,,ii  #aae? ,,congress  #a/ ,session    
,s4 #aged  ,,9 ,,! ,,s5ate ,,( ,,!      
,,unit$ ,,/ates  ,augu/ #c1 #bjag,ms4   
,coll9s 7= h]self1 ,mr4 ,te/]1 ,mr4     
,co*ran1 ,mr4 ,man*91 ,mr4 ,da9es1 ,ms4 
,h>ris1 & ,mr4 ,boozman7 introduc$ !    
foll[+ bill2 :i* 0 read twice & ref]r$  
to ! ,committee on ,heal?1 ,education1  
,labor1 & ,p5sions  ,a ,,bill  ,to      
reau?orize section #cdj;,h ( ! ,public  
,heal? ,s]vice ,act to cont9ue to       
enc\rage ! expansion1 ma9t5ance1 &      
e/abli%m5t ( approv$ graduate m$ical    
resid5cy programs at qualifi$ tea*+     
heal? c5t]s1 & = o!r purposes4  #a4     
,%ort title ,?is ,act may be cit$ z !   
,tra9+ ! ,next ,g5]ation ( ,prim>y ,c>e 
,doctors ,act ( #bjag4  #b4 ,f9d+s ,!   
,congress f9ds z foll[s3  7#a7 ,!       
program ( paym5ts to tea*+ heal? c5t]s =
 graduate m$ical education "u section   
#cdj;,h ( ! ,public ,heal? ,s]vice ,act 
7#db ,u4,s4,c4 #bef;h7 0 enact$ 9 #bjaj 
to address ! crisis-level %ortage (     
prim>y c>e physicians1 especially 9     

rural & m$ically und]s]v$ communities4  
7#b7 ,tea*+ heal? c5t] resid5ts &       
faculty w provide m ?an "o million      
prim>y c>e m$ical visits 9 #bjag to     
und]s]v$ communities4  7#c7 ,:5 comp>$ )
 traditional ,m$ic>e ,,gme resid5ts1    
resid5ts :o tra9 at tea*+ heal? c5t]s   
are m likely to practice prim>y c>e &   
rema9 9 und]s]v$ or rural communities4  
7#d7 ,! tea*+ heal? c5t] program n only 
plays a vital role 9 tra9+ ! ,nation's  
next g5]ation ( prim>y c>e physicians   
7includ+ d5ti/s71 b helps bridge !      
,nation's physician %ortfall4  7#e7 ,=  
^! reasons1 x is ( vital importance to  
cont9ue ! program "u section #cdj;,h ( !
 ,public ,heal? ,s]vice ,act 7#db       
,u4,s4,c4 #bef;h7 at a su/a9able level (
 fund+ p] full-"t equival5t resid5t1 z  
recomm5d$ 9 ! fact %eet ( ! ,heal?      
,res\rces & ,s]vices ,adm9i/ration      
entitl$ ,co/ ,e/imates = ,tra9+         
,resid5ts 9 a ,tea*+ ,heal? ,c5t]4  #c4 
,reau?orization ( program ( paym5ts to  
tea*+ heal? c5t]s t op]ate graduate     

m$ical education programs  7a7 ,paym5ts 
,subsection 7a7 ( section #cdj;,h ( !   
,public ,heal? ,s]vice ,act 7#db        
,u4,s4,c4 #bef;h7 is am5d$ to read z    
foll[s3  7a7 ,paym5ts  7#a7 ,9 g5]al    
,subject to subsection 7h77#b71 !       
,secret>y %all make paym5ts "u ?is      
section = direct exp5ses & indirect     
exp5ses to qualifi$ tea*+ heal? c5t]s t 
are li/$ z sponsor+ in/itutions by !    
relevant accr$it+ body =--  7,a7        
ma9t5ance ( exi/+ approv$ graduate      
m$ical resid5cy tra9+ programs2  7,b7   
expansion ( exi/+ approv$ graduate      
m$ical resid5cy tra9+ programs2 &  7,c7 
e/abli%m5t ( new approv$ graduate m$ical
 resid5cy tra9+ programs4  7#b7 ,new    
programs  7,a7 ,paym5ts ,! ,secret>y    
%all make paym5ts "u p>agraph           
7#a77;,c7--  7i7 = fiscal ye> #bjai1 = a
 total ( up to #fj full-"t equival5t    
resid5ts at new approv$ graduate m$ical 
resid5cy programs2 &  7ii7 = fiscal ye> 
#bjbj1 = a total ( up to #abj full-"t   
equival5t resid5ts at new approv$       

