,,ii #aah? ,,congress #a/ ,session ,s4 #bhdj ,,9 ,,! ,,s5ate ,,( ,,! ,,unit$ ,,/ates ,septemb] #ai1 #bjbc,mr4 ,s&]s 7= himself & ,mr4 ,m>%all7 introduc$ ! foll[+ bill2 :i* 0 read twice & ref]r$ to ! ,committee on ,heal?1 ,education1 ,labor1 & ,p5sions ,a ,,bill ,to improve access to & ! quality ( prim>y heal? c>e1 exp& ! heal? work=ce1 & = o!r purposes4 #a4 ,%ort title2 table ( cont5ts 7a7 ,%ort title ,?is ,act may be cit$ z ! ,bip>tisan ,prim>y ,c>e & ,heal? ,work=ce ,act4 7b7 ,table ( cont5ts ,! table ( cont5ts = ?is ,act is z foll[s3 ,sec4 #a4 ,%ort title2 table ( cont5ts4,,title ,i--,ext5sion = community heal? c5t]s1 ! ,national ,heal? ,s]vice ,corps1 & tea*+ heal? c5t]s t op]ate ,,gme programs ,sec4 #aja4 ,programs ( paym5ts to tea*+ heal? c5t]s t op]ate graduate m$ical education programs4,sec4 #ajb4 ,community heal? c5t]s4,sec4 #ajc4 ,national ,heal? ,s]vice ,corps4,sec4 #ajd4 ,,gao report4,sec4 #aje4 ,,oig report4,sec4 #ajf4 ,application ( provisions4,,title ,,ii--,support+ ! heal? c>e workforce,sec4 #bja4 ,rural resid5cy plann+ & developm5t program4,sec4 #bjb4 ,prim>y c>e tra9+ & enhancem5t program4,sec4 #bjc4 ,teleheal? te*nology-enabl$ le>n+ program4,sec4 #bjd4 ,exp&+ ! numb] ( prim>y c>e doctors4,sec4 #bje4 ,nurse education1 practice1 quality1 & ret5tion grants4,sec4 #bjf4 ,nurse faculty loan program4,sec4 #bjg4 ,nurse faculty demon/ration program4,sec4 #bjh4 ,nurse corps s*ol>%ip & loan repaym5t program4,sec4 #bji4 ,grants = prim>y c>e nurse resid5cy tra9+ programs4,sec4 #baj4 ,/ate oral heal? work=ce improvem5t grant program4,sec4 #baa4 ,oral heal? tra9+ programs4,sec4 #bab4 ,alli$ heal? pr(essionals4,sec4 #bac4 ,budget>y treatm5t4,,title ,,iii--,r$uc+ heal? c>e co/s = patients,sec4 #cja4 ,bann+ anticompetitive t]ms 9 facility & insurance contracts t limit access to high] quality1 l[] co/ c>e4,sec4 #cjb4 ,hone/ bill+ requirem5ts applicable to provid]s4,sec4 #cjc4 ,bann+ facility fees = c]ta9 s]vices4,sec4 #cjd4 ,prev5tion & ,public ,heal? ,fund4 ,i ,ext5sion = community heal? c5t]s1 ! ,national ,heal? ,s]vice ,corps1 & tea*+ heal? c5t]s t op]ate ,,gme programs #aja4 ,programs ( paym5ts to tea*+ heal? c5t]s t op]ate graduate m$ical education programs 7a7 ,fund+ ,section #cdj;,h7g77#a7 ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #bef;h7g77#a77 is am5d$-- 7#a7 by /rik+ su* sums z may be necess>y1 n to exce$2 7#b7 by /rik+ #bjag1 & & ins]t+ #bjag12 & 7#c7 by ins]t+ & #cjj1jjj1jjj = ea* ( fiscal ye>s #bjbd ?r\gh #bjbh1 aft] #bjbc14 7b7 ,p] resid5t am\nt ,section #cdj;,h7a77#b7 ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #bef;h7a77#b77 is am5d$ by add+ at ! end ! foll[+3 ,beg9n+ 9 fiscal ye> #bjbd1 9 accordance ) p>agraph 7#a71 b not)/&+ ! capp$ am\nt ref]5c$ 9 subsections 7b77#b7 & 7d77#b71 ! qualifi$ tea*+ heal? c5t] p] resid5t am\nt = a fiscal ye> %all be n less ?an su* am\nt = ! previ\s fiscal ye>44 7c7 ,am\nt ( paym5ts ,section #cdj;,h ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #bef;h7 is am5d$-- 7#a7 9 subsection 7b77#b7-- 7,a7 9 subp>agraph 7,a71 by /rik+ am\nt ( funds appropriat$ "u subsection 7g7 = su* paym5ts = t fiscal ye> & ins]t+ total am\nt ( funds available "u subsection 7g7 & any am\nts rec\p$ "u subsection 7f72 & 7,b7 9 subp>agraph 7,b71 by /rik+ appropriat$ 9 a fiscal ye> "u subsection 7g7 & ins]t+ available "u subsection 7g7 & any am\nts rec\p$ "u subsection 7f72 & 7#b7 9 subsection 7d77#b77;,b71 by /rik+ am\nt appropriat$ = su* exp5ses z det]m9$ 9 subsection 7g7 & ins]t+ total am\nt ( funds available "u subsection 7g7 & any am\nts rec\p$ "u subsection 7f74 7d7 ,priority paym5ts ,section #cdj;,h7a77#c7 ( ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #bef;h7a77#c77 is am5d$-- 7#a7 9 subp>agraph 7,a71 by /rik+ 2 or & ins]t+ a semicolon2 7#b7 9 subp>agraph 7,b71 by /rik+ ! p]iod & ins]t+ 2 or2 & 7#c7 by add+ at ! end ! foll[+3 7,c7 are locat$ 9 a ,/ate t does n already h a qualifi$ tea*+ heal? c5t] receiv+ fund+ "u ?is section4 4 7e7 ,report+ requirem5ts ,section #cdj;,h7h77#a7 ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #bef;h7h77#a77 is am5d$-- 7#a7 by r$esignat+ subp>agraph 7,h7 z subp>agraph 7,i72 & 7#b7 by ins]t+ aft] subp>agraph 7,g7 ! foll[+3 7,h7 ,( ! numb] ( resid5ts describ$ 9 p>agraph 7#d7 :o complet$ _! resid5cy tra9+1 ! numb] practic+ prim>y c>e 7mean+ any ( ! areas ( practice li/$ 9 ! def9ition ( a prim>y c>e resid5cy program 9 section #gdi;,a7 #e ye>s foll[+ completion ( su* tra9+4 4 7f7 ,guidance ,! ,secret>y %all update guidance & relevant in=mation reg>d+ ,/ates describ$ 9 subp>agraph 7,c7 ( section #cdj;,h7a77#c7 ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #bef;h7a77#c771 z am5d$ by subsection 7d71 & make available model templates to assi/ heal? c5t]s 9 su* ,/ates to e/abli% a tea*+ heal? c5t]4 #ajb4 ,community heal? c5t]s 7a7 ,community heal? c5t] fund ,section #ajejc ( ! ,pati5t ,protection & ,af=dable ,c>e ,act 7#db ,u4,s4,c4 #bed;b-#b7 is am5d$-- 7#a7 9 subsection 7b77#a77;,f7-- 7,a7 by /rik+ #bjah & & ins]t+ #bjah12 & 7,b7 by ins]t+ be=e ! semicolon ! foll[+3 1 & #e1hjj1jjj1jjj = ea* ( fiscal ye>s #bjbd ?r\gh #bjbf2 & 7#b7 by add+ at ! end ! foll[+3 7f7 ,priority use ( funds ,= fiscal ye>s #bjbd ?r\gh #bjbf1 ) respect to #a1hjj1jjj1jjj ( ! am\nt appropriat$ "u subsection 7b77#a77;,f71 ! ,secret>y %all prioritize aw>ds to entities = purposes (-- 7#a7 increas+ ! numb] ( l[-income pati5ts n enroll$ 9 a gr\p heal? plan or gr\p or individual heal? insurance cov]age :o are s]v$ by heal? c5t]s1 includ+ ?r\gh ,heal? ,c5t] ,program ,new ,access ,po9ts describ$ 9 section #ccj7;e77#f7 ( ! ,public ,heal? ,s]vice ,act1 includ+ s*ool-bas$ s]vice sites2 7#b7 increas+ ! requir$ prim>y heal? s]vices describ$ 9 p>agraph 7#a77;,a77i7 ( section #ccj7;b7 ( ! ,public ,heal? ,s]vice ,act & additional heal? s]vices 7z def9$ 9 p>agraph 7#b7 ( su* section7 (f]$ by heal? c5t]s2 & 7#c7 increas+ pati5t case managem5t1 enabl+ s]vices1 & education s]vices1 z describ$ 9 clauses 7iii7 ?r\gh 7v7 ( section #ccj7;b77#a77;,a7 ( ! ,public ,heal? ,s]vice ,act4 4 7b7 ,au?orization ( appropriations ,section #ccj7r77#a7 ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #bed;b7r77#a77 is am5d$-- 7#a7 9 subp>agraph 7,g71 by /rik+ fiscal ye> #bjaf1 & ea* subsequ5t fiscal ye> & ins]t+ ea* ( fiscal ye>s #bjaf ?r\gh #bjbc2 & 7#b7 by add+ at ! end ! foll[+3 7,h7 ,= ea* ( fiscal ye>s #bjbd ?r\gh #bjbf1 #b1bjj1jjj1jjj4 7,i7 ,= fiscal ye> #bjbg1 & ea* subsequ5t fiscal ye>1 ! am\nt appropriat$ = ! prec$+ fiscal ye> adju/$ by ! product (-- 7i7 "o plus ! av]age p]c5tage increase 9 co/s incurr$ p] pati5t s]v$2 & 7ii7 "o plus ! av]age p]c5tage increase 9 ! total numb] ( pati5ts s]v$4 4 7c7 ,allocation ( funds ,section #ajejc ( ! ,pati5t ,protection & ,af=dable ,c>e ,act 7#db ,u4,s4,c4 #bed;b-#b71 z am5d$ by subsection 7a71 is fur!r am5d$ by add+ at ! end ! foll[+3 7g7 ,allocation ( funds ,= ea* ( fiscal ye>s #bjbd ?r\gh #bjbf1 ( ! am\nts appropriat$ "u subsection 7b77#a77;,f7 = a fiscal ye>1 ! ,secret>y %all use-- 7#a7 at lea/ #bde1jjj1jjj = aw>ds to support heal? c5t]s 9 ea* ,/ate t are receiv+ aw>ds "u section #ccj ( ! ,public ,heal? ,s]vice ,act 9 ext5d+ op]at+ h\rs1 9 an am\nt det]m9$ pursuant to a =mula & eligibility crit]ia develop$ by ! ,secret>y1 = ! purposes ( increas+ access to s]vices2 7#b7 at lea/ #ee1jjj1jjj = aw>ds "u ?is section = heal? c5t]s to exp& s*ool-bas$ s]vices & e/abli% new s*ool-bas$ s]vice sites2 & 7#c7 su* sums z may be necess>y = purposes ( increas+ ! am\nt aw>d$ pursuant to grants or coop]ative agreem5ts "u section #ccj ( ! ,public ,heal? ,s]vice ,act s t ea* recipi5t ( su* an aw>d receives-- 7,a7 = fiscal ye> #bjbd1 at lea/ #ae p]c5t m ?an su* recipi5t receiv$ = fiscal ye> #bjbc2 & 7,b7 = ea* ( fiscal ye>s #bjbe & #bjbf1 ! am\nt receiv$ 9 ! previ\s ye> adju/$ by-- 7i7 ! p]c5t increase 9 ! m$ical compon5t ( ! consum] price index = ! mo/ rec5t #ab-mon? p]iod = :i* applicable data is available2 plus 7ii7 "o p]c5t4 4 7d7 ,capital fund+ ,section #ajejc7;c7 ( ! ,pati5t ,protection & ,af=dable ,c>e ,act 7#db ,u4,s4,c4 #bed;b-#b7;c77 is am5d$-- 7#a7 9 ! subsection head+1 by ins]t+ 1 ,capital fund+ aft] ,con/ruction2 7#b7 by /rik+ ,!re is & ins]t+ ! foll[+3 7#a7 ,con/ruction ,!re is 2 & 7#c7 by add+ at ! end ! foll[+3 7#b7 ,capital fund+ ,= ! alt]ation1 r5ovation1 con/ruction1 equipm5t1 & o!r capital co/s ( heal? c5t]s t receive fund+ "u section #ccj ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #bed;b71 9 addition to am\nts o!rwise made available = su* purpose1 !re is appropriat$ to ! ,secret>y ( ,heal? & ,human ,s]vices1 out ( am\nts 9 ! ,treasury n o!rwise appropriat$1 #c1jjj1jjj1jjj = fiscal ye> #bjbd1 to rema9 available until ,septemb] #cj1 #bjbf4 ,9 aw>d+ am\nts appropriat$ "u ?is p>agraph1 ! ,secret>y %all prioritize aw>ds relat$ to increas+ access to d5tal & behavioral heal? s]vices4 4 7e7 ,/rategic plan ,to improve heal? outcomes ?r\gh nutrition 7#a7 ,9 g5]al ,n lat] ?an "o ye> aft] ! date ( enactm5t ( ?is ,act1 ! ,secret>y ( ,heal? & ,human ,s]vices1 9 consultation ) ! ,secret>y ( ,agriculture1 %all submit to ! ,committee on ,heal?1 ,education1 ,labor1 & ,p5sions ( ! ,s5ate & ! ,committee on ,en]gy & ,comm]ce ( ! ,h\se ( ,repres5tatives a #e-ye> /rategic plan to improve heal? outcomes ?r\gh nutrition = l[-income or un9sur$ pati5t populations ) sev]e1 complex *ronic conditions & "o or m diet-relat$ conditions4 7#b7 ,report ,9 c>ry+ out