,i  #aai? ,,congress  #b;d ,session  ,h4
 ,r4 #hfbi  ,,9 ,,! ,,h\se ,,(          
,,repres5tatives  ,april #cj1 #bjbf,mr4 
,ruiz 7= himself & ,mr4 ,bilirakis7     
introduc$ ! foll[+ bill2 :i* 0 ref]r$ to
 ! ,committee on ,en]gy & ,comm]ce1 & 9 
addition to ! ,committee on ,ways &     
,means1 = a p]iod to be subsequ5tly     
det]m9$ by ! ,speak]1 9 ea* case =      
consid]ation ( su* provisions z fall )9 
! jurisdiction ( ! committee conc]n$  ,a
 ,,bill  ,to /r5g!n recruitm5t1 tra9+1 &
 ret5tion ( ! heal? c5t] work=ce to     
improve access to c>e & heal? outcomes 9
 rural & und]s]v$ communities1 & = o!r  
purposes4  #a4 ,%ort title ,?is ,act may
 be cit$ z ! ,develop+ ! ,community     
,heal? ,work=ce ,act ( #bjbf4  #b4      
,improv+ recruitm5t & ret5tion ( ,f$]al 
qualifi$ heal? c5t] /aff  7a7 ,priority 
to ,f,q,h,cs & rural heal? cl9ics       
,section #ccc7;a7 ( ! ,public ,heal?    
,s]vice ,act 7#db ,u4,s4,c4 #bed;f7a77  
is am5d$ by add+ at ! end ! foll[+3     
7#d7 ,9 approv+ applications = assignm5t

 ( memb]s ( ! ,corps1 ! ,secret>y %all1 
not)/&+ p>agraph 7#c71 give priority to 
applications ) respect to heal?         
pr(essional %ortage areas t are ,f$]ally
 qualifi$ heal? c5t]s & rural heal?     
cl9ics1 z def9$ 9 section #ahfa7;aa7 ( !
 ,social ,security ,act4  4  7b7 ,loan  
repaym5t program  7#a7 ,9 g5]al ,!      
,secret>y ( ,heal? & ,human ,s]vices    
%all aw>d grants to ,f$]ally qualifi$   
heal? c5t]s 7z def9$ 9 section          
#ahfa7;aa7 ( ! ,social ,security ,act   
7#db ,u4,s4,c4 #aciex7aa777 = ! purpose 
( address+ heal? pr(essional work=ce    
%ortages by mak+ loan repaym5ts on      
behalf ( heal? c>e pr(essionals s]v+ at 
su* c5t]s4  7#b7 ,applications ,to seek 
a grant "u p>agraph 7#a71 a ,f$]ally    
qualifi$ heal? c5t] %all submit an      
application to ! ,secret>y ( ,heal? &   
,human ,s]vices at su* "t1 9 su* mann]1 
& conta9+ su* in=mation z ! ,secret>y   
may require4 ,at a m9imum1 su* an       
application %all include-- 7,a7 a       
description ( ! c5t]'s capacity to      

address specific regional work=ce       
%ortages1 support$ by data2  7,b7 a plan
 = mak+ loan repaym5ts z describ$ 9     
p>agraph 7#a72 &  7,c7 a description ( !
 c5t]'s use ( an int]discipl9>y approa* 
to c>e 7su* z ?r\gh ! use ( teams to    
provide c>e t include physicians1       
nurses1 social work]s1 community heal?  
work]s1 ph>maci/s1 & o!r heal? c>e      
pr(essionals74  #c4 ,community ,heal?   
,c5t] ,work=ce ,pipel9e ,program  7a7   
,grants ,to recruit1 tra91 & reta9 a    
community-,bas$ heal? c5t] work=ce  7#a7
  ,9 g5]al  ,section #ccj ( ! ,public   
,heal? ,s]vice ,act 7#db ,u4,s4,c4      
#bed;b7 is am5d$--  7,a7 by r$esignat+  
subsection 7r7 z subsection 7u72 &  7,b7
 by ins]t+ aft] subsection 7q7 ! foll[+ 
new subsection3  7r7  ,recruit+1 tra9+1 
& reta9+ a community-,bas$ work=ce  ,!  
,secret>y may aw>d grants to heal? c5t]s
 = ! purpose ( assi/+ su* c5t]s 9--     
7#a7 recruit+ & hir+ /aff ) ! skills &  
exp]i5ce necess>y to effectively s]ve   
heal? c5t] pati5t populations 9 rural & 