graduate m$ical resid5cy programs4  7,b7
 ,priority ,subject to subp>agraph 7,c71
 9 mak+ paym5ts pursuant to p>agraph    
7#a77;,c71 ! ,secret>y %all give        
priority to qualifi$ tea*+ heal? c5t]s  
t--  7i7 s]ve a heal? pr(essional       
%ortage area ) a designation 9 effect "u
 section #ccb or a m$ically und]s]v$    
community 7z def9$ 9 section #gii;,b72  
or  7ii7 are locat$ 9 a rural area 7z   
def9$ 9 section #ahhf7;d77#b77;,d7 ( !  
,social ,security ,act74  7,c7          
,limitations ,! numb] ( full-"t         
equival5t resid5ts = :i* a qualifi$     
tea*+ heal? c5t] receives paym5ts       
pursuant to p>agraph 7#a77;,c7 = a      
fiscal ye> %all n exce$ by m ?an #f !   
numb] ( full-"t equival5t resid5ts = :i*
 ! c5t] receiv$ su* paym5ts = ! prec$+  
fiscal ye>4 ,! total numb] ( full-"t    
equival5t resid5ts at all qualifi$ tea*+
 heal? c5t]s = :i* paym5ts are made by !
 ,secret>y "u subp>agraphs 7,a7 & 7,b7 (
 subsection 7a77#a7 %all n exce$ ! total
 numb] ( full-"t equival5t resid5ts at  

all qualifi$ tea*+ heal? c5t]s = :i*    
paym5ts 7 made by ! ,secret>y z (       
,janu>y #a1 #bjag1 pursuant to ?is      
section4  4  7b7 ,fund+ ,subsection 7g7 
( ! fir/ section #cdj;,h ( ! ,public    
,heal? ,s]vice ,act 7#db ,u4,s4,c4      
#bef;h7 is am5d$ to read z foll[s3  7g7 
,fund+  7#a7 ,exi/+ programs ,out ( any 
money 9 ! ,treasury n o!rwise           
appropriat$1 !re are appropriat$ =      
paym5ts "u subp>agraphs 7,a7 & 7,b7 (   
subsection 7a77#a7 #aaf1ejj1jjj = ea* ( 
fiscal ye>s #bjah1 #bjai1 & #bjbj1 to   
rema9 available until exp5d$4  7#b7     
,inc5tive = new programs ,out ( any     
money 9 ! ,treasury n o!rwise           
appropriat$1 !re are appropriat$ =      
paym5ts "u subsection 7a77#a77;,c71     
#aj1jjj1jjj = fiscal ye> #bjai &        
#ai1jjj1jjj = fiscal ye> #bjbj1 to rema9
 available until exp5d$4  7#c7          
,adm9i/rative exp5ses ,( ! am\nt made   
available to c>ry out ?is section = any 
fiscal ye>1 ! ,secret>y may n use m ?an 
#e p]c5t ( su* am\nt = ! exp5ses (      