p>agraph 7#a71 ! ,secret>y ( ,heal? & ,human ,s]vices %all-- 7,a7 conduct an evaluation ( previ\s & curr5t f$]ally-fund$ ef=ts ( ! ,dep>tm5t ( ,heal? & ,human ,s]vices to improve pati5t outcomes ?r\gh nutrition int]v5tions1 su* z m$ically tailor$ meals & nutrition c\nsel+2 & 7,b7 include 9 ! /rategic report recomm5dations =-- 7i7 r$uc+ ! f9ancial impact ( obesity & prev5table *ronic conditions result+ f obesity2 7ii7 emp[]+ f$]ally-fund$ community heal? c5t]s1 rural heal? cl9ics1 & o!r relevant f$]ally-fund$ facilities to provide produce prescriptions1 m$ically tailor$ groc]ies1 & m$ically tailor$ meals2 7iii7 promot+ long-t]m adoption ( improv$ nutrition habits1 includ+ ?r\gh increas$ cul9>y education & consum] nutrition align$ ) ! mo/ rec5t ,diet>y ,guidel9es = ,am]icans publi%$ "u section #cja ( ! ,national ,nutrition ,monitor+ & ,relat$ ,rese>* ,act ( #aiij 7#g ,u4,s4,c4 #ecda7 & incorporat+ behavioral model+ or o!r novel me?ods across ,f$]al programs2 7iv7 develop+ p]=mance & quality metrics relat$ to ! deliv]y ( produce prescriptions1 m$ically tailor$ groc]ies1 & m$ically tailor$ meals across relevant ,f$]al pay]s to aid 9 reimbursem5t /rategies2 7v7 develop+ paym5t models = novel obesity c>e !rapies = ! treatm5t ( diabetes t include behavioral & nutritional & diet>y s]vices & education2 7vi7 improv+ coord9ation ( c>e & integrat+ nutrition s]vices & res\rces )9 f$]ally-fund$ community heal? c5t]s1 rural heal? cl9ics1 & o!r f$]ally-fund$ prim>y c>e facilities2 7vii7 bol/]+ p>tn]%ips ) ,/ate & local gov]nm5ts & nongov]nm5tal organizations2 & 7viii7 address+ geographic disp>ities 9 access to nutrition s]vices & res\rces4 7f7 ,requir$ prim>y heal? s]vices 7#a7 ,9 g5]al ,section #ccj ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #bed;b7 is am5d$-- 7,a7 9 subsection 7b77#a77;,a7-- 7i7 9 clause 7i7-- 7,i7 9 subclause 7,,iv71 by /rik+ 2 & & ins]t+ a semicolon2 7,,ii7 9 subclause 7,v71 by add+ & aft] ! semicolon2 & 7,,iii7 by add+ at ! end ! foll[+3 7,,vi7 appropriate nutritional & diet>y s]vices2 2 7ii7 9 clause 7ii71 by ins]t+ & nutrition s]vices aft] m5tal heal? s]vices2 & 7iii7 9 clause 7iii71 by ins]t+ nutritional1 aft] educational12 & 7,b7 9 subsection 7d77#a77;,a71 by ins]t+ or "o or m diet-relat$ conditions be=e ! semicolon4 7#b7 ,implem5tation ( new requir$ prim>y heal? s]vice ,p>agraph 7#d7 ( section #ccj7;e7 ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #bed;b7e77 is am5d$ to read z foll[s3 7#d7 ,limitation ,n m ?an #b grants may be made "u p>agraph 7#a77;,b7 = ! same entity1 except t su* limitation %all n apply = ! p]iod ( #b ye>s beg9n+ on ! date ( enactm5t ( ! ,bip>tisan ,prim>y ,c>e & ,heal? ,work=ce ,act1 9 any case :]e ! only basis ^u :i* p>agraph 7#a77;,b7 applies to a heal? c5t] is t ! heal? c5t] is n 9 noncompliance ) ! requirem5ts "u subsection 7b77#a77;,a77i77,,vi7 to provide appropriate nutritional & diet>y s]vices4 4 7g7 ,increase ! use ( provid] tools ,to improve heal? outcomes ,n lat] ?an "o ye> aft] ! date ( enactm5t ( ?is ,act1 ! ,secret>y ( ,heal? & ,human ,s]vices1 9 consultation ) ! ,secret>y ( ,agriculture1 %all submit to ,congress a report t includes-- 7#a7 recomm5dations = ,/ates to support ! coord9ation ( f$]ally-fund$ nutrition programs & s]vices provid$ by heal? c>e pr(essionals 9 community heal? c5t]s2 & 7#b7 data on ! numb] ( individuals enroll$ 9 f$]ally-subsidiz$ heal? insurance cov]age :o are also enroll$ 9 or eligible = f$]ally-subsidiz$ nutrition & food programs4 #ajc4 ,national ,heal? ,s]vice ,corps ,section #ajejc7;b77#b7 ( ! ,pati5t ,protection & ,af=dable ,c>e ,act 7#db ,u4,s4,c4 #bed;b-#b7;b77#b77 is am5d$-- 7#a7 9 subp>agraph 7,g71 by /rik+ 2 & & ins]t+ a semicolon2 7#b7 9 subp>agraph 7,h71 by /rik+ ! p]iod & ins]t+ 2 &2 & 7#c7 by add+ at ! end ! foll[+3 7,i7 #iej1jjj1jjj = ea* ( fiscal ye>s #bjbd ?r\gh #bjbf4 4 #ajd4 ,,gao report 7a7 ,9 g5]al ,n lat] ?an "o ye> aft] ! date ( enactm5t ( ?is ,act1 ! ,comptroll] ,g5]al ( ! ,unit$ ,/ates %all submit to ! ,committee on ,heal?1 ,education1 ,labor1 & ,p5sions ( ! ,s5ate & ! ,committee on ,en]gy & ,comm]ce ( ! ,h\se ( ,repres5tatives a report assess+ ! effectiv5ess ( ! ,national ,heal? ,s]vice ,corps 7ref]r$ to 9 ?is section z ! ,,nhsc7 at attract+ heal? c>e pr(essionals to heal? pr(essional %ortage areas designat$ "u section #ccb ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #bed;e7 7ref]r$ to 9 ?is section z ,h,p,s,as71 su* z by-- 7#a7 assess+ ! metrics us$ by ! ,heal? ,res\rces & ,s]vices ,adm9i/ration 9 evaluat+ ! program2 7#b7 comp>+ ! ret5tion rates ( ,,nhsc p>ticipants 9 ! ,h,p,s,as :]e !y complet$ _! p]iod ( obligat$ s]vice to ! ret5tion rate ( non-,,nhsc p>ticipants 9 ! correspond+ ,h,p,s,as2 7#c7 comp>+ ! ret5tion rates ( ,,nhsc p>ticipants 9 ! ,h,p,s,as :]e !y complet$ _! p]iod ( obligat$ s]vice to ! ret5tion rates ( ,,nhsc p>ticipants 9 ,h,p,s,as o!r ?an ^? :]e !y complet$ _! p]iod ( obligat$ s]vice2 7#d7 id5tify+ factors t influ5ce a ,,nhsc p>ticipant's decision to practice 9 a ,,hpsa o!r ?an ! ,,hpsa :]e !y complet$ _! p]iod ( obligat$ s]vice2 7#e7 id5tify+ factors o!r ?an p>ticipation 9 ! ,national ,heal? ,s]vice ,corps ,s*ol>%ip & ,loan ,repaym5t ,programs t attract heal? c>e pr(essionals to a ,,hpsa2 7#f7 assess+ ! impact ! ,,nhsc has on wages = heal? c>e pr(essionals 9 a ,,hpsa2 & 7#g7 comp>+ ! di/ribution ( ,,nhsc p>ticipants across ,h,p,s,as1 includ+ a comp>ison ( rural v]sus non-rural ,h,p,s,as4 7b7 ,def9ition ,9 ?is section1 ! t]m ,,nhsc p>ticipant means a ,national ,heal? ,s]vice ,corps memb] p>ticipat+ 9 ! ,national ,heal? ,s]vice ,corps ,s*ol>%ip or ,loan ,repaym5t ,program "u subp>t ,,iii ( "p ,d ( title ,,iii ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #bedl et seq474 #aje4 ,,oig report ,n lat] ?an #b ye>s aft] ! date ( enactm5t ( ?is ,act1 ! ,inspector ,g5]al ( ! ,dep>tm5t ( ,heal? & ,human ,s]vices %all submit to ,congress a report on integrity ef=ts ( ! ,heal? ,res\rces & ,s]vices ,adm9i/ration ) respect to programs c>ri$ out by ! ,heal? ,res\rces & ,s]vices ,adm9i/ration4 ,su* report %all include an assessm5t (-- 7#a7 ! ways 9 :i* ! ,adm9i/rator ( ! ,heal? ,res\rces & ,s]vices ,adm9i/ration 7ref]r$ to 9 ?is section z ! ,adm9i/rator7 det]m9es reasonable ef=ts are cont9u\sly made to e/abli% & ma9ta9 collaborative relation%ips ) heal? c>e provid]s2 7#b7 ! ways 9 :i* ! ,adm9i/rator ensures quality & cont9uity ( c>e = und]s]v$ areas2 & 7#c7 ! ext5t to :i* ! ,adm9i/rator validates ! f9ancial responsibility ( & use ( grant fund+ by community heal? c5t]s4 #ajf4 ,application ( provisions 7a7 ,9 g5]al ,am\nts appropriat$ pursuant to ! am5dm5ts made by ?is title %all be subject to ! requirem5ts conta9$ 9 ,public ,law #aag-cbh = funds = programs au?oriz$ "u sections #ccj ?r\gh #cdj ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #bed;b ?r\gh #bef74 7b7 ,con=m+ am5dm5t ,p>agraph 7#d7 ( section #cjad7;h7 ( title #ah1 ,unit$ ,/ates ,code1 & section #cja7;d7 ( division ,,bb ( ! ,consolidat$ ,appropriations ,act1 #bjba4 & ins]t+ section #cja7;d7 ( division ,,bb ( ! ,consolidat$ ,appropriations ,act1 #bjba1 & section #ajf7;a7 ( ! ,bip>tisan ,prim>y ,c>e & ,heal? ,work=ce ,act4 ,,ii ,support+ ! heal? c>e work=ce #bja4 ,rural resid5cy plann+ & developm5t program ,title ,,iii ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #bda et seq47 is am5d$ by ins]t+ aft] section #ccj;,a-#b ! foll[+3 #ccj;,a-#c4 ,rural resid5cy plann+ & developm5t program & rural resid5cy plann+ & developm5t te*nical assi/ance program 7a7 ,def9ition ( rural resid5cy program ,9 ?is section1 ! t]m rural resid5cy program means a physician resid5cy program1 includ+ a rural track program1 accr$it$ by ! ,accr$itation ,c\ncil = ,graduate ,m$ical ,education 7or a simil> body7 t-- 7#a7 tra9s resid5ts 9 rural areas 7z def9$ by ! ,secret>y7 = m ?an #ej p]c5t ( ! total "t ( _! resid5cy2 & 7#b7 prim>ily focuses on produc+ physicians :o w practice 9 rural areas1 z def9$ by ! ,secret>y4 7b7 ,rural resid5cy plann+ & developm5t program 7#a7 ,def9ition ( eligible entity ,9 ?is subsection1 ! t]m eligible entity-- 7,a7 means-- 7i7 a dome/ic public or private nonpr(it or =-pr(it entity2 7ii7 an ,indian ,tribe1 ,tribal heal? program1 ,tribal organization1 or ,urban ,indian organization 7z su* t]ms are def9$ 9 section #d ( ! ,indian ,heal? ,c>e ,improvem5t ,act72 or 7iii7 a ,native ,hawaiian ,heal? organization z def9$ 9 section #ab ( ! ,native ,hawaiian ,heal? ,c>e ,improvem5t2 & 7,b7 may include fai?