attendance for purposes of subparagraph (B), the obligation of the individual under the agreement under paragraph (1) shall be considered to have been suspended for the period in which the individual was not in attendance.

(D)This paragraph may not be construed as authorizing the waiver or suspension of the obligation of a student to repay, in accordance with section 292r of this title, loans from student loan funds under section 292q of this title.

(b)Requirements for schools

(1)In general

Subject to the provisions of this subsection, in the case of student loan funds established under section 292q of this title by schools of medicine or osteopathic medicine, each agreement entered into under such section with such a school shall provide (in addition to the provisions required in subsection (b) of such section) that, for the 1-year period ending on June 30, 1997; and for the 1-year period ending on June 30 of each subsequent fiscal year, the school will meet not less than 1 of the conditions described in paragraph (2) with respect to graduates of the school whose date of graduation from the school occurred approximately 4 years before the end of the 1-year period involved.

(2)Description of conditions

With respect to graduates described in paragraph (1) (in this paragraph referred to as “designated graduates”), the conditions referred to in such paragraph for a school for a 1-year period are as follows:

(A)Not less than 50 percent of designated graduates of the school meet the criterion of either being in a residency training program in primary health care, or being engaged in a practice in such care (having completed such a program).

(B)Not less than 25 percent of the designated graduates of the school meet such criterion, and such percentage is not less than 5 percentage points above the percentage of such graduates meeting such criterion for the preceding 1-year period.

(C)In the case of schools of medicine or osteopathic medicine with student loans funds under section 292q of this title, the school involved is at or above the 75th percentile of such schools whose designated graduates meet such criterion.

(3)Determinations by Secretary

Not later than 90 days after the close of each 1-year period described in paragraph (1), the Secretary shall make a determination of whether the school involved has for such period complied with such paragraph and shall in writing inform the school of the determination. Such determination shall be made only after consideration of the report submitted to the Secretary by the school under paragraph (6).

(4)Noncompliance by school

(A)(i)Subject to subparagraph (C), each agreement under section 292q of this title with a school of medicine or osteopathic medicine shall provide that, if the school fails to comply with paragraph (1) for a 1-year period under such paragraph, the school—

(I)will pay to the Secretary the amount applicable under subparagraph (B) for the period; and

(II)will pay such amount not later than 90 days after the school is informed under paragraph (3) of the determination of the Secretary regarding such period.

(ii)Any amount that a school is required to pay under clause (i) may be paid from the student loan fund of the school under section 292q of this title.

(B)For purposes of subparagraph (A), the amount applicable for a school, subject to subparagraph (C), is—

(i)for the 1-year period ending June 30, 1997, an amount equal to 10 percent of the income received during such period by the student loan fund of the school under section 292q of this title;

(ii)for the 1-year period ending June 30, 1998, an amount equal to 20 percent of the income received during such period by the student loan fund; and

(iii)for any subsequent 1-year period under paragraph (1), an amount equal to 30 percent of the income received during such period by the student loan fund.

(C)In determining the amount of income that a student loan fund has received for purposes of subparagraph (B), the Secretary shall exclude any income derived from exempt contributions. Payments made to the Secretary under subparagraph (A) may not be made with such contributions or with income derived from such contributions.

(5)Expenditure of payments

(A)Amounts paid to the Secretary under paragraph (4) shall be expended to make Federal capital contributions to student loan funds under section 292q of this title of schools that are in compliance with paragraph (1).

(B)A Federal capital contribution under section 292q of this title may not be construed as being an exempt Federal capital contribution if the contribution is made from payments under subparagraph (A). A school contribution under such section may not be construed as being an exempt school contribution if the contribution is made pursuant to a Federal capital contribution from such payments.

(6)Reports by schools

Each agreement under section 292q of this title with a school of medicine or osteopathic medicine shall provide that the school will submit to the Secretary a report for each 1-year period under paragraph (1) that provides such information as the Secretary determines to be necessary for carrying out this subsection. Each such report shall include statistics concerning the current training or practice status of all graduates of such school whose date of graduation from the school occurred approximately 4 years before the end of the 1-year period involved.