und]s]v$ areas2 &  7#b7 support+ c>e]   
advancem5t & work=ce developm5t         
opportunities = su* /aff4  4  7b7       
,f,q,h,cs deem$ eligible ,to regi/] z   
appr5tice%ip program  ,n lat] ?an #ahj  
days aft] ! date ( ! enactm5t ( ?is     
,act1 ! ,secret>y ( ,labor %all revise !
 regulations "u "p #bi ( title #bi1     
,code ( ,f$]al ,regulations1 z 9 effect 
on ! date ( ! enactm5t ( ?is ,act1 s t  
,f$]ally qualifi$ heal? c5t]s 7z def9$ 9
 section #ahfa7;aa7 ( ! ,social         
,security ,act 7#db ,u4,s4,c4           
#aciex7aa777 are eligible to regi/] z   
appr5tice%ip programs "u su* "p4  7c7   
,heal? c5t]s c>e] opportunities ,section
 #ccj ( ! ,public ,heal? ,s]vice ,act   
7#db ,u4,s4,c4 #bed;b7 is fur!r am5d$ by
 ins]t+ aft] subsection 7r71 z ins]t$ by
 subsection 7a7 ( ?is section1 ! foll[+3
  7s7 ,heal? c5t]s c>e] opportunities   
7#a7 ,9 g5]al ,! ,secret>y may aw>d     
grants to in/itutions ( high] education1
 includ+ community colleges &           
m9ority-s]v+ in/itutions1 to e/abli%    

p>tn]%ips ) "o or m heal? c5t]s fund$ "u
 ?is section = tra9+ /ud5ts 9 heal?     
pr(essions4  7#b7 ,use ( funds  7,a7    
,co/s ,an in/itution ( high] education  
receiv+ a grant "u ?is subsection may   
use ! grant to pay ! co/s ( tra9+1      
includ+ ! sal>y ( ! cl9icians or o!r    
educators :o provide ! tra9+4  7,b7     
,tra9+ support$ ,! tra9+ support$       
pursuant to a grant "u ?is subsection   
may include =mal tra9+ & m5tor%ips4     
7,c7 ,types ( tra9+ ,! types ( tra9+    
support$ pursuant to a grant "u ?is     
subsection may include cl9ical1         
in=mation te*nology1 op]ations1 f9ance1 
or o!r tra9+ = /ud5ts ( heal?           
pr(essions1 z det]m9$ by ! in/itution ( 
high] education receiv+ ! grant 9       
p>tn]%ip ) ! heal? c5t] involv$4  7#c7  
,def9itions ,9 ?is subsection3  7,a7 ,! 
t]m in/itution ( high] education means  
an in/itution ( high] education describ$
 9 subsection 7a7 or 7b7 ( section #aja 
( ! ,high] ,education ,act ( #aife4     
7,b7 ,! t]m m9ority-s]v+ in/itution     

means an in/itution ( high] education   
describ$ 9 section #cga7;a7 ( ! ,high]  
,education ,act ( #aife4  4  7d7        
,behavioral heal? speciali/s ,section   
#ccj ( ! ,public ,heal? ,s]vice ,act    
7#db ,u4,s4,c4 #bed;b7 is fur!r am5d$ by
 ins]t+ aft] subsection 7s71 z ins]t$ by
 subsection 7c7 ( ?is section1 ! foll[+3
  7t7 ,behavioral heal? speciali/s  7#a7
 ,9 g5]al ,! ,secret>y may aw>d grants  
to heal? c5t]s to e/abli%1 op]ate1 or   
exp& tra9+ programs = behavioral heal?  
speciali/s4  7#b7 ,use ( funds ,! tra9+ 
programs = behavioral heal? speciali/s  
support$ pursuant to a grant "u ?is     
subsection may include-- 7,a7 /ip5ds =  
p]sonnel to op]ate ! tra9+ programs2    
7,b7 appr5tice%ip programs2 &  7,c7 o!r 
recruitm5t & ret5tion activities =      
behavioral heal? speciali/s4  4  #d4    
,exp&+ hospital & ,,fqhc p>tn]%ips =    
graduate m$ical education  7a7 ,paym5ts 
to tea*+ heal? c5t]s  7#a7 ,9 g5]al     
,section #cdj;,h ( ! ,public ,heal?     
,s]vice ,act 7#db ,u4,s4,c4 #bef;h7 is  