-bas$ or community-bas$ organizations1 rural hospitals1 rural community-bas$ ambulatory pati5t c>e c5t]s 7includ+ rural heal? cl9ics71 heal? c5t]s op]at$ by a ,native ,hawaiian ,heal? organization 7def9$ z describ$ 9 subp>agraph 7,a77iii771 an ,indian ,tribe1 a ,tribal heal? program1 a ,tribal organization1 or an ,urban ,indian organization 7def9$ z describ$ 9 subp>agraph 7,a77ii771 graduate m$ical education consortiums 7includ+ in/itutions ( high] education1 su* z s*ools ( allopa?ic m$ic9e1 s*ools ( o/eopa?ic m$ic9e1 or hi/orically ,black colleges or univ]sities 7z def9$ by ! t]m "p ,b in/itution 9 section #cbb ( ! ,high] ,education ,act ( #aife or describ$ 9 section #cbf7;e77#a7 ( ! ,high] ,education ,act ( #aife7 or o!r m9ority-s]v+ in/itutions 7z describ$ 9 section #cga7;a7 ( ! ,high] ,education ,act ( #aife71 or o!r organizations z det]m9$ appropriate by ! ,secret>y4 7#b7 ,grants 7,a7 ,9 g5]al ,! ,secret>y may aw>d grants to eligible entities to create new rural resid5cy programs 7includ+ add+ new rural tra9+ sites to exi/+ rural track programs74 7,b7 ,fund+ ,grants aw>d$ "u ?is subsection may be fully fund$ at ! "t ( ! aw>d4 7,c7 ,t]m ,! t]m ( a grant "u ?is subsection %all be #d ye>s & may be ext5d$ at ! discretion ( ! ,secret>y4 7#c7 ,applications 7,a7 ,9 g5]al ,to be eligible to receive a grant "u ?is subsection1 an eligible entity %all prep>e & submit to ! ,secret>y an application at su* "t1 9 su* mann]1 & conta9+ su* in=mation z ! ,secret>y may require1 includ+ a description ( ! pa?way ( ! rural resid5cy program z describ$ 9 subp>agraph 7,b74 7,b7 ,pa?way ,a pa?way ( a rural resid5cy program support$ "u ?is subsection %all be =-- 7i7 g5]al prim>y c>e & high-ne$ specialty c>e1 includ+ family m$ic9e1 int]nal m$ic9e1 prev5tive m$ic9e1 psy*iatry1 or g5]al surg]y2 7ii7 mat]nal heal? & ob/etrics1 :i* may be ob/etrics & gynecology or family m$ic9e ) enhanc$ ob/etrical tra9+2 or 7iii7 any o!r pa?way z det]m9$ appropriate by ! ,secret>y4 7c7 ,rural resid5cy plann+ & developm5t te*nical assi/ance 7#a7 ,def9ition ( eligible entity ,9 ?is subsection1 ! t]m eligible entity means-- 7,a7 a dome/ic public or private nonpr(it or =-pr(it entity2 or 7,b7 an ,indian ,tribe or ,tribal organization 7z su* t]ms are def9$ 9 section #d ( ! ,indian ,heal? ,c>e ,improvem5t ,act74 7#b7 ,grants 7,a7 ,9 g5]al ,! ,secret>y may aw>d grants to eligible entities to provide te*nical assi/ance to aw>dees ( & pot5tial applicants ( ! program describ$ 9 subsection 7b74 7,b7 ,fund+ ,grants aw>d$ "u ?is subsection may be fully fund$ at ! "t ( ! aw>d4 7,c7 ,t]m ,! t]m ( a grant "u ?is subsection %all be #d ye>s & may be ext5d$ at ! discretion ( ! ,secret>y4 7#c7 ,applications ,to be eligible to receive a grant "u ?is subsection1 an eligible entity %all prep>e & submit to ! ,secret>y an application at su* "t1 9 su* mann]1 & conta9+ su* in=mation z ! ,secret>y may require4 7d7 ,au?orization ( appropriations ,!re is au?oriz$ to be appropriat$ to c>ry out ?is section #ac1jjj1jjj = fiscal ye> #bjbd1 #ac1ejj1jj = fiscal ye> #bjbe1 & #ad1jjj1jjj = fiscal ye> #bjbf1 to rema9 available until exp5d$4 4 #bjb4 ,prim>y c>e tra9+ & enhancem5t program ,section #gdg7;c77#a7 ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #bick7c77#a77 is am5d$-- 7#a7 by /rik+ #dh1ibd1jjj = ea* ( fiscal ye>s #bjba ?r\gh #bjbe & ins]t+ #di1bej1jjj = fiscal ye> #bjbd1 #di1ejj1jjj = fiscal ye> #bjbe1 & #ej1jjj1jjj = fiscal ye> #bjbf2 & 7#b7 by /rik+ subsection 7b77#a77;,b7 & ins]t+ subsections 7b77#a77;,b7 & 7c74 #bjc4 ,teleheal? te*nology-enabl$ le>n+ program ,section #ccj,n7k7 ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #bed;c-#bj7k77 is am5d$ by /rik+ #bjbf & ins]t+ #bjbe1 & #aa1jjj1jjj = ea* ( fiscal ye>s #bjbf ?r\gh #bjbh1 to rema9 available until exp5d$4 #bjd4 ,exp&+ ! numb] ( prim>y c>e doctors ,section #gdg ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #bick71 z am5d$ by section #bjb1 is fur!r am5d$-- 7#a7 by r$esignat+ subsection 7c7 z subsection 7d72 & 7#b7 by ins]t+ aft] subsection 7b7 ! foll[+3 7c7 ,exp&+ ! numb] ( prim>y c>e doctors 7#a7 ,9 g5]al ,! ,secret>y %all aw>d grants to eligible m$ical s*ools describ$ 9 p>agraph 7#b7 = ! purpose ( graduat+ m physicians :o w practice a prim>y c>e discipl9e4 ,funds aw>d$ "u ?is subsection may be us$ = co/s associat$ ) faculty1 con/ruction & capital improvem5ts1 cl9ical support1 rese>* support1 /ud5t supports1 & any o!r co/s1 z det]m9$ by ! ,secret>y4 7#b7 ,eligibility ,to be eligible to receive a grant "u ?is subsection1 a m$ical s*ool %all-- 7,a7 be a nonpr(it s*ool ( m$ic9e or o/eopa?ic m$ic9e t is accr$it$ by a nationally recogniz$ accr$it+ ag5cy or association2 & 7,b7 demon/rate 9 ! grant application ( ! m$ical s*ool-- 7i7 t n less ?an #cc p]c5t ( graduates f ! m$ical s*ool ent] prim>y c>e & are1 z ( ! date ( ! application1 practic+ prim>y c>e1 z calculat$ by divid+-- 7,i7 ! numb] ( physicians :o graduat$ dur+ su* "t p]iod z is specifi$ by ! ,secret>y :o are practic+ prim>y c>e2 by 7,,ii7 ! total numb] ( physicians :o graduat$ dur+ su* "t p]iod2 & 7ii7 a plan to exp& ! numb] ( graduates ( ! m$ical s*ool :o are practic+ prim>y c>e2 & 7iii7 a commitm5t to use grant funds to supplem5t1 n supplant1 su* s*ool's inve/m5t 9 prim>y c>e m$ical education4 7#c7 ,exp&+ ! numb] ( m9ority prim>y c>e doctors ,( ! am\nts appropriat$ "u p>agraph 7#f77;,c71 ! ,secret>y %all aw>ds n less ?an #bj p]c5t to eligible m$ical s*ools describ$ 9 p>agraph 7#b7 t are hi/orically ,black colleges & univ]sities 7z def9$ by ! t]m "p ,b in/itution 9 section #cbb ( ! ,high] ,education ,act ( #aife 7#bj ,u4,s4,c4 #ajfa7 or describ$ 9 section #cbf7;e77#a7 ( su* ,act 7#bj ,u4,s4,c4 #ajfc;b7e77#a777 or o!r m9ority-s]v+ in/itutions 7z describ$ 9 section #cga7;a7 ( ! ,high] ,education ,act ( #aife 7#bj ,u4,s4,c4 #ajfgq7a7774 7#d7 ,grant am\nts2 geographic di/ribution 7,a7 ,grant am\nts ,! ,secret>y %all det]m9e ! am\nt ( ea* grant aw>d$ "u ?is subsection1 :i* %all be bas$ on ! scope ( ! plan submitt$ by ! m$ical s*ool "u p>agraph 7#b77;,b77ii71 & o!r appropriate factors4 7,b7 ,geographic di/ribution ,9 aw>d+ grants "u ?is subsection1 ! ,secret>y %all ensure1 to ! greate/ ext5t practicable1 t su* grants are equitably di/ribut$ among ! geographic regions ( ! ,unit$ ,/ates4 7#e7 ,prim>y c>e ,9 ?is subsection1 ! t]m prim>y c>e means heal? c>e s]vices relat$ to family m$ic9e1 int]nal m$ic9e1 p$iatrics1 ob/etrics1 gynecology1 g]iatrics1 or psy*iatry4 7#f7 ,acc\nt to ,address ! ,prim>y ,c>e ,physician ,%ortage 7,a7 ,e/abli%m5t ( acc\nt ,!re is e/abli%$ 9 ! ,treasury an acc\nt1 to be kn[n z ! ,acc\nt to ,address ! ,prim>y ,c>e ,physician ,%ortage 7ref]r$ to 9 ?is subsection z ! ,acc\nt71 = purposes ( c>ry+ out ?is subsection4 7,b7 ,transf] ( direct sp5d+ 7i7 ,9 g5]al ,! ,secret>y ( ! ,treasury %all transf]1 f ! g5]al fund ( ! ,treasury1 to ! ,acc\nt #cjj1jjj1jjj = fiscal ye> #bjbd4 7ii7 ,am\nts deposit$ ,any am\nts transf]r$ "u clause 7i7 %all rema9 unavailable 9 ! ,acc\nt until su* am\nts are appropriat$ pursuant to subp>agraph 7,c74 7,c7 ,appropriations 7i7 ,au?orization ( appropriations ,= ! p]iod ( fiscal ye>s #bjbd ?r\gh #bjbf1 !re is au?oriz$ to be appropriat$ f ! ,acc\nt to ! ,secret>y1 = ! purpose ( c>ry+ out ! activities "u ?is subsection1 an am\nt n to exce$ ! total am\nt transf]r$ to ! ,acc\nt "u subp>agraph 7,b77i74 7ii7 ,(fsett+ future appropriations ,= fiscal ye>s #bjbd ?r\gh #bjbf1 = any discretion>y appropriation "u ! head+ ,acc\nt to ,address ! ,prim>y ,c>e ,physician ,%ortage provid$ to ! ,secret>y pursuant to ! au?orization ( appropriations "u clause 7i7 = ! purpose ( c>ry+ out ?is subsection1 ! total am\nt ( su* appropriations = ! applicable fiscal ye> 7n to exce$ ! total am\nt rema9+ 9 ! ,acc\nt7 %all be subtract$ f ! e/imate ( discretion>y budget au?ority & ! result+ outlays = any e/imate "u ! ,congressional ,budget & ,imp\ndm5t ,control ,act ( #aigd or ! ,balanc$ ,budget & ,em]g5cy ,deficit ,control ,act ( #aihe1 & ! am\nt transf]r$ to ! ,acc\nt %all be r$uc$ by ! same am\nt4 7#g7 ,annual reports ,n lat] ?an ,octob] #a ( fiscal ye>s #bjbe ?r\gh #bjbg1 ! ,secret>y %all submit to ! ,committee on ,heal?1 ,education1 ,labor1 & ,p5sions & ! ,committee on ,appropriations ( ! ,s5ate & ! ,committee on ,en]gy & ,comm]ce & ! ,committee on ,appropriations ( ! ,h\se ( ,repres5tatives1 a report includ+ a description ( any use ( funds provid$ pursuant to ! au?orization ( appropriations "u p>agraph 7#f77;,c74 7#h7 ,limitations ,not)/&+ any transf] au?ority au?oriz$ by ?is subsection or any appropriations ,act1 any funds made available pursuant to ! au?orization ( appropriations "u p>agraph 7#f77;,c7 may n be us$ = any purpose o!r ?an ! program e/abli%$ "u p>agraph 7#a74 7#i7 ,sunset ,am\nts rema9+ unappropriat$ 9 ! ,acc\nt "u ?is subsection %all be transf]r$ back to ! g5]al fund ( ! ,treasury on ,octob] #a1 #bjbf4 4 #bje4 ,nurse education1 practice1 quality1 & ret5tion grants 7a7 ,reau?orization ,section #hca ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #bifp7 is am5d$ by add+ at ! end ! foll[+3 7g7 ,au?orization ( appropriations ,to c>ry out ?is section 7o!r ?an subsection 7e771 9 addition to am\nts made available "u section #hga7;a71 !re are au?oriz$ to be appropriat$ #ei1dac1jjj = ea* ( fiscal ye>s #bjbd ?r\gh #bjbf1 to rema9 available until exp5d$4 4 7b7 ,exp&+ associate degree nurs+ programs ,section #hca ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #bifp71 z am5d$ by subsection 7a71 is fur!r am5d$-- 7#a7 by r$esignat+ subsections 7e7 ?r\gh 7g7 z subsections 7f7 ?r\gh 7h71 respectively2 & 7#b7 by ins]t+ aft] subsection 7d7 ! foll[+3 7e7 ,supplem5tal appropriations exp&+ associate degree nurs+ programs 7#a7 ,au?orization ,! ,secret>y %all aw>d grants to in/itutions ( high] education 7z def9$ 9 section #aja ( ! ,high] ,education ,act ( #aife7 (f]+ an accr$it$ regi/]$ nurs+ program at ! associate degree level = ! purpose ( exp&+ ! numb] ( /ud5ts enroll$ 9 ea* su* program4 7#b7 ,use ( funds ,a recipi5t ( a grant "u ?is subsection %all use ! grant funds to exp& ! numb] ( /ud5ts enroll$ 9 ! recipi5t's accr$it$ regi/]$ nurs+ program1 :i* may include increas+ nurse faculty & nurse faculty sal>ies1 exp&+ ! numb] ( qualifi$ preceptors at cl9ical rotations sites1 provid+ direct support = /ud5ts1 support+ p>tn]%ips ) heal? facilities = cl9ical tra9+1 pur*as+ & tra9+ faculty to use di/ance le>n+ te*nologies & simulation equipm5t1 alt]ation1 r5ovation1 con/ruction1 equipm5t1 & o!r capital improvem5t co/s1 & o!r projects det]m9$ appropriate by ! ,secret>y4 7#c7 ,det]m9ation ( numb] ( /ud5ts & application ,ea* in/itution ( high] education t (f]s a program describ$ 9 p>agraph 7#a7 t desires to receive a grant "u ?is subsection %all-- 7,a7 provide docum5tation f ! la/ #d academic ye>s1 or numb] ( academic ye>s ! program has be5 accr$it$ if less ?an #d1 demon/rat+ ! av]age p]c5tage ( individuals :o graduat$ f ! nurs+ degree program ) an associate degree )9 #aej p]c5t ( ! expect$ completion "t designat$ = ! program2 & 7,b7 submit an application to ! ,secret>y at su* "t1 9 su* mann]1 & accompani$ by su* in=mation z ! ,secret>y may require1 includ+ ! av]age p]c5t ( individuals det]m9$ "u subp>agraph 7,a74 7#d7 ,def9ition ,= purposes ( ?is subsection1 ! t]m heal? facility means an ,indian heal? s]vice c5t]1 a ,native ,hawaiian heal? c5t]1 a ,f$]ally qualifi$ heal? c5t]1 a rural heal? cl9ic1 a nurs+ home1 a home heal? ag5cy1 a hospice program1 a public heal? cl9ic1 a ,/ate or local dep>tm5t ( public heal?1 a skill$ nurs+ facility1 or an ambulatory surgical c5t]4 7#e7 ,acc\nt to ,address ! ,nurs+ ,work=ce ,%ortage 7,a7 ,e/abli%m5t ( acc\nt ,!re is e/abli%$ 9 ! ,treasury an acc\nt1 to be kn[n z ! ,acc\nt to ,address ! ,nurs+ ,work=ce ,%ortage 7ref]r$ to 9 ?is subsection z ! ,acc\nt71 = purposes ( c>ry+ out ?is subsection1 9 addition to am\nts o!rwise made available1 includ+ "u section #hga7;a74 7,b7 ,transf] ( direct sp5d+ 7i7 ,9 g5]al ,! ,secret>y ( ! ,treasury %all transf]1 f ! g5]al fund ( ! ,treasury1 to ! ,acc\nt #bdj1jjj1jjj = ea* ( fiscal ye>s #bjbd ?r\gh #bjbh4 7ii7 ,am\nts deposit$ ,any am\nts transf]r$ "u clause 7i7 %all rema9 unavailable 9 ! ,acc\nt until su* am\nts are appropriat$ pursuant to subp>agraph 7,c74 7,c7 ,appropriations 7i7 ,au?orization ( appropriations ,= ea* ( fiscal ye>s #bjbd ?r\gh #bjbh1 !re is au?oriz$ to be appropriat$ f ! ,acc\nt to ! ,secret>y1 = ! purpose ( c>ry+ out ! activities "u ?is subsection1 9 addition to am\nts o!rwise made available = su* purpose1 an am\nt n to exce$ ! total am\nt transf]r$ to ! ,acc\nt "u subp>agraph 7,b77i74 7ii7 ,(fsett+ future appropriations ,= any ( fiscal ye>s #bjbd ?r\gh #bjbh1 = any discretion>y appropriation "u ! head+ ,acc\nt to ,address ! ,nurs+ ,work=ce ,%ortage provid$ to ! ,secret>y pursuant to ! au?orization ( appropriations "u clause 7i7 = an additional am\nt = c>ry+ out ?is subsection1 ! total am\nt ( su* appropriations = ! applicable fiscal ye> 7n to exce$ ! total am\nt rema9+ 9 ! ,acc\nt7 %all be subtract$ f ! e/imate ( discretion>y budget au?ority & ! result+ outlays = any e/imate "u ! ,congressional ,budget & ,imp\ndm5t ,control ,act ( #aigd or ! ,balanc$ ,budget & ,em]g5cy ,deficit ,control ,act ( #aihe1 & ! am\nt transf]r$ to ! ,acc\nt %all be r$uc$ by ! same am\nt4 7#f7 ,annual reports ,n lat] ?an ,octob] #a ( fiscal ye>s #bjbe ?r\gh #bjbi1 ! ,secret>y %all submit to ! ,committee on ,heal?1 ,education1 ,labor1 & ,p5sions & ! ,committee on ,appropriations ( ! ,s5ate & ! ,committee on ,en]gy & ,comm]ce & ! ,committee on ,appropriations ( ! ,h\se ( ,repres5tatives1 a report includ+ a description ( any use ( funds provid$ pursuant to ! au?orization ( appropriations "u p>agraph 7#e77;,c74 7#g7 ,limitations ,not)/&+ any transf] au?ority au?oriz$ by ?is subsection or any appropriations ,act1 any funds made available pursuant to ! au?orization ( appropriations "u p>agraph 7#e77;,c7 may n be us$ = any purpose o!r ?an ! program e/abli%$ "u p>agraph 7#a74 7#h7 ,sunset ,am\nts rema9+ unappropriat$ 9 ! ,acc\nt "u ?is subsection %all be transf]r$ back to ! g5]al fund ( ! ,treasury on ,octob] #a1 #bjbh4 4 #bjf4 ,nurse faculty loan program ,section #hdf;,a ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #bign-#a71 z am5d$ by section #bjg1 is am5d$ by ins]t+ aft] subsection 7b7 ! foll[+3 7c7 ,fund+ 7#a7 ,au?orization ( appropriations 7,a7 ,9 g5]al ,to c>ry out ?is section 7o!r ?an subsection 7d771 9 addition to am\nts o!rwise made available1 includ+ "u section #hga7;b7 & p>agraph 7#b71 !re are au?oriz$ to be appropriat$ #bh1ejj1jjj = ea* ( fiscal ye>s #bjbd ?r\gh #bjbf1 to rema9 available until exp5d$4 7#b7 ,acc\nt to ,address ! ,nurse ,faculty ,work=ce ,%ortage 7,a7 ,e/abli%m5t ( acc\nt ,!re is e/abli%$ 9 ! ,treasury an acc\nt1 to be kn[n z ! ,acc\nt to ,address ! ,nurse ,faculty ,%ortage 7ref]r$ to 9 ?is p>agraph z ! ,acc\nt71 = purposes ( c>ry+ out ?is section 7o!r ?an subsection 7d77 9 addition to am\nts o!rwise made available1 includ+ "u section #hga7;b7 & p>agraph 7#a74 7,b7 ,transf] ( direct sp5d+ 7i7 ,9 g5]al ,! ,secret>y ( ! ,treasury %all transf]1 f ! g5]al fund ( ! ,treasury1 to ! ,acc\nt #eg1jjj1jjj = ea* ( fiscal ye>s #bjbd ?r\gh #bjbf4 7ii7 ,am\nts deposit$ ,any am\nts transf]r$ "u clause 7i7 %all rema9 unavailable 9 ! ,acc\nt until su* am\nts are appropriat$ pursuant to subp>agraph 7,c74 7,c7 ,appropriations 7i7 ,au?orization ( appropriations ,= ea* ( fiscal ye>s #bjbd ?r\gh #bjbf1 !re is au?oriz$ to be appropriat$ f ! ,acc\nt to ! ,secret>y1 = ! purpose ( c>ry+ out ! activities "u ?is section1 9 addition to am\nts o!rwise made available = su* purpose1 an am\nt n to exce$ ! total am\nt transf]r$ to ! ,acc\nt "u subp>agraph 7,b77i74 7ii7 ,(fsett+ future appropriations ,= any ( fiscal ye>s #bjbd ?r\gh #bjbf1 = any discretion>y appropriation "u ! head+ ,acc\nt to ,address ! ,nurse ,faculty ,%ortage provid$ to ! ,secret>y pursuant to ! au?orization ( appropriations "u clause 7i7 = an additional am\nt = c>ry+ out ?is section1 ! total am\nt ( su* appropriations = ! applicable fiscal ye> 7n to exce$ ! total am\nt rema9+ 9 ! ,acc\nt7 %all be subtract$ f ! e/imate ( discretion>y budget au?ority & ! result+ outlays = any e/imate "u ! ,congressional ,budget & ,imp\ndm5t ,control ,act ( #aigd or ! ,balanc$ ,budget & ,em]g5cy ,deficit ,control ,act ( #aihe1 & ! am\nt transf]r$ to ! ,acc\nt %all be r$uc$ by ! same am\nt4 7,d7 ,annual reports ,n lat] ?an ,octob] #a ( fiscal ye>s #bjbe ?r\gh #bjbg1 ! ,secret>y %all submit to ! ,committee on ,heal?1 ,education1 ,labor1 & ,p5sions & ! ,committee on ,appropriations ( ! ,s5ate & ! ,committee on ,en]gy & ,comm]ce & ! ,committee on ,appropriations ( ! ,h\se ( ,repres5tatives1 a report includ+ a description ( any use ( funds provid$ pursuant to ! au?orization ( appropriations "u subp>agraph 7,c74 7,e7 ,limitations ,not)/&+ any transf] au?ority au?oriz$ by ?is p>agraph or any appropriations ,act1 any funds made available pursuant to ! au?orization ( appropriations "u subp>agraph 7,c7 may n be us$ = any purpose o!r ?an ! program "u ?is section4 7,f7 ,sunset ,am\nts rema9+ unappropriat$ 9 ! ,acc\nt "u ?is p>agraph %all be transf]r$ back to ! g5]al fund ( ! ,treasury on ,octob] #a1 #bjbf4 4 #bjg4 ,nurse faculty demon/ration program ,section #hdf;,a ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #bign-#a7 is am5d$-- 7#a7 by am5d+ subsection 7a7 to read z foll[s3 7a7 ,9 g5]al ,to increase ! numb] ( qualifi$ nurs+ faculty1 ! ,secret>y may-- 7#a7 ent] into an agreem5t ) any accr$it$ s*ool ( nurs+ = ! e/abli%m5t & op]ation ( a /ud5t loan fund 9 accordance ) subsection 7b72 & 7#b7 aw>d nurse faculty grants 9 accordance ) subsection 7d74 2 7#b7 9 subsection 7b7-- 7,a7 by r$esignat+ subp>agraphs 7,a7 ?r\gh 7,d7 ( p>agraph 7#b7 z clauses 7i7 ?r\gh 7iv71 respectively1 & adju/+ ! m>g9s accord+ly2 7,b7 by r$esignat+ p>agraphs 7#a7 ?r\gh 7#e7 z subp>agraphs 7,a7 ?r\gh 7,e71 respectively1 & adju/+ ! m>g9s accord+ly2 7,c7 9 subp>agraph 7,c71 z s r$esignat$1 by /rik+ subsection 7c7 & ins]t+ p>agraph 7#b72 & 7,d7 by /rik+ 7b7 ,agreem5ts--,ea* agreem5t ent]$ into "u subsection 7a7 %all-- & ins]t+ ! foll[+3 7b7 ,s*ool ( nurs+ /ud5t loan fund 7#a7 ,9 g5]al ,ea* agreem5t ent]$ into "u subsection 7a77#a7 %all-- 2 7#c7 9 subsection 7c7-- 7,a7 by /rik+ subsection 7a7 ea* place x appe>s & ins]t+ subsection 7a77#a72 7,b7 9 p>agraph 7#c71 by r$esignat+ subp>agraphs 7,a7 & 7,b7 z clauses 7i7 & 7ii71 respectively1 & adju/+ ! m>g9s accord+ly2 7,c7 9 p>agraph 7#f71 by r$esignat+ subp>agraphs 7,a7 & 7,b7 z clauses 7i7 & 7ii71 respectively1 & adju/+ ! m>g9s accord+ly2 7,d7 by r$esignat+ p>agraphs 7#a7 ?r\gh 7#f7 z subp>agraphs 7,a7 ?r\gh 7,f71 respectively1 & adju/+ ! m>g9s accord+ly2 & 7,e7 9 subp>agraph 7,f77ii71 z s r$esignat$1 by /rik+ subsection 7e7 & ins]t+ p>agraph 7#d72 7#d7 9 subsection 7e71 by /rik+ subsection 7c77#f77;,b7 & ins]t+ p>agraph 7#b77;,f77ii72 7#e7 by r$esignat+ subsections 7c7 ?r\gh 7e7 7be=e application ( ! am5dm5t made by section #bjf7 z p>agraphs 7#b7 ?r\gh 7#d71 respectively1 & adju/+ ! m>g9s accord+ly2 & 7#f7 by add+ aft] subsection 7c71 z add$ by section #bjf1 ! foll[+3 7d7 ,nurse faculty demon/ration program 7#a7 ,9 g5]al ,! ,secret>y %all e/abli% & c>ry out a demon/ration program describ$ 9 subsection 7a77#b7 "u :i* eligible s*ools ( nurs+ receive a grant = purposes ( supplem5t+ ! sal>ies ( eligible nurs+ faculty memb]s to enhance recruitm5t & ret5tion ( nurs+ faculty memb]s4 7#b7 ,eligible entities ,to be eligible to receive a grant "u ?is subsection1 an entity %all-- 7,a7 be an accr$it$ s*ool ( nurs+2 & 7,b7 submit an application to ! ,secret>y1 at su* "t1 9 su* mann]1 & conta9+ su* in=mation z ! ,secret>y may require1 includ+-- 7i7 7,i7 to ! ext5t su* in=mation is available