adm9i/]+ ?is section4  4  7c7 ,annual   
report+ ,p>agraph 7#a7 ( subsection 7h7 
( ! fir/ section #cdj;,h ( ! ,public    
,heal? ,s]vice ,act 7#db ,u4,s4,c4      
#bef;h7 is am5d$--  7#a7 by r$esignat+  
subp>agraph 7,d7 z subp>agraph 7,h72 &  
7#b7 by ins]t+ aft] subp>agraph 7,c7 !  
foll[+3  7,d7 ,! numb] ( pati5ts treat$ 
by resid5ts describ$ 9 p>agraph 7#d74   
7,e7 ,! numb] ( visits by pati5ts treat$
 by resid5ts describ$ 9 p>agraph 7#d74  
7,f7 ,( ! numb] ( resid5ts describ$ 9   
p>agraph 7#d7 :o complet$ _! resid5cy   
tra9+ at ! end ( su* resid5cy academic  
ye>1 ! numb] & p]c5tage ( su* resid5ts  
ent]+ prim>y c>e practice 7mean+ any ( !
 areas ( practice li/$ 9 ! def9ition ( a
 prim>y c>e resid5cy program 9 section  
#gdi;,a74  7,g7 ,( ! numb] ( resid5ts   
describ$ 9 p>agraph 7#d7 :o complet$ _! 
resid5cy tra9+ at ! end ( su* resid5cy  
academic ye>1 ! numb] & p]c5tage ( su*  
resid5ts :o ent]$ practice at a heal?   
c>e facility--  7i7 prim>ily s]v+ a     
heal? pr(essional %ortage area ) a      

designation 9 effect "u section #ccb or 
a m$ically und]s]v$ community 7z def9$ 9
 section #gii;,b72 or  7ii7 locat$ 9 a  
rural area 7z def9$ 9 section           
#ahhf7;d77#b77;,d7 ( ! ,social ,security
 ,act74  4  7d7 ,report on tra9+ co/s ,n
 lat] ?an ,m>* #ca1 #bjbj1 ! ,secret>y (
 ,heal? & ,human ,s]vices %all submit to
 ! ,congress a report on ! direct       
graduate exp5ses ( approv$ graduate     
m$ical resid5cy tra9+ programs1 & !     
indirect exp5ses associat$ ) !          
additional co/s ( tea*+ resid5ts1 (     
qualifi$ tea*+ heal? c5t]s 7z su* t]ms  
are us$ or def9$ 9 section #cdj;,h ( !  
,public ,heal? ,s]vice ,act 7#db        
,u4,s4,c4 #bef;h774  7e7 ,def9ition     
,subsection 7j7 ( ! fir/ section #cdj;,h
 ( ! ,public ,heal? ,s]vice ,act 7#db   
,u4,s4,c4 #bef;h7 is am5d$--  7#a7 by   
r$esignat+ p>agraphs 7#b7 & 7#c7 z      
p>agraphs 7#c7 & 7#d71 respectively2 &  
7#b7 by ins]t+ aft] p>agraph 7#a7 !     
foll[+3  7#b7 ,new approv$ graduate     
m$ical resid5cy tra9+ program ,! t]m new

 approv$ graduate m$ical resid5cy tra9+ 
program means an approv$ graduate m$ical
 resid5cy tra9+ program = :i* ! sponsor+
 qualifi$ tea*+ heal? c5t] has n receiv$
 a paym5t "u ?is section = a previ\s    
fiscal ye> 7o!r ?an pursuant to         
subsection 7a77#a77;,c774  4  7f7       
,te*nical corrections ,"p ,d ( title    
,,iii ( ! ,public ,heal? ,s]vice ,act   
7#db ,u4,s4,c4 #bed;b et seq47 is       
am5d$-- 7#a7 9 subsection 7f7 ( ! fir/  
section #cdj;,h 7#db ,u4,s4,c4 #bef;h71 
by /rik+ hospital ea* place x appe>s &  
ins]t+ tea*+ heal? c5t]2  7#b7 by       
r$esignat+ ! second subp>t ,,xi 7relat+ 
to a community-bas$ collaborative c>e   
network program7 z subp>t ,,xii2 &  7#c7
 by r$esignat+ ! second section #cdj;,h 
7#db ,u4,s4,c4 #bef;i7 z section        
#cdj;,i4  7g7 ,paym5ts = previ\s fiscal 
ye>s ,! provisions ( ! fir/ section     
#cdj;,h ( ! ,public ,heal? ,s]vice ,act 
7#db ,u4,s4,c4 #bef;h71 z 9 effect on ! 
day be=e ! date ( enactm5t ( ?is ,act1  
%all cont9ue to apply ) respect to      

paym5ts "u su* section = fiscal ye>s    
be=e fiscal ye> #bjah4