,,ii #aahth ,,congress #ast ,session ,s4 #gje ,,in ,,the ,,senate ,,of ,,the ,,united ,,states ,march #h1 #bjbc,ms4 ,rosen 7for herself and ,mr4 ,wicker7 introduced the following bill2 which was read twice and referred to the ,committee on ,health1 ,education1 ,labor1 and ,pensions ,a ,,bill ,to amend the ,public ,health ,service ,act to authorize a loan repayment program to encourage specialty medicine physicians to serve in rural communities experiencing a shortage of specialty medicine physicians1 and for other purposes4 #a4 ,short title ,this ,act may be cited as the ,specialty ,physicians ,advancing ,rural ,care ,act or the ,,sparc ,act4 #b4 ,specialty medical practitioners workforce in rural communities ,title ,,vii of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bib et seq47 is amended-- 7#a7 by redesignating part ,g 7#db ,u4,s4,c4 #gie;j et seq47 as part ,h2 and 7#b7 by inserting after part ,f 7#db ,u4,s4,c4 #bie;h7 the following new part3 ,g ,specialty medicine workforce in rural communities #ghb4 ,loan repayment program 7a7 ,in general 7#a7 ,program for specialty medicine physicians ,the ,secretary1 acting through the ,administrator of the ,health ,resources and ,services ,administration1 shall carry out a program under which-- 7,a7 the ,secretary enters into agreements with specialty medicine physicians to make payments in accordance with subsection 7b7 on the principal of and interest on any eligible loans described in subsection 7c72 and 7,b7 the specialty medicine physicians each agree to complete a period of obligated service described in subsection 7d7 as a specialty medicine physician in the ,united ,states in a rural community experiencing a shortage of specialty medicine physicians4 7#b7 ,program for non-physician specialty health care providers ,the ,secretary1 acting through the ,administrator of the ,health ,resources and ,services ,administration1 may carry out a program under which-- 7,a7 the ,secretary enters into agreements with non-physician specialty health care providers to make payments in accordance with subsection 7b7 on the principal of and interest on any eligible loans described in subsection 7c72 and 7,b7 the non-physician specialty health care providers each agree to complete a period of obligated service described in subsection 7d7 as a non-physician specialty health care provider in the ,united ,states in a rural community experiencing a shortage of such providers4 7b7 ,payments ,for each year of obligated service by a specialty medicine physician pursuant to an agreement under subsection 7a77#a7 or by a non-physician specialty health care provider pursuant to an agreement under subsection 7a77#b71 the ,secretary shall make a payment to such physician or provider as follows3 7#a7 ,service in shortage area ,the ,secretary shall pay-- 7,a7 for each year of obligated service by a specialty medicine physician or non-physician specialty health care provider pursuant to an agreement under paragraph 7#a7 or 7#b7 of subsection 7a71 #a_/f of the principal of and interest on each eligible loan of the physician or provider which is outstanding on the date the physician or provider began service pursuant to the agreement2 and 7,b7 for completion of the sixth and final year of such service1 the remainder of such principal and interest4 7#b7 ,maximum amount ,the total amount of payments under this section to any specialty medicine physician or non-physician specialty health care provider shall not exceed #bej1jjj4 7c7 ,eligible loans ,the loans eligible for repayment under this section are each of the following3 7#a7 ,any loan for education in specialty medicine or specialty health care4 7#b7 ,any ,federal ,direct ,stafford ,loan1 ,federal ,direct ,,plus ,loan1 ,federal ,direct ,unsubsidized ,stafford ,loan1 or ,federal ,direct ,consolidation ,loan 7as such terms are used in section #dee of the ,higher ,education ,act of #aife74 7#c7 ,any ,federal ,perkins ,loan under part ,e of title ,i of the ,higher ,education ,act of #aife4 7#d7 ,any other ,federal loan as determined appropriate by the ,secretary4 7d7 ,period of obligated service ,any specialty medicine physician or non-physician specialty health care provider receiving payments under this section as required by an agreement under paragraph 7#a7 or 7#b7 of subsection 7a7 shall agree to a #f-year commitment to full-time employment1 with no more than #a year passing between any #b years of covered employment1 as a specialty medicine physician or non-physician specialty health care provider1 as applicable1 in the ,united ,states in a rural community experiencing a shortage of specialty medicine physicians or non-physician specialty health care providers1 as applicable4 7e7 ,ineligibility for double benefits ,no borrower may1 for the same service1 receive a reduction of loan obligations or a loan repayment under both-- 7#a7 this section2 and 7#b7 any federally supported loan forgiveness program1 including under section #cch;,b1 #cch;,i1 or #hdf of this ,act1 or section #dbh;,j1 #dbh,l1 #dee7m71 or #dfj of the ,higher ,education ,act of #aife4 7f7 ,breach 7#a7 ,liquidated damages formula ,the ,secretary may establish a liquidated damages formula to be used in the event of a breach of an agreement entered into under paragraph 7#a7 or 7#b7 of subsection 7a74 7#b7 ,limitation ,the failure by a specialty medicine physician or a non-physician specialty health care provider to complete the full period of service obligated pursuant to such an agreement1 taken alone1 shall not constitute a breach of the agreement1 so long as the physician or provider completed in good faith the years of service for which payments were made to the physician or provider under this section4 7g7 ,special rules for non-,physician specialty health care providers ,non-physician specialty health care providers participating in the program under this section are not eligible for other ,federal loan forgiveness programs specific to health care providers4 ,not more than #ae percent of amounts made available to carry out this section for a fiscal year may be allocated to awards to non-physician specialty health care providers4 7h7 ,reports to ,congress ,not later than #e years after the date of enactment of this section1 and not less than every other year thereafter through fiscal year #bjca1 the ,secretary shall report to ,congress on-- 7#a7 the practice location of special medicine physicians and non-physician specialty health care providers participating1 or who have participated1 in the loan repayment program under this section2 and 7#b7 the impact of the loan repayment program under this section on the availability of specialty medicine or specialty health care services in the ,united ,states in rural communities experiencing a shortage of specialty medicine physicians or non-physician specialty health care providers4 7i7 ,data updates ,the ,administrator of the ,health ,resources and ,services ,administration shall update publicly available data on the supply of specialty medicine physicians and non-physician specialty health care providers1 as appropriate4 7j7 ,definitions ,in this section3 7#a7 ,non-physician specialty health care provider ,the term non-physician specialty health care provider means a health professional other than a physician who is licensed to provide patient care other than primary care services4 7#b7 ,specialty medicine physician ,the term specialty medicine physician means a physician practicing in-- 7,a7 a specialty identified in the report of the ,health ,resources and ,services ,administration1 titled ,projecting the ,supply of ,non-,primary ,care ,specialty and ,subspecialty ,clinicians3 #bjaj-bjbe2 7,b7 hospice and palliative medicine2 7,c7 geriatric medicine2 or 7,d7 another medical specialty1 if the ,secretary determines that there is evidence demonstrating a significant shortage of providers in the medical specialty and limited patient access to care4 7k7 ,authorization of appropriations ,to carry out this section1 there are authorized to be appropriated such sums as may be necessary for fiscal years #bjbc through #bjcb4 4