to ! s*ool ( nurs+1 ! sal>y hi/ory ( nurs+ faculty at su* s*ool :o previ\sly 7 nurses 9 cl9ical practice1 = ! mo/ rec5t #c-ye> p]iod end+ on ! date ( application1 adju/$ = inflation z appropriate & brok5 d[n by cr$5tials1 exp]i5ce1 & levels ( education ( su* nurses2 or 7,,ii7 if ! in=mation describ$ 9 subclause 7,i7 is n available1 in=mation on ! av]age local sal>y ( nurses 9 cl9ical practice1 adju/$ = inflation z appropriate & brok5 d[n by cr$5tials1 exp]i5ce1 & levels ( education ( ! individual nurses1 9 accordance ) su* requirem5ts z ! ,secret>y may specify2 7ii7 an atte/ation ( ! av]age nurs+ faculty sal>y at ! s*ool ( nurs+ dur+ ! mo/ rec5t #c-ye> p]iod prior to ! date ( application1 adju/$ = inflation1 z appropriate1 brok5 d[n by cr$5tials1 exp]i5ce1 & levels ( education ( su* faculty memb]s2 7iii7 ! numb] ( nurs+ faculty memb] vacancies at ! entity at ! "t ( application1 & ! entity's projection ( su* vacancies ov] ! ensu+ #e-ye> p]iod2 & 7iv7 a description ( ! entity's plans to id5tify fund+ s\rces to su/a9ably cont9ue1 aft] ! #b-ye> grant p]iod1 ! sal>y available to ! eligible nurs+ faculty memb] pursuant to ! program "u ?is subsection dur+ su* grant program & to reta9 eligible nurs+ faculty memb]s aft] ! end ( ! grant p]iod4 7#c7 ,aw>ds ,a grant aw>d$ "u ?is subsection1 ) respect to support+ eligible nurs+ faculty memb]s1 %all-- 7,a7 be aw>d$ to ! s*ool ( nurs+ to supplem5t ! sal>ies ( eligible faculty memb]s at ! s*ool ( nurs+1 annually1 = up to a #b-ye> p]iod1 9 an am\nt equal to1 = ea* eligible nurs+ faculty memb] at ! eligible entity dur+ ! grant p]iod1 ! diff]5ce betwe5-- 7i7 ! av]age sal>y ( nurses 9 cl9ical practice submitt$ "u subclause 7,i7 or 7,,ii7 ( p>agraph 7#b77;,b77i72 & 7ii7 ! great] (-- 7,i7 ! sal>y = ! eligible nurs+ faculty memb] at ! s*ool ( nurs+2 or 7,,ii7 ! av]age nurs+ faculty sal>y submitt$ "u p>agraph 7#b77;,b77ii7 = faculty memb]s ) ! same or simil> cr$5tials & level ( education2 7,b7 not)/&+ section #hjc7;a71 be us$ 9 its entirety to supplem5t ! eligible faculty memb]'s sal>y2 & 7,c7 be condition$ ^u ! s*ool ( nurs+ ma9ta9+1 = ea* ye> 9 :i* ! aw>d is made z describ$ 9 subp>agraph 7,a71 a sal>y = su* faculty memb] at a level t is n less ?an ! great] ( ! am\nt "u subclause 7,i7 or 7,,ii7 ( subp>agraph 7,a77ii74 7#d7 ,priority ,9 aw>d+ grants "u ?is subsection1 ! ,secret>y %all ensure ! equitable geographic di/ribution ( aw>ds1 & %all give priority to applications f s*ools ( nurs+ t demon/rate-- 7,a7 ! greate/ ne$ = su* grant1 :i* may be bas$ ^u ! f9ancial circum/ances ( ! s*ool ( nurs+1 eligible nurse faculty memb]s1 ! plann$ numb] ( /ud5ts to be tra9$ or admitt$ (f a wait li/2 7,b7 tra9+ or p>tn]%ips to s]ve vuln]able pati5t populations1 su* z ?r\gh ! location or activity ( a s*ool 9 a heal? pr(essional %ortage area 7z def9$ 9 section #ccb72 7,c7 recruitm5t & ret5tion ( faculty f und]repres5t$ populations2 or 7,d7 o!r p>ticul> ne$ = su* grant1 includ+ public in/itutions ( high] education t (f] #d-ye> degrees b at :i* ! pr$om9ant degree aw>d$ is an associate degree4 7#e7 ,rule ( con/ruction ,no?+ 9 ?is subsection precludes a s*ool ( nurs+ or an eligible nurs+ faculty memb] receiv+ an aw>d "u ?is section f obta9+ or receiv+ any o!r =m ( ,f$]al support or fund+4 7#f7 ,report ,n lat] ?an #c ye>s aft] ! date ( enactm5t ( ! ,bip>tisan ,prim>y ,c>e & ,heal? ,work=ce ,act1 ! ,secret>y %all submit to ! ,committee on ,f9ance & ! ,committee on ,heal?1 ,education1 ,labor1 & ,p5sions ( ! ,s5ate & ! ,committee on ,ways & ,means & ! ,committee on ,en]gy & ,comm]ce ( ! ,h\se ( ,repres5tatives1 a report t evaluates ! program e/abli%$ "u ?is subsection1 includ+-- 7,a7 ! impact ( su* program on recruitm5t & ret5tion rates ( nurs+ faculty1 z available1 & specifically = ea* faculty memb] p>ticipat+ 9 ! program2 & 7,b7 recomm5dations & consid]ations = ,congress on cont9u+ ! program "u ?is subsection4 7#g7 ,def9itions ,9 ?is subsection3 7,a7 ,eligible nurs+ faculty memb] ,! t]m eligible nurs+ faculty memb] means a nurs+ faculty memb] :o-- 7i7 0 hir$ by a s*ool ( nurs+ )9 ! #b-ye> p]iod prec$+ ! submission ( an application "u p>agraph 7#b71 or a prospective nurs+ faculty memb]2 7ii7 is curr5tly employ$ at ! s*ool ( nurs+ & :o demon/rates ! ne$ = su* support2 7iii7 previ\sly work$ z a nurse 9 cl9ical practice or z a nurse faculty memb] at ano!r s*ool ( nurs+2 or 7iv7 may "w on a "p-"t basis z a nurs+ faculty memb]1 = :om su* aw>d am\nts describ$ 9 p>agraph 7#c7 %all be prorat$ relative to ! am\nt ( "t p>ticipat+ 9 "p-"t tea*+4 7,b7 ,inflation ,! t]m inflation means ! ,consum] ,price ,index = all urban consum]s 7all items2 ,u4,s4 city av]age74 7#h7 ,au?orization ( appropriations ,to c>ry out ?is subsection1 9 addition to am\nts o!rwise available1 includ+ "u section #hga7;b71 !re is au?oriz$ to be appropriat$ #ae1jjj1jjj = ea* ( fiscal ye>s #bjbd & #bjbe4 4 #bjh4 ,nurse corps s*ol>%ip & loan repaym5t program ,section #hdf ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #bign7 is am5d$ by add+ at ! end ! foll[+3 7j7 ,au?orization ( appropriations ,to c>ry out ?is section1 9 addition to am\nts o!rwise made available1 includ+ "u section #hga7;b71 !re are au?oriz$ to be appropriat$ #ic1fjj1jjj = fiscal ye> #bjbd1 #id1fjj1jjj = fiscal ye> #bjbe1 & #ie1fjj1jjj = fiscal ye> #bjbf1 to rema9 available until exp5d$4 4 #bji4 ,grants = prim>y c>e nurse resid5cy tra9+ programs ,section #ecaf ( ! ,pati5t ,protection & ,af=dable ,c>e ,act 7#db ,u4,s4,c4 #bif;j-#a7 is am5d$-- 7#a7 9 ! section head+1 by /rik+ ,demon/ration2 7#b7 9 subsection 7a71 by /rik+ demon/ration2 7#c7 9 subsection 7d7-- 7,a7 9 p>agraph 7#a77;,b71 by /rik+ & at ! end2 7,b7 by r$esignat+ p>agraph 7#b7 z p>agraph 7#c72 & 7,c7 by ins]t+ aft] p>agraph 7#a7 ! foll[+3 7#b7 7,a7 9 ! case ( an entity t does n h an e/abli%$ resid5cy program = nurse practition]s at ! "t ( ! application1 demon/rate plans to e/abli% a new resid5cy program = nurse practition]s2 or 7,b7 9 ! case ( an entity t has an e/abli%$ resid5cy program = nurse practition]s at ! "t ( ! application1 demon/rate plans to use ! grant "u ?is section to (f] n few] ?an #d additional resid5cy positions = new nurse practition]s to p>ticipate 9 su* program2 & 2 & 7#d7 9 subsection 7i71 by /rik+ su* sums z may be necess>y = ea* ( fiscal ye>s #bjaa ?r\gh #bjad & ins]t+ #cj1jjj1jjj = ea* ( fiscal ye>s #bjbd ?r\gh #bjbf4 #baj4 ,/ate oral heal? work=ce improvem5t grant program ,subsection 7f7 ( section #cdj;,g ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #bef;g7 is am5d$ by /rik+ #ac1ijc1jjj = ea* ( fiscal ye>s #bjai ?r\gh #bjbc & ins]t+ #ae1bjj1jjj = fiscal ye> #bjbd1 #ae1ejj1jjj = fiscal ye> #bjbe1 & #ae1hjj1jjj = fiscal ye> #bjbf1 to rema9 available until exp5d$4 #baa4 ,oral heal? tra9+ programs ,subsection 7f7 ( section #gdh ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #bick-#b7 is am5d$ to read z foll[s3 7f7 ,au?orization ( appropriations 7#a7 ,9 g5]al ,to c>ry out ?is section1 !re is au?oriz$ to be appropriat$ #bh1ejj1jjj = fiscal ye> #bjbf1 to rema9 available until exp5d$4 7#b7 ,geographic di/ribution ,9 aw>d+ grants "u ?is section1 ! ,secret>y %all ensure1 to ! greate/ ext5t practicable1 t su* grants are equitably di/ribut$ among ! geographical regions ( ! ,unit$ ,/ates4 4 #bab4 ,alli$ heal? pr(essionals 7a7 ,support+ dual or concurr5t enrollm5t 9 ! alli$ heal? projects program ,section #gee7;b77#a7 ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #bid;e7b77#a77 is am5d$-- 7#a7 9 subp>agraph 7,b71 by /rik+ to individuals :o h baccalaureate degrees 9 heal?-relat$ sci5ces2 7#b7 9 ! flu% text at ! end ( subp>agraph 7,i71 by /rik+ 2 & & ins]t+ a semicolon2 7#c7 9 subp>agraph 7,j71 by /rik+ ! p]iod & ins]t+ 2 &2 & 7#d7 by add+ at ! end ! foll[+3 7,k7 ^? t e/abli% or support a dual or concurr5t enrollm5t program 7z def9$ 9 section #haja ( ! ,elem5t>y & ,second>y ,education ,act ( #aife7 if ! dual or concurr5t enrollm5t program-- 7i7 provides outrea* on alli$ heal? c>e]s requir+ an indu/ry-recogniz$ cr$5tial1 a c]tificate1 or an associate degree1 to all high s*ools s]v$ by ! local educational ag5cy t is a p>tn] 9 ! p>tn]%ip (f]+ ! dual or concurr5t enrollm5t program2 7ii7 provides in=mation to high s*ool /ud5ts ab\t ! tra9+ requirem5ts & expect$ sal>y ( alli$ heal? pr(essions2 & 7iii7 provides academic & f9ancial aid c\nsel+ to /ud5ts :o p>ticipate 9 ! dual or concurr5t enrollm5t program4 4 7b7 ,support+ dual or concurr5t enrollm5t 9 ! heal? c>e]s opportunity program ,section #gci7;a77#b7 ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #bic;c7a77#b77 is am5d$-- 7#a7 9 subp>agraph 7,h71 by /rik+ & aft] ! semicolon2 7#b7 9 subp>agraph 7,i71 by /rik+ ! p]iod at ! end & ins]t+ 2 &2 & 7#c7 by add+ at ! end ! foll[+3 7,j7 provid+ academic & f9ancial aid c\nsel+ to support p>ticipation 9 a dual or concurr5t enrollm5t program 7z def9$ 9 section #haja ( ! ,elem5t>y & ,second>y ,education ,act ( #aife7 t leads to an indu/ry-recogniz$ cr$5tial1 a c]tificate1 or an associate degree 9 ! heal? pr(essions or academic cr$its t c be transf]r$1 z indicat$ ?r\gh an articulation agreem5t betwe5 #b or m community colleges or univ]sities1 to obta9 an indu/ry-recogniz$ cr$5tial1 a c]tificate1 or a degree 9 ! heal? pr(essions4 4 7c7 ,heal? c>e work=ce innovation program ,section #gee7;b7 ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #bid;e7b77 is am5d$ by add+ at ! end ! foll[+3 7#e7 7,a7 ,support+ & develop+ new innovative1 community-driv5 approa*es = ! education & tra9+ ( alli$ heal? pr(essionals1 includ+ ^? describ$ 9 subp>agraph 7,f77i71 ) an emphasis on exp&+ ! supply ( su* pr(essionals locat$ 91 & meet+ ! ne$s (1 und]s]v$ communities & rural areas4 ,grants "u ?is p>agraph %all be aw>d$ ?r\gh a new program 7ref]r$ to z ! ,heal? ,c>e ,work=ce ,innovation ,program or 9 ?is p>agraph z ! ,program74 7,b7 ,to be eligible to receive a grant "u ! ,program an entity %all-- 7i7 be a ,f$]ally qualifi$ heal? c5t] 7z def9$ 9 section #aije7l77#b77;,b7 ( ! ,social ,security ,act71 a ,/ate-level association or o!r consortium t repres5ts & is compris$ ( ,f$]ally qualifi$ heal? c5t]s1 or a c]tifi$ rural heal? cl9ic t meets ! requirem5ts ( section #ccd2 & 7ii7 submit to ! ,secret>y an application t1 at a m9imum1 conta9s-- 7,i7 a description ( h[ all tra9ees w be tra9$ 9 accr$it$ tra9+ programs ei!r directly or ?r\gh p>tn]%ips ) public or nonpr(it private entities2 7,,ii7 a description ( ! community-driv5 heal? c>e work=ce innovation model to be c>ri$ out "u ! grant1 includ+ ! specific pr(essions to be fund$2 7,,iii7 ! geographic s]vice area t w be s]v$1 includ+ quantitative data1 if available1 %[+ t su* p>ticul> area faces a %ortage ( heal? pr(essionals & lacks access to heal? c>e2 7,,iv7 a description ( ! b5efits provid$ to ea* heal? c>e pr(essional tra9$ "u ! propos$ model dur+ ! education & tra9+ phase2 7,v7 a description ( ! exp]i5ce t ! applicant has 9 ! recruitm5t1 ret5tion1 & promotion ( ! well-be+ ( work]s & volunte]s2 7,,vi7 a description ( h[ ! fund+ aw>d$ "u ! ,program w supplem5t r ?an supplant exi/+ fund+2 7,,vii7 a description ( ! scalability & replicability ( ! community-driv5 approa* to be fund$ "u ! ,program2 7,,viii7 a description ( ! infra/ructure1 outrea* & communication plan & o!r program support co/s requir$ to op]ationalize ! propos$ model2 & 7,,ix7 any o!r in=mation1 z ! ,secret>y det]m9es appropriate4 7,c7 7i7 ,an entity %all use am\nts receiv$ "u a grant aw>d$ "u ! ,program to c>ry out ! innovative1 community-driv5 model describ$ 9 ! application "u subp>agraph 7,b74 ,su* am\nts may be us$ = laun*+ new or exp&+ exi/+ innovative heal? c>e pr(essional p>tn]%ips1 includ+ ! foll[+ specific uses3 7,i7 ,e/abli%+ or exp&+ a p>tn]%ip betwe5 an eligible entity & #a or m high s*ools1 accr$it$ public or nonpr(it private vocational-te*nical s*ools1 accr$it$ public or nonpr(it private #b-ye> colleges1 area heal? education c5t]s1 & entities ) cl9ical sett+s = ! provision ( education & tra9+ opportunities n available at ! grantee's facilities4 7,,ii7 ,provid+ education & tra9+ programs to improve alli$ heal? pr(essionals' read9ess 9 sett+s t s]ve und]s]v$ communities & rural areas2 enc\rag+ /ud5ts f und]s]v$ & disadvantag$ backgr\nds & =m] pati5ts to consid] c>e]s 9 heal? c>e1 & bett] reflect+ & meet+ community ne$s2 provid+ education & tra9+ programs = individuals to "w 9 pati5t-c5t]$1 team-bas$1 community-driv5 heal? c>e models t include integration ) o!r cl9ical practition]s & tra9+ 9 cultural & l+ui/ic compet5ce2 provid+ pre-appr5tice%ip & appr5tice%ip programs = heal? c>e te*nical1 support1 & entry-level occupations1 p>ticul>ly = ^? enroll$ 9 dual or concurr5t enrollm5t programs2 build+ a preceptor%ip tra9+-to-practice model = m$ical1 behavioral heal?1 oral heal?1 & public heal? discipl9es 9 an integrat$1 community-driv5 sett+2 provid+ & exp&+ int]n%ips1 c>e] ladd]s1 & developm5t opportunities = heal? c>e pr(essionals1 includ+ new & exi/+ /aff2 or inve/+ 9 tra9+ equipm5t1 supplies1 & limit$ r5ovations or retr(itt+ ( tra9+ space ne$$ = grantees to c>ry out _! p>ticul> model4 7ii7 ,am\nts receiv$ "u a grant aw>d$ "u ! ,program %all n be us$ to support con/ruction co/s or to supplant fund+ f exi/+ programs t support ! applicant's heal? work=ce4 7iii7 ,models fund$ "u ! ,program %all be = a duration ( at lea/ #c ye>s4 7,d7 ,9 aw>d+ grants "u ! ,program1 ! ,secret>y may give priority to applicants t w use grant funds to support work=ce innovation models t increase ! numb] ( individuals f und]s]v$ & disadvantag$ backgr\nds work+ 9 su* heal? c>e pr(essions1 improve access to heal? c>e 7includ+ m$ical1 behavioral heal? & oral heal?7 9 und]s]v$ communities1 or demon/rate t ! model c be replicat$ 9 o!r und]s]v$ communities 9 a co/-effici5t & effective mann] to a*ieve ! purposes ( ! ,program4 7,e7 ,an entity t receives a grant "u ! ,program %all provide p]iodic reports to ! ,secret>y detail+ ! f9d+s & outcomes ( ! innovative1 community-driv5 model c>ri$ out "u ! grant4 ,su* reports %all conta9 in=mation 9 a mann] & at su* times z det]m9$ appropriate by ! ,secret>y4 7,f7 ,9 ?is p>agraph3 7i7 ,! t]m alli$ heal? c>e pr(essional includes individuals :o provide cl9ical support s]vices1 includ+ m$ical assi/ants1 d5tal assi/ants1 d5tal hygi5i/s1 ph>macy te*nicians1 physical !rapi/s & heal? c>e int]pret]s2 individuals provid+ non-cl9ical support1 su* z bill+ & cod+ pr(essionals & heal? in=mation te*nology pr(essionals2 dieticians2 m$ical te*nologi/s2 em]g5cy m$ical te*nicians2 community heal? work]s2 public heal? p]sonnel2 & pe] support work]s4 7ii7 ,! t]m rural area has ! mean+ giv5 su* t]m by ! ,adm9i/rator ( ! ,heal? ,res\rces & ,s]vices ,adm9i/ration4 7iii7 ,! t]m und]s]v$ communities means areas1 population gr\ps1 & facilities designat$ z heal? pr(essional %ortage areas "u section #ccb1 m$ically und]s]v$ areas z def9$ "u section #ccj;,i7a771 or m$ically und]s]v$ populations z def9$ "u section #ccj7;b77#c74 7,g7 7i7 ,!re are au?oriz$ to be appropriat$ #ajj1jjj1jjj = ea* ( fiscal ye>s #bjbd ?r\gh #bjbf1 to c>ry out ?is section1 to rema9 available until exp5d$4 7ii7 ,a grant provid$ "u ! ,program %all n exce$ #b1ejj1jjj = a grant p]iod4 4 #bac4 ,budget>y treatm5t 7a7 ,/atutory paygo scorec>ds ,! budget>y effects ( section #cjb 7includ+ ! am5dm5ts made by su* section71 up to #a1fga1jjj1jjj1 %all n be ent]$ on ei!r ,,paygo scorec>d ma9ta9$ pursuant to section #d7;d7 ( ! ,/atutory ,pay ,z-,y-,g ,act ( #bjaj 7#b ,u4,s4,c4 #icc7;d774 7b7 ,s5ate paygo scorec>ds ,! budget>y effects ( section #cjb 7includ+ ! am5dm5ts made by su* section71 up to #a1fga1jjj1jjj1 %all n be ent]$ on any ,,paygo scorec>d ma9ta9$ = purposes ( section #dajf ( ,h4 ,con4 ,res4 #ga 7#aae? ,congress74 7c7 ,res]vation ( sav+s ,none ( ! funds 9 ! ,acc\nt to ,address ! ,prim>y ,c>e ,physician ,%ortage 7e/abli%$ "u section #gdg7;c77#f7 ( ! ,public ,heal? ,s]vice ,act1 z am5d$ by section #bjd71 ! ,acc\nt to ,address ! ,nurs+ ,work=ce ,%ortage 7e/abli%$ "u section #hca7;e77#e7 ( ! ,public ,heal? ,s]vice ,act1 z am5d$ by section #bje71 or ! ,acc\nt to ,address ! ,nurse ,faculty ,%ortage 7e/abli%$ "u section #hdf;,a7c77#b7 ( ! ,public ,heal? ,s]vice ,act1 z am5d$ by section #bjf7 %all be made available except to ! ext5t provid$ 9 advance 9 appropriations ,acts1 & legislation or an ,act t resc9ds or r$uces am\nts 9 su* acc\nts %all n be e/imat$ z a r$uction 9 direct sp5d+ "u ! ,congressional ,budget & ,imp\ndm5t ,control ,act ( #aigd or ! ,balanc$ ,budget & ,em]g5cy ,deficit ,control ,act ( #aihe4 ,,iii ,r$uc+ heal? c>e co/s = pati5ts #cja4 ,bann+ anticompetitive t]ms 9 facility & insurance contracts t limit access to high] quality1 l[] co/ c>e 7a7 ,9 g5]al 7#a7 ,public ,heal? ,s]vice ,act ,section #bgii;,a-#i ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #cjj;gg-#aai7 is am5d$-- 7,a7 by add+ at ! end ! foll[+3 7b7 ,protect+ ,heal? ,plans ,network ,design ,flexibility 7#a7 ,9 g5]al ,a gr\p heal? plan or a heal? insurance issu] (f]+ gr\p or individual heal? insurance cov]age %all n ent] into an agreem5t ) a provid]1 network or association ( provid]s1 or o!r s]vice provid] (f]+ access to a network ( s]vice provid]s if su* agreem5t1 directly or indirectly-- 7,a7 re/ricts ! gr\p heal? plan or heal? insurance issu] f-- 7i7 direct+ or /e]+ enrollees to o!r heal? c>e provid]s2 or 7ii7 (f]+ inc5tives to enc\rage enrollees to utilize specific heal? c>e provid]s2 7,b7 requires ! gr\p heal? plan or heal? insurance issu] to ent] into any additional contract ) an affiliate ( ! provid] z a condition ( ent]+ into a contract ) su* provid]2 7,c7 requires ! gr\p heal? plan or heal? insurance issu] to agree to paym5t rates or o!r t]ms = any affiliate n p>ty to ! contract ( ! provid] involv$2 or 7,d7 re/ricts o!r gr\p heal? plans or heal? insurance issu]s n p>ty to ! contract f pay+ a l[] rate = items or s]vices ?an ! contract+ plan or issu] pays = su* items or s]vices4 7#b7 ,additional requirem5t = self-insur$ plans ,a self-insur$ gr\p heal? plan %all n ent] into an agreem5t ) a provid]1 network or association ( provid]s1 ?ird-p>ty adm9i/rator1 or o!r s]vice provid] (f]+ access to a network ( provid]s if su* agreem5t directly or indirectly requires ! gr\p heal? plan to c]tify1 atte/1 or o!rwise confirm 9 writ+ t ! gr\p heal? plan is b\nd by re/rictive contract+ t]ms betwe5 ! s]vice provid] & a ?ird-p>ty adm9i/rator t ! gr\p heal? plan is n p>ty to1 )\t a disclosure t su* t]ms exi/4 7#c7 ,exception = plans & issu]s ,p>agraph 7#a77;,a7 %all n apply to a gr\p heal? plan or heal? insurance issu] (f]+ gr\p or individual heal? insurance cov]age ) respect to-- 7,a7 a heal? ma9t5ance organization 7z def9$ 9 section #bgia7;b77#c771 if su* heal? ma9t5ance organization op]ates prim>ily ?r\gh exclusive contracts ) multi-specialty physician gr\ps1 nor to any arrangem5t betwe5 su* a heal? ma9t5ance organization & its affiliates2 or 7,b7 a value-bas$ network arrangem5t1 su* z an exclusive provid] network1 acc\ntable c>e organization1 c5t] ( excell5ce1 a provid] sponsor$ heal? insurance issu] t op]ates prim>ily ?r\gh align$ multi-specialty physician gr\p practices or integrat$ heal? sy/ems1 or su* o!r simil> network arrangem5ts z det]m9$ by ! ,secret>y ?r\gh rulemak+4 7#d7 ,atte/ation ,a gr\p heal? plan or heal? insurance issu] (f]+ gr\p or individual heal? insurance cov]age %all annually submit to1 z applicable1 ! applicable au?ority describ$ 9 section #bgbc or ! ,secret>y ( ,labor or ! ,secret>y ( ! ,treasury1 an atte/ation t su* plan or issu] is 9 compliance ) ! requirem5ts ( ?is subsection4 7#e7 ,rule ( con/ruction ,no?