42 U.S.C. § 292s — Medical schools and primary health care

submitted 82 years ago by Pub. L. 102-408 to r/title-42-THE-PUBLIC-HEALTH-AND-WELFARE · 1,596 words · no verdicts yet

in plain englishAI-generated · not legal advice

Medical and osteopathic schools with these loan funds face special rules. Borrowing students who take these loans must train in and then practice primary care. Schools that don't graduate enough primary-care doctors must pay a penalty, though students can get hardship waivers.

(a) Requirements for students: (1) In general: If a medical or osteopathic school has a loan fund under section 292q, its agreement must also require that any student who gets a loan agrees to two things: (A) start and finish a primary-care residency within 4 years of graduating; and (B) practice primary care for 10 years — counting the residency — or until the loan is fully repaid, whichever comes first. (2) Inapplicability to certain students: (A) This requirement does not apply if (i) the student's first loan from the fund was made before July 1, 1993; or (ii) the loan came from an "exempt" federal or matching school contribution — money tied to appropriations under section 292t(f). (B) A federal contribution is not "exempt" if it came from money appropriated before October 1, 1990; the same goes for a school's matching contribution tied to such an early federal contribution. (3) Noncompliance by student: If a student breaks this agreement, the loan's interest rate goes up by 2 percentage points above what a compliant student would pay that year. (4) Waivers: (A) The Secretary must partly or fully waive or suspend a student's obligation whenever following it is impossible or would cause extreme hardship, and enforcing it would be unfair. (B) The obligation is automatically waived if the student's enrollment ends before graduation — whether by choice or not — and the student never resumes at that school or starts at another medical or osteopathic school. (C) If the student does resume or start elsewhere, the obligation is only suspended (paused) for the time they were not enrolled. (D) None of this waives or suspends the separate duty to actually repay the loan itself under section 292r. (b) Requirements for schools: (1) In general: Each school's agreement must also require that, for the year ending June 30, 1997, and every year after that, the school meet at least one of the conditions in paragraph (2), measured against students who graduated about 4 years before that year ended. (2) Description of conditions — a school meets this rule if: (A) at least 50 percent of those graduates are either doing a primary-care residency, or, having finished one, are practicing primary care; or (B) at least 25 percent meet that same standard, and that percentage is at least 5 points higher than the school's percentage the year before; or (C) the school ranks at or above the 75th percentile among all schools with these loan funds, based on this same standard. (3) Determinations by Secretary: Within 90 days after each 1-year period ends, the Secretary decides whether the school complied and tells the school in writing, after reviewing the school's report (see paragraph (6)). (4) Noncompliance by school: (A) If a school misses the target for a year, its agreement requires it to (I) pay the Secretary the amount set in (B), and (II) pay within 90 days of being told about the failure. This payment can come out of the school's own loan fund. (B) The amount owed depends on the year: 10 percent of the loan fund's income for the year ending June 30, 1997; 20 percent for the year ending June 30, 1998; and 30 percent for every year after that. (C) In figuring "income" for this payment, the Secretary leaves out any income from exempt contributions (see subsection (c)), and a school cannot pay this penalty using exempt-contribution money either. (5) Expenditure of payments: (A) Money the Secretary collects this way gets used to make new federal contributions to the loan funds of schools that are complying. (B) That new money is not treated as an "exempt" contribution. (6) Reports by schools: Each school's agreement must require it to send the Secretary a yearly report with whatever information the Secretary needs, including statistics on the training or practice status of the graduates from about 4 years earlier. (c) Definitions: (1) "Exempt contributions" means exempt Federal capital contributions plus exempt school contributions. (2) "Exempt Federal capital contribution" means the kind described in subsection (a)(2)(A)(ii)(I). (3) "Exempt school contribution" means the kind described in subsection (a)(2)(A)(ii)(II). (4) "Income," for a loan fund, means principal and interest payments on its loans plus any other money the fund earns. (5) "Primary health care" means family medicine, general internal medicine, general pediatrics, preventive medicine, or osteopathic general practice. (d) Sense of Congress: It is Congress's view that money repaid under this loan program should stay in the program — not go to the U.S. Treasury or be used for any other purpose.

the actual law source: uscode.house.gov ↗public domain

(a) Requirements for students

(1) In general

(A)

to enter and complete a residency training program in primary health care not later than 4 years after the date on which the student graduates from such school; and

(B)

to practice in such care for 10 years (including residency training in primary health care) or through the date on which the loan is repaid in full, whichever occurs first.

