Title 42 › CHAPTER 6A — PUBLIC HEALTH SERVICE › SUBCHAPTER XI — HEALTH MAINTENANCE ORGANIZATIONS › § 300e–7
Approves or makes a loan only when the loan’s terms protect the United States’ money and are fair. The person in charge must decide the interest rate is reasonable compared to similar private loans and the risks the government takes. The loan must not be something the borrower could get on fair terms without the government’s help. If the government pays under a guarantee, it can try to get that money back from the borrower unless it waives that right for good cause. After a payment, the government gets the same legal rights the paid party had to collect the debt. Guarantees can be changed if needed to protect the government’s money. A guarantee cannot be attacked later except if someone used fraud or lied to get it. Loan applicants must show they can pay back principal and interest and must promise they have any extra money needed to finish the project. Loans must have appropriate security, a set maturity, repayment schedule, and an interest rate tied to comparable U.S. market rates plus administrative charges. The interest rate on later disbursements can be reset to match prevailing comparable U.S. rates. The government can waive its recovery rights for good cause, but such waivers do not affect guarantees when a loan has been sold and guaranteed. The government can sell loans it made, but it must protect the federal interest when it does. It can also guarantee a purchaser that the borrower will follow the loan terms, act as the purchaser’s agent to collect payments, or agree to repurchase the loan. Interest a purchaser gets from certain public health maintenance organization loans is taxable as gross income under chapter 1 of title 26. Money from loan sales goes into a loan fund. There is a separate loan guarantee fund in the Treasury, available without yearly limits, and Congress can appropriate money to it. If that fund lacks money to cover guarantees issued before October 1, 1986, the Secretary may issue notes that the Treasury will buy, and those notes are treated as public debt. Finally, if a borrower defaults, the Secretary may take actions needed to protect the U.S., including taking and using property pledged as security.
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The Public Health and Welfare, Source: USLM XML via OLRC
Legislative History
Reference
Citation
42 U.S.C. § 300e–7
Title 42, The Public Health and Welfare
Last Updated
Sep 22, 2026
Release point: 119-110