+ 9 ?is subsection %all be con/ru$ to limit network design or co/ or quality initiatives by a gr\p heal? plan or heal? insurance issu]1 includ+ acc\ntable c>e organizations1 exclusive provid] organizations1 networks t ti] provid]s by co/ or quality or /e] enrollees to c5t]s ( excell5ce1 or o!r pay-=-p]=mance programs4 7#f7 ,compliance ) respect to antitru/ laws ,compliance ) ?is subsection does n con/itute compliance ) ! antitru/ laws1 z def9$ 9 subsection 7a7 ( ! fir/ section ( ! ,clayton ,act 7#ae ,u4,s4,c4 #ab7;a774 7#g7 ,gr&fa!r+ ,an applicable ,/ate au?ority may make a det]m9ation t ! prohibitions "u p>agraph 7#a7 7) respect to conditions t w\ld direct or /e] to1 or (f] inc5tives to enc\rage enrollees to use1 o!r heal? c>e provid]s7 w n apply 9 ! ,/ate ) respect to any specifi$ agreem5t t is execut$ be=e ! date ( enactm5t ( ! ,bip>tisan ,prim>y ,c>e & ,heal? ,work=ce ,act1 = a maximum l5g? ( nonapplicability ( up to #aj ye>s f ! date ( execution ( ! contract if ! applicable ,/ate au?ority det]m9es t ! contract is unlikely to significantly less5 competition4 ,) respect to a specifi$ agreem5t = :i* an applicable ,/ate au?ority has made a det]m9ation "u ! prec$+ s5t5ce an applicable ,/ate au?ority may det]m9e :e!r r5ewal ( ! contract1 )9 ! applicable #aj-ye> p]iod1 is all[$4 2 & 7,b7 by r$esignat+ p>agraph 7#e7 ( subsection 7a7 z subsection 7c71 adju/+ ! m>g9 ( su* subsection accord+ly1 & transf]r+ su* subsection 7c7 to appe> aft] subsection 7b71 z add$ by subp>agraph 7,a74 7#b7 ,employee ,retirem5t ,income ,security ,act ( #aigd ,section #gbd ( ! ,employee ,retirem5t ,income ,security ,act ( #aigd 7#bi ,u4,s4,c4 #aahem7 is am5d$-- 7,a7 by add+ at ! end ! foll[+3 7b7 ,protect+ ,heal? ,plans ,network ,design ,flexibility 7#a7 ,9 g5]al ,a gr\p heal? plan or a heal? insurance issu] (f]+ gr\p heal? insurance cov]age %all n ent] into an agreem5t ) a provid]1 network or association ( provid]s1 or o!r s]vice provid] (f]+ access to a network ( s]vice provid]s if su* agreem5t1 directly or indirectly-- 7,a7 re/ricts ! gr\p heal? plan or heal? insurance issu] f-- 7i7 direct+ or /e]+ enrollees to o!r heal? c>e provid]s2 or 7ii7 (f]+ inc5tives to enc\rage enrollees to utilize specific heal? c>e provid]s2 7,b7 requires ! gr\p heal? plan or heal? insurance issu] to ent] into any additional contract ) an affiliate ( ! provid] z a condition ( ent]+ into a contract ) su* provid]2 7,c7 requires ! gr\p heal? plan or heal? insurance issu] to agree to paym5t rates or o!r t]ms = any affiliate n p>ty to ! contract ( ! provid] involv$2 or 7,d7 re/ricts o!r gr\p heal? plans or heal? insurance issu]s n p>ty to ! contract f pay+ a l[] rate = items or s]vices ?an ! contract+ plan or issu] pays = su* items or s]vices4 7#b7 ,additional requirem5t = self-insur$ plans ,a self-insur$ gr\p heal? plan %all n ent] into an agreem5t ) a provid]1 network or association ( provid]s1 ?ird-p>ty adm9i/rator1 or o!r s]vice provid] (f]+ access to a network ( provid]s if su* agreem5t directly or indirectly requires ! gr\p heal? plan to c]tify1 atte/1 or o!rwise confirm 9 writ+ t ! gr\p heal? plan is b\nd by re/rictive contract+ t]ms betwe5 ! s]vice provid] & a ?ird-p>ty adm9i/rator t ! gr\p heal? plan is n p>ty to1 )\t a disclosure t su* t]ms exi/4 7#c7 ,exception = plans & issu]s ,p>agraph 7#a77;,a7 %all n apply to a gr\p heal? plan or heal? insurance issu] (f]+ gr\p heal? insurance cov]age ) respect to-- 7,a7 a heal? ma9t5ance organization 7z def9$ 9 section #gcc7;b77#c771 if su* heal? ma9t5ance organization op]ates prim>ily ?r\gh exclusive contracts ) multi-specialty physician gr\ps1 nor to any arrangem5t betwe5 su* a heal? ma9t5ance organization & its affiliates2 or 7,b7 a value-bas$ network arrangem5t1 su* z an exclusive provid] network1 acc\ntable c>e organization1 c5t] ( excell5ce1 a provid] sponsor$ heal? insurance issu] t op]ates prim>ily ?r\gh align$ multi-specialty physician gr\p practices or integrat$ heal? sy/ems1 or su* o!r simil> network arrangem5ts z det]m9$ by ! ,secret>y ?r\gh rulemak+4 7#d7 ,atte/ation ,a gr\p heal? plan or heal? insurance issu] (f]+ gr\p heal? insurance cov]age %all annually submit to1 z applicable1 ! applicable au?ority describ$ 9 section #bgbc ( ! ,public ,heal? ,s]vice ,act or ! ,secret>y ( ,labor or ! ,secret>y ( ! ,treasury1 an atte/ation t su* plan or issu] is 9 compliance ) ! requirem5ts ( ?is subsection4 7#e7 ,rule ( con/ruction ,no?+ 9 ?is subsection %all be con/ru$ to limit network design or co/ or quality initiatives by a gr\p heal? plan or heal? insurance issu]1 includ+ acc\ntable c>e organizations1 exclusive provid] organizations1 networks t ti] provid]s by co/ or quality or /e] enrollees to c5t]s ( excell5ce1 or o!r pay-=-p]=mance programs4 7#f7 ,compliance ) respect to antitru/ laws ,compliance ) ?is subsection does n con/itute compliance ) ! antitru/ laws1 z def9$ 9 subsection 7a7 ( ! fir/ section ( ! ,clayton ,act 7#ae ,u4,s4,c4 #ab7;a774 7#g7 ,gr&fa!r+ ,an applicable ,/ate au?ority may make a det]m9ation t ! prohibitions "u p>agraph 7#a7 7) respect to conditions t w\ld direct or /e] to1 or (f] inc5tives to enc\rage enrollees to use1 o!r heal? c>e provid]s7 w n apply 9 ! ,/ate ) respect to any specifi$ agreem5t t is execut$ be=e ! date ( enactm5t ( ! ,bip>tisan ,prim>y ,c>e & ,heal? ,work=ce ,act1 = a maximum l5g? ( nonapplicability ( up to #aj ye>s f ! date ( execution ( ! contract if ! applicable ,/ate au?ority det]m9es t ! contract is unlikely to significantly less5 competition4 ,) respect to a specifi$ agreem5t = :i* an applicable ,/ate au?ority has made a det]m9ation "u ! prec$+ s5t5ce an applicable ,/ate au?ority may det]m9e :e!r r5ewal ( ! contract1 )9 ! applicable #aj-ye> p]iod1 is all[$4 2 & 7,b7 by r$esignat+ p>agraph 7#d7 ( subsection 7a7 z subsection 7c71 adju/+ ! m>g9 ( su* subsection accord+ly1 & transf]r+ su* subsection 7c7 to appe> aft] subsection 7b71 z add$ by subp>agraph 7,a74 7#c7 ,int]nal ,rev5ue ,code ( #aihf ,section #ihbd ( ! ,int]nal ,rev5ue ,code ( #aihf is am5d$-- 7,a7 by add+ at ! end ! foll[+3 7b7 ,protect+ ,heal? ,plans ,network ,design ,flexibility 7#a7 ,9 g5]al ,a gr\p heal? plan %all n ent] into an agreem5t ) a provid]1 network or association ( provid]s1 or o!r s]vice provid] (f]+ access to a network ( s]vice provid]s if su* agreem5t1 directly or indirectly-- 7,a7 re/ricts ! gr\p heal? plan f-- 7i7 direct+ or /e]+ enrollees to o!r heal? c>e provid]s2 or 7ii7 (f]+ inc5tives to enc\rage enrollees to utilize specific heal? c>e provid]s2 7,b7 requires ! gr\p heal? plan to ent] into any additional contract ) an affiliate ( ! provid] z a condition ( ent]+ into a contract ) su* provid]2 7,c7 requires ! gr\p heal? plan to agree to paym5t rates or o!r t]ms = any affiliate n p>ty to ! contract ( ! provid] involv$2 or 7,d7 re/ricts o!r gr\p heal? plans n p>ty to ! contract f pay+ a l[] rate = items or s]vices ?an ! contract+ plan pays = su* items or s]vices4 7#b7 ,additional requirem5t = self-insur$ plans ,a self-insur$ gr\p heal? plan %all n ent] into an agreem5t ) a provid]1 network or association ( provid]s1 ?ird-p>ty adm9i/rator1 or o!r s]vice provid] (f]+ access to a network ( provid]s if su* agreem5t directly or indirectly requires ! gr\p heal? plan to c]tify1 atte/1 or o!rwise confirm 9 writ+ t ! gr\p heal? plan is b\nd by re/rictive contract+ t]ms betwe5 ! s]vice provid] & a ?ird-p>ty adm9i/rator t ! gr\p heal? plan is n p>ty to1 )\t a disclosure t su* t]ms exi/4 7#c7 ,exception = c]ta9 plans ,p>agraph 7#a77;,a7 %all n apply to a gr\p heal? plan ) respect to-- 7,a7 a heal? ma9t5ance organization 7z def9$ 9 section #ihcb7;b77#c771 if su* heal? ma9t5ance organization op]ates prim>ily ?r\gh exclusive contracts ) multi-specialty physician gr\ps1 nor to any arrangem5t betwe5 su* a heal? ma9t5ance organization & its affiliates2 or 7,b7 a value-bas$ network arrangem5t1 su* z an exclusive provid] network1 acc\ntable c>e organization1 c5t] ( excell5ce1 a provid] sponsor$ heal? insurance issu] t op]ates prim>ily ?r\gh align$ multi-specialty physician gr\p practices or integrat$ heal? sy/ems1 or su* o!r simil> network arrangem5ts z det]m9$ by ! ,secret>y ?r\gh rulemak+4 7#d7 ,atte/ation ,a gr\p heal? plan %all annually submit to1 z applicable1 ! applicable au?ority describ$ 9 section #bgbc ( ! ,public ,heal? ,s]vice ,act or ! ,secret>y ( ,labor or ! ,secret>y ( ! ,treasury1 an atte/ation t su* plan is 9 compliance ) ! requirem5ts ( ?is subsection4 7#e7 ,rule ( con/ruction ,no?