(2) Inapplicability to certain students

(A)

The requirement established in paragraph (1) regarding the student loan fund of a school does not apply to a student if—

(i)

the first loan to the student from such fund is made before July 1, 1993; or

(ii)

the loan is made from—

(I)

a Federal capital contribution under section 292q of this title that is made from amounts appropriated under section 292t(f) 1 of this title (in this section referred to as an “exempt Federal capital contribution”); or

(II)

a school contribution made under section 292q of this title pursuant to such a Federal capital contribution (in this section referred to as an “exempt school contribution”).

(B)

A Federal capital contribution under section 292q of this title may not be construed as being an exempt Federal capital contribution if the contribution was made from amounts appropriated before October 1, 1990. A school contribution under section 292q of this title may not be construed as being an exempt school contribution if the contribution was made pursuant to a Federal capital contribution under such section that was made from amounts appropriated before such date.

(3) Noncompliance by student

Each agreement entered into with a student pursuant to paragraph (1) shall provide that, if the student fails to comply with such agreement, the loan involved will begin to accrue interest at a rate of 2 percent per year greater than the rate at which the student would pay if compliant in such year.

(4) Waivers

(A)

With respect to the obligation of an individual under an agreement made under paragraph (1) as a student, the Secretary shall provide for the partial or total waiver or suspension of the obligation whenever compliance by the individual is impossible, or would involve extreme hardship to the individual, and if enforcement of the obligation with respect to the individual would be unconscionable.

(B)

For purposes of subparagraph (A), the obligation of an individual shall be waived if—

(i)

the status of the individual as a student of the school involved is terminated before graduation from the school, whether voluntarily or involuntarily; and

(ii)

the individual does not, after such termination, resume attendance at the school or begin attendance at any other school of medicine or osteopathic medicine.

(C)

If an individual resumes or begins attendance for purposes of subparagraph (B), the obligation of the individual under the agreement under paragraph (1) shall be considered to have been suspended for the period in which the individual was not in attendance.

(D)

This paragraph may not be construed as authorizing the waiver or suspension of the obligation of a student to repay, in accordance with section 292r of this title, loans from student loan funds under section 292q of this title.

(b) Requirements for schools

(1) In general

Subject to the provisions of this subsection, in the case of student loan funds established under section 292q of this title by schools of medicine or osteopathic medicine, each agreement entered into under such section with such a school shall provide (in addition to the provisions required in subsection (b) of such section) that, for the 1-year period ending on June 30, 1997; 2 and for the 1-year period ending on June 30 of each subsequent fiscal year, the school will meet not less than 1 of the conditions described in paragraph (2) with respect to graduates of the school whose date of graduation from the school occurred approximately 4 years before the end of the 1-year period involved.

(2) Description of conditions

With respect to graduates described in paragraph (1) (in this paragraph referred to as “designated graduates”), the conditions referred to in such paragraph for a school for a 1-year period are as follows:

(A)

Not less than 50 percent of designated graduates of the school meet the criterion of either being in a residency training program in primary health care, or being engaged in a practice in such care (having completed such a program).

(B)

Not less than 25 percent of the designated graduates of the school meet such criterion, and such percentage is not less than 5 percentage points above the percentage of such graduates meeting such criterion for the preceding 1-year period.

(C)

In the case of schools of medicine or osteopathic medicine with student loans funds under section 292q of this title, the school involved is at or above the 75th percentile of such schools whose designated graduates meet such criterion.

(3) Determinations by Secretary

Not later than 90 days after the close of each 1-year period described in paragraph (1), the Secretary shall make a determination of whether the school involved has for such period complied with such paragraph and shall in writing inform the school of the determination. Such determination shall be made only after consideration of the report submitted to the Secretary by the school under paragraph (6).