(c)Definitions

For purposes of this section: (1)

(2)The term “exempt Federal capital contribution” means a Federal capital contribution described in subclause (I) of subsection (a)(2)(A)(ii).

(3)The term “exempt school contribution” means a school contribution described in subclause (II) of subsection (a)(2)(A)(ii).

(4)The term “income”, with respect to a student fund under section 292q of this title, means payments of principal and interest on any loan made from the fund, and any other earnings of the fund.

(5)The term “primary health care” means family medicine, general internal medicine, general pediatrics, preventive medicine, or osteopathic general practice.

(d)Sense of Congress

It is the sense of Congress that funds repaid under the loan program under this section should not be transferred to the Treasury of the United States or otherwise used for any other purpose other than to carry out this section.

Notes & Related Subsidiaries

Editorial Notes

References in Text

section 292t(f) of this title, referred to in subsec. (a)(2)(A)(ii)(I), contained provisions in par. (1) relating to appropriation of funds for Federal capital contributions to student loan funds, prior to repeal by Pub. L. 105–392, title I, § 132(b), Nov. 13, 1998, 112 Stat. 3575, eff. Oct. 1, 2002.

Prior Provisions

A prior section 723 of act July 1, 1944, was classified to section 293c of this title prior to the general revision of this subchapter by Pub. L. 102–408.

Amendments

2010—Subsec. (a)(1)(B). Pub. L. 111–148, § 5201(a)(1)(A), added subpar. (B) and struck out former subpar. (B) which read as follows: “to practice in such care through the date on which the loan is repaid in full.” Subsec. (a)(3). Pub. L. 111–148, § 5201(a)(1)(B), added par. (3) and struck out former par. (3). Prior to amendment, text read as follows: “Each agreement entered into with a student pursuant to paragraph (1) shall provide that, if the student fails to comply with such agreement, the loan involved will begin to accrue interest at a rate of 18 percent per year beginning on the date of such noncompliance.” Subsec. (d). Pub. L. 111–148, § 5201(a)(2), added subsec. (d). 1998—Subsec. (a)(3). Pub. L. 105–392, § 131(b), reenacted heading without change and amended text of par. (3) generally. Prior to amendment, text read as follows: “Each agreement entered into with a student pursuant to paragraph (1) shall provide that, if the student fails to comply with the agreement— “(A) the balance due on the loan involved will be immediately recomputed from the date of issuance at an interest rate of 12 percent per year, compounded annually; and “(B) the recomputed balance will be paid not later than the expiration of the 3-year period beginning on the date on which the student fails to comply with the agreement.” Subsec. (b)(1). Pub. L. 105–392, § 131(a), substituted “4 years before” for “3 years before”. Subsecs. (c), (d). Pub. L. 105–392, § 131(c), redesignated subsec. (d) as (c) and struck out heading and text of subsec. (c). Text read as follows: “The Secretary shall each fiscal year submit to the Committee on Energy and Commerce of the House of Representatives, and the Committee on Labor and Human Resources of the Senate, a report regarding the administration of this section, including the extent of compliance with the requirements of this section, during the preceding fiscal year.” 1993—Subsec. (a)(4). Pub. L. 103–43, § 2014(c)(1), added par. (4). Subsec. (b)(1). Pub. L. 103–43, § 2014(c)(2)(A), substituted “1997;” for “1994,” and “3 years before” for “4 years before”. Subsec. (b)(2)(B). Pub. L. 103–43, § 2014(c)(2)(B), substituted “25 percent” for “15 percent”. Subsec. (b)(4)(B). Pub. L. 103–43, § 2014(c)(2)(C), substituted “1997” for “1994” in cl. (i) and “1998” for “1995” in cl. (ii).

Statutory Notes and Related Subsidiaries

Student Loan Guidelines Pub. L. 111–148, title V, § 5201(b), Mar. 23, 2010, 124 Stat. 607, provided that: “The Secretary of Health and Human Services shall not require parental financial information for an independent student to determine financial need under section 723 of the Public Health Service Act (42 U.S.C. 292s) and the determination of need for such information shall be at the discretion of applicable school loan officer. The Secretary shall amend guidelines issued by the Health Resources and Services Administration in accordance with the preceding sentence.”

§292s Medical Schools and Primary Health Care