+ 9 ?is subsection %all be con/ru$ to limit network design or co/ or quality initiatives by a gr\p heal? plan1 includ+ acc\ntable c>e organizations1 exclusive provid] organizations1 networks t ti] provid]s by co/ or quality or /e] enrollees to c5t]s ( excell5ce1 or o!r pay-=-p]=mance programs4 7#f7 ,compliance ) respect to antitru/ laws ,compliance ) ?is subsection does n con/itute compliance ) ! antitru/ laws1 z def9$ 9 subsection 7a7 ( ! fir/ section ( ! ,clayton ,act 7#ae ,u4,s4,c4 #ab7;a774 7#g7 ,gr&fa!r+ ,an applicable ,/ate au?ority may make a det]m9ation t ! prohibitions "u p>agraph 7#a7 7) respect to conditions t w\ld direct or /e] to1 or (f] inc5tives to enc\rage enrollees to use1 o!r heal? c>e provid]s7 w n apply 9 ! ,/ate ) respect to any specifi$ agreem5t t is execut$ be=e ! date ( enactm5t ( ! ,bip>tisan ,prim>y ,c>e & ,heal? ,work=ce ,act1 = a maximum l5g? ( nonapplicability ( up to #aj ye>s f ! date ( execution ( ! contract if ! applicable ,/ate au?ority det]m9es t ! contract is unlikely to significantly less5 competition4 ,) respect to a specifi$ agreem5t = :i* an applicable ,/ate au?ority has made a det]m9ation "u ! prec$+ s5t5ce an applicable ,/ate au?ority may det]m9e :e!r r5ewal ( ! contract1 )9 ! applicable #aj-ye> p]iod1 is all[$4 2 & 7,b7 by r$esignat+ p>agraph 7#d7 ( subsection 7a7 z subsection 7c71 adju/+ ! m>g9 ( su* subsection accord+ly1 & transf]r+ su* subsection 7c7 to appe> aft] subsection 7b71 z add$ by subp>agraph 7,a74 7b7 ,regulations ,n lat] ?an #a ye> aft] ! date ( enactm5t ( ?is ,act1 ! ,secret>y ( ,heal? & ,human ,s]vices1 ! ,secret>y ( ,labor1 & ! ,secret>y ( ! ,treasury1 jo9tly1 %all promulgate regulations to c>ry out section #bgii;,a-#i7;b7 ( ! ,public ,heal? ,s]vice ,act1 section #gbd7;b7 ( ! ,employee ,retirem5t ,income ,security ,act ( #aigd1 & section #ihbd7;b7 ( ! ,int]nal ,rev5ue ,code ( #aihf1 z add$ by subsection 7a74 7c7 ,effective date ,subsection 7b7 ( section #bgii;,a-#i ( ! ,public ,heal? ,s]vice ,act1 subsection 7b7 ( section #gbd ( ! ,employee ,retirem5t ,income ,security ,act ( #aigd1 & subsection 7b7 ( section #ihbd ( ! ,int]nal ,rev5ue ,code ( #aihf 7z add$ by p>agraphs 7#a71 7#b71 & 7#c71 respectively1 ( subsection 7a77 %all apply ) respect to any contract ent]$ into on or aft] ! date t is #ah mon?s aft] ! date ( enactm5t ( ?is ,act4 ,) respect to an applicable contract t is 9 effect on ! date ( enactm5t ( ?is ,act1 su* subsection 7b7 %all apply on ! e>li] ( ! date ( r5ewal ( su* contract or #c ye>s aft] su* date ( enactm5t4 #cjb4 ,hone/ bill+ requirem5ts applicable to provid]s 7a7 ,gr\p heal? plan & heal? insurance issu] requirem5ts 7#a7 ,public ,heal? ,s]vice ,act ,"p ,d ( title ,,xxvii ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #cjj;gg-#aaa et seq47 is am5d$ by add+ at ! end ! foll[+3 #bgii;,a-#aa4 ,hone/ bill+ requirem5ts applicable to plans & issu]s ,a gr\p heal? plan or heal? insurance issu] (f]+ gr\p or individual heal? insurance cov]age may n pay a claim = items & s]vices furni%$ on or aft] ,janu>y #a1 #bjbf1 to an individual at an (f-campus outpati5t dep>tm5t ( a provid] 7z def9$ 9 section #bgii;,b-#aj7;b777 submitt$ by a heal? c>e provid] or facility unless su* claim submitt$ by su* provid] or facility includes a sep>ate unique heal? id5tifi] = ! dep>tm5t :]e items & s]vices 7 furni%$1 9 accordance ) section #bgii;,b-#aj4 4 7#b7 ,employee ,retirem5t ,income ,security ,act ( #aigd 7,a7 ,9 g5]al ,subp>t ,b ( "p #g ( subtitle ,b ( title ,i ( ! ,employee ,retirem5t ,income ,security ,act ( #aigd 7#bi ,u4,s4,c4 #aahe et seq47 is am5d$ by add+ at ! end ! foll[+3 #gbf4 ,hone/ bill+ requirem5ts applicable to plans & issu]s ,a gr\p heal? plan or heal? insurance issu] (f]+ gr\p heal? insurance cov]age may n pay a claim = items & s]vices furni%$ on or aft] ,janu>y #a1 #bjbf1 to an individual at an (f-campus outpati5t dep>tm5t ( a provid] 7z def9$ 9 section #bgii;,b-#aj7;b77 ( ! ,public ,heal? ,s]vice ,act7 submitt$ by a heal? c>e provid] or facility unless su* claim submitt$ by su* provid] or facility includes a sep>ate unique heal? id5tifi] = ! dep>tm5t :]e items & s]vices 7 furni%$1 9 accordance ) section #bgii;,b-#aj ( su* ,act4 4 7,b7 ,cl]ical am5dm5t ,! table ( cont5ts 9 section #a ( ! ,employee ,retirem5t ,income ,security ,act ( #aigd 7#bi ,u4,s4,c4 #ajja et seq47 is am5d$ by ins]t+ aft] ! item relat+ to section #gbe ! foll[+ new item3 ,sec4 #gbf4 ,hone/ bill+ requirem5ts applicable to plans & issu]s4 4 7#c7 ,int]nal ,rev5ue ,code ( #aihf 7,a7 ,9 g5]al ,sub*apt] ,b ( *apt] #ajj ( ! ,int]nal ,rev5ue ,code ( #aihf is am5d$ by add+ at ! end ! foll[+3 #ihbf4 ,hone/ bill+ requirem5ts applicable to plans ,a gr\p heal? plan may n pay a claim = items & s]vices furni%$ on or aft] ,janu>y #a1 #bjbf1 to an individual at an (f-campus outpati5t dep>tm5t ( a provid] 7z def9$ 9 section #bgii;,b-#aj7;b77 ( ! ,public ,heal? ,s]vice ,act7 submitt$ by a heal? c>e provid] or facility unless su* claim submitt$ by su* provid] or facility includes a sep>ate unique heal? id5tifi] = ! dep>tm5t :]e items & s]vices 7 furni%$1 9 accordance ) section #bgii;,b-#aj ( su* ,act4 4 7,b7 ,cl]ical am5dm5t ,! table ( sections = sub*apt] ,b ( *apt] #ajj ( ! ,int]nal ,rev5ue ,code ( #aihf is am5d$ by add+ at ! end ! foll[+ new item3 ,sec4 #ihbf4 ,hone/ bill+ requirem5ts applicable to plans4 4 7b7 ,requir+ a sep>ate id5tification numb] & an atte/ation = ea* (f-,campus outpati5t dep>tm5t ( a provid] 7#a7 ,9 g5]al ,"p ,e ( title ,,xxvii ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #cjj;gg-#aca et seq47 is am5d$ by add+ at ! end ! foll[+3 #bgii;,b-#aj4 ,hone/ bill+ requirem5ts applicable to provid]s 7a7 ,requirem5ts relat+ to unique heal? id5tifi]s ,= items & s]vices furni%$1 on or aft] ,janu>y #a1 #bjbf1 at an (f-campus outpati5t dep>tm5t ( a provid] to a p>ticipant1 b5efici>y1 or enrollee ) b5efits "u a gr\p heal? plan or gr\p or individual heal? insurance cov]age (f]$ by a heal? insurance issu]1 a heal? c>e provid] or facility may n submit a claim to ! gr\p heal? plan or heal? insurance issu]1 bill ! p>ticipant1 b5efici>y1 or enrollee1 or hold liable ! p>ticipant1 b5efici>y1 or enrollee1 unless-- 7#a7 su* provid] or facility obta9s a sep>ate unique heal? id5tifi] e/abli%$ = su* dep>tm5t pursuant to section #aagc7;b7 ( ! ,social ,security ,act2 & 7#b7 su* items & s]vices are bill$ us+ ! sep>ate unique heal? id5tifi] e/abli%$ = su* dep>tm5t pursuant to p>agraph 7#a74 7b7 ,(f-,campus outpati5t dep>tm5t ( a provid] ,! t]m (f-campus outpati5t dep>tm5t ( a provid] means a dep>tm5t ( a provid] 7z def9$ 9 section #dac4fe7;a77#b7 ( title #db ( ! ,code ( ,f$]al ,regulations1 z 9 effect on ! date ( ! enactm5t ( ! ,bip>tisan ,prim>y ,c>e & ,heal? ,work=ce ,act7 t is n locat$-- 7#a7 on ! campus 7z def9$ 9 su* section #dac4fe7;a77#b77 ( su* provid]2 or 7#b7 )9 ! di/ance 7describ$ 9 su* def9ition ( campus7 f a remote location ( a hospital 7z def9$ 9 su* section #dac4fe7;a77#b774 7c7 ,process = report+ suspect$ violations ,! ,secret>y %all e/abli% a process "u :i* a suspect$ violation ( ?is section may be report$ to su* ,secret>y4 7d7 ,p5alties ,! ,secret>y may assess a civil monet>y p5alty aga9/ a hospital = a violation "u ?is section 9 an am\nt-- 7#a7 9 ! case ( a hospital ) n m ?an #cj b$s 7z det]m9$ "u section #ahj4ij7;c77#b77;ii77,d7 ( title #de1 ,code ( ,f$]al ,regulations1 z 9 effect on ! date ( ! enactm5t ( ! ,bip>tisan ,prim>y ,c>e & ,heal? ,work=ce ,act 7or any successor regulations771 n to exce$ #cjj p] day t ! violation is ongo+1 z det]m9$ by ! ,secret>y2 & 7#b7 9 ! case ( a hospital ) m ?an #cj b$s 7z s det]m9$71 n to exce$ #e1ejj p] day t ! violation is ongo+1 z det]m9$ by ! ,secret>y4 4 7#b7 ,con=m+ am5dm5t ,section #bgii;,b-#d7;a77#a7 ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #cjj;gg-#acd7;a77#a77 is am5d$ by ins]t+ 7o!r ?an section #bgii;,b-#aj7 aft] ?is "p4 #cjc4 ,bann+ facility fees = c]ta9 s]vices ,"p ,e ( title ,,xxvii ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #cjj;gg-#aca et seq471 z am5d$ by section #cjb7;b71 is fur!r am5d$ by add+ at ! end ! foll[+3 #bgii;,b-#aa4 ,bann+ facility fees = c]ta9 s]vices 7a7 ,9 g5]al ,) respect to applicable items & s]vices furni%$ to an individual on or aft] ,janu>y #a1 #bjbf1 a heal? c>e provid] or facility may n *>ge a facility fee 7reg>dless ( h[ ! fee is label$7 to a gr\p heal? plan1 a heal? insurance issu] (f]+ gr\p or individual heal? insurance cov]age1 a p>ticipant1 b5efici>y1 or enrollee 9 su* a plan or cov]age1 or an individual pati5t :o is n cov]$ by a gr\p heal? plan1 heal? insurance cov]age1 or a ,f$]al heal? c>e program 7z def9$ 9 section #aabh7;f7 ( ! ,social ,security ,act74 7b7 ,applicable items & s]vices ,9 ?is section1 ! t]m applicable items & s]vices means-- 7#a7 evaluation & managem5t s]vices describ$ 9 section #ahcc7;cc77#a77;,b77i7 ( ! ,social ,security ,act2 7#b7 outpati5t behavioral heal? s]vices 7n includ+ p>tial hospitalizations1 int5sive outpati5t program s]vices1 & o!r s]vices n typically provid$ 9 an (fice sett+ 7z ! ,secret>y may det]m9e772 & 7#c7 any items & s]vices 7includ+ ! items & s]vices describ$ 9 p>agraphs 7#a7 & 7#b77 furni%$ via teleheal?4 4 #cjd4 ,prev5tion & ,public ,heal? ,fund ,section #djjb7;b7 ( ! ,pati5t ,protection & ,af=dable ,c>e ,act 7#db ,u4,s4,c4 #cjju-#aa7;b77 is am5d$ by /rik+ p>agraphs 7#h7 ?r\gh 7#aj7 & ins]t+ ! foll[+3 7#h7 = ea* ( fiscal ye>s #bjbf & #bjbg1 #a1dbe1jjj1jjj2 7#i7 = ea* ( fiscal ye>s #bjbh & #bjbi1 #a1die1jjj1jjj2 7#aj7 = fiscal ye> #bjcj1 #a1fhj1jjj1jjj2 & 7#aa7 = fiscal ye> #bjca & ea* fiscal ye> !reaft]1 #b1jjj1jjj1jjj4 4