am5d$-- 7,a7 9 subsection 7a77#a71 by   
ins]t+ 1 or t h 9 effect a cov]$        
agreem5t ) a sponsor+ in/itution s li/$1
 aft] relevant accr$it+ body2 &  7,b7 9 
subsection 7j71 by add+ at ! end !      
foll[+ new p>agraph3  7#e7 ,cov]$       
agreem5t ,! t]m cov]$ agreem5t means a  
writt5 contract1 memor&um ( und]/&+1 or 
o!r writt5 agreem5t ent]$ into = n less 
?an #b ye>s = ! purpose ( conduct+ an   
approv$ graduate m$ical resid5cy tra9+  
program4  4  7#b7 ,effective date ,!    
am5dm5t made by p>agraph 7#a7 %all apply
 ) respect to exp5ses incurr$ on or aft]
 ,octob] #a1 #bjbe4  7b7 ,m$ic>e ,,gme  
cap ,section #ahhf7;h7 ( ! ,social      
,security ,act 7#db ,u4,s4,c4           
#acieww7h77 is am5d$--  7#a7 9          
subsection 7#d77;,f71 by /rik+ & 7#aj7 &
 ins]t+ 7#aj71 & 7#aa72 &  7#b7 by add+ 
at ! end ! foll[+ new p>agraph3  7#aa7  
,tra9+ programs at ,f$]ally qualifi$    
heal? c5t]s  7,a7 ,9 g5]al ,= co/       
report+ p]iods beg9n+ on or aft] ,octob]
 #a1 #bjbe1 9 ! case ( a hospital t has 

an approv$ m$ical resid5cy tra9+ program
 :]e a significant portion ( su* program
 occurs at a ,f$]ally qualifi$ heal?    
c5t] 7z det]m9$ by ! ,secret>y71 !      
,secret>y %all increase ! o!rwise       
applicable resid5t limit = su* hospital 
by #c full-"t equival5t resid5cy        
positions4  7,b7 ,def9itions ,9 ?is     
p>agraph3  7i7 ,o!rwise applicable      
resid5t limit ,! t]m o!rwise applicable 
resid5t limit means1 ) respect to a     
hospital1 ! limit o!rwise applicable "u 
subp>agraphs 7,f77i7 & 7,h7 ( p>agraph  
7#d7 on ! resid5t level = ! hospital    
det]m9$ )\t reg>d to ?is p>agraph b tak+
 into acc\nt p>agraphs 7#g77;,a71       
7#g77;,b71 7#h77;,a71 7#h77;,b71        
7#i77;,a71 & 7#aj77;,a74  7ii7 ,resid5t 
level ,! t]m resid5t level has ! mean+  
giv5 su* t]m 9 p>agraph 7#g77;,c77i74  4
  #e4 ,exp&+ ,,fqhc s]vices  7a7        
,behavioral heal? pr(essional & case    
manag] s]vices  7#a7 ,m$ic>e ,section   
#ahfa7;aa7 ( ! ,social ,security ,act   
7#db ,u4,s4,c4 #aciex7aa77 is am5d$--   

7,a7 9 p>agraph 7#a7--  7i7 9           
subp>agraph 7,b71 by ins]t+ su* s]vices 
furni%$ on or aft] ,octob] #a1 #bjbe1 by
 a behavioral heal? consultant1 pe]     
support speciali/1 or o!r behavioral    
heal? pr(essional 7z su* t]ms are def9$ 
by ! ,secret>y71 be=e & su* s]vices2    
7ii7 9 subp>agraph 7,c71 by /rik+ & at !
 end2  7iii7 9 subp>agraph 7,d71 by     
/rik+ ! comma at ! end & ins]t+ 1 &2 &  
7iv7 by ins]t+ aft] subp>agraph 7,d7 !  
foll[+ new subp>agraph3  7,e7 case      
managem5t s]vices furni%$ on or aft]    
,octob] #a1 #bjbe1 by a case manag] 7z  
def9$ by ! ,secret>y71  2 &  7,b7 9     
p>agraph 7#c77;,a71 by /rik+ 7,d7 &     
ins]t+ 7,e74  7#b7 ,m$icaid ,section    
#aije7l77#b77;,a7 ( ! ,social ,security 
,act 7#db ,u4,s4,c4 #acif;d7l77#b77;,a77
 is am5d$ by ins]t+ & 7,e7 be=e (       
section4  7b7 ,guidance on ,/ate        
,m$icaid paym5ts to ,f,q,h,cs ,section  
#aijb7;bb7 ( ! ,social ,security ,act   
7#db ,u4,s4,c4 #acif;a7bb77 is am5d$ by 
add+ at ! end ! foll[+ new p>agraph3    

7#g7 ,/udy & guidance on paym5t         
adju/m5ts ,n lat] ?an ,octob] #a1 #bjbe1
 & n less frequ5tly ?an annually        
!reaft]1 ! ,secret>y %all--  7,a7       
conduct a /udy on any diff]5ces 9 !     
me?ods by :i* ,/ate plans adju/ ! paym5t
 am\nt "u p>agraph 7#c7 = s]vices       
furni%$ dur+ a fiscal ye>2 &  7,b7 bas$ 
on ! results ( ! /udy conduct$ "u       
subp>agraph 7,a71 issue guidance to     
,/ate plans on be/ practices = adju/+ ! 
paym5t am\nt "u p>agraph 7#c7 = s]vices 
furni%$ dur+ a fiscal ye>4  4