(4) Noncompliance by school

(A)

(i)

Subject to subparagraph (C), each agreement under section 292q of this title with a school of medicine or osteopathic medicine shall provide that, if the school fails to comply with paragraph (1) for a 1-year period under such paragraph, the school—

(I)

will pay to the Secretary the amount applicable under subparagraph (B) for the period; and

(II)

will pay such amount not later than 90 days after the school is informed under paragraph (3) of the determination of the Secretary regarding such period.

(ii)

Any amount that a school is required to pay under clause (i) may be paid from the student loan fund of the school under section 292q of this title.

(B)

For purposes of subparagraph (A), the amount applicable for a school, subject to subparagraph (C), is—

(i)

for the 1-year period ending June 30, 1997, an amount equal to 10 percent of the income received during such period by the student loan fund of the school under section 292q of this title;

(ii)

for the 1-year period ending June 30, 1998, an amount equal to 20 percent of the income received during such period by the student loan fund; and

(iii)

for any subsequent 1-year period under paragraph (1), an amount equal to 30 percent of the income received during such period by the student loan fund.

(C)

In determining the amount of income that a student loan fund has received for purposes of subparagraph (B), the Secretary shall exclude any income derived from exempt contributions. Payments made to the Secretary under subparagraph (A) may not be made with such contributions or with income derived from such contributions.

(5) Expenditure of payments

(A)

Amounts paid to the Secretary under paragraph (4) shall be expended to make Federal capital contributions to student loan funds under section 292q of this title of schools that are in compliance with paragraph (1).

(B)

A Federal capital contribution under section 292q of this title may not be construed as being an exempt Federal capital contribution if the contribution is made from payments under subparagraph (A). A school contribution under such section may not be construed as being an exempt school contribution if the contribution is made pursuant to a Federal capital contribution from such payments.

(6) Reports by schools

Each agreement under section 292q of this title with a school of medicine or osteopathic medicine shall provide that the school will submit to the Secretary a report for each 1-year period under paragraph (1) that provides such information as the Secretary determines to be necessary for carrying out this subsection. Each such report shall include statistics concerning the current training or practice status of all graduates of such school whose date of graduation from the school occurred approximately 4 years before the end of the 1-year period involved.

For purposes of this section:

(1)

The term “exempt contributions” means exempt Federal capital contributions and exempt school contributions.

(2)

The term “exempt Federal capital contribution” means a Federal capital contribution described in subclause (I) of subsection (a)(2)(A)(ii).

(3)

The term “exempt school contribution” means a school contribution described in subclause (II) of subsection (a)(2)(A)(ii).

(4)

The term “income”, with respect to a student fund under section 292q of this title, means payments of principal and interest on any loan made from the fund, and any other earnings of the fund.

(5)

The term “primary health care” means family medicine, general internal medicine, general pediatrics, preventive medicine, or osteopathic general practice.

(d) Sense of Congress

It is the sense of Congress that funds repaid under the loan program under this section should not be transferred to the Treasury of the United States or otherwise used for any other purpose other than to carry out this section.

Source credit: (July 1, 1944, ch. 373, title VII, § 723, as added Pub. L. 102–408, title I, § 102, Oct. 13, 1992, 106 Stat. 2015; amended Pub. L. 103–43, title XX, § 2014(c), June 10, 1993, 107 Stat. 216; Pub. L. 105–392, title I, § 131, Nov. 13, 1998, 112 Stat. 3574; Pub. L. 111–148, title V, § 5201(a), Mar. 23, 2010, 124 Stat. 606.)

history & why it existsrecord from the source credit

1944Enacted · Pub. L. 102-408 · 106 Stat. 2015
1993Amended · Pub. L. 103-43 · 107 Stat. 216
1998Amended · Pub. L. 105-392 · 112 Stat. 3574
2010Amended · Pub. L. 111-148 · 124 Stat. 606

A history note hasn’t been published yet. The record shows enactment by Pub. L. 102-408 on 1944-07-01.

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