H.R. 4681

119 HR 4681 IH: Specialty Physicians Advancing Rural Care Act
 U.S. House of Representatives
 2025-07-23
 text/xml
 EN
 Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain.
 I
 119th CONGRESS  1st Session
 H. R. 4681
 IN THE HOUSE OF REPRESENTATIVES
 July 23, 2025
  Mr. Joyce of Pennsylvania  (for himself and  Ms. Ross ) introduced the following bill; which was referred to the  Committee on Energy and Commerce
 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 physicians, and for other purposes.
1.
Short title
This Act may be cited as the   Specialty Physicians Advancing Rural Care Act   or the   SPARC Act  .
2.
Specialty medical practitioners workforce in rural communities
Title VII of the Public Health Service Act ( 42 U.S.C. 292 et seq. ) is amended—
(1)
by redesignating part G ( 42 U.S.C. 795j et seq. ) as part H; and
(2)
by inserting after part F ( 42 U.S.C. 295h ) the following new part:
G
Specialty medicine workforce in rural communities
782.
Loan repayment program
(a)
In general
(1)
Program for specialty medicine physicians
The Secretary, acting through the Administrator of the Health Resources and Services Administration, shall carry out a program under which—
(A)
the Secretary enters into agreements with specialty medicine physicians to make payments in accordance with subsection (b) on the principal of and interest on any eligible loans described in subsection (c); and
(B)
the specialty medicine physicians each agree to complete a period of obligated service described in subsection (d) as a specialty medicine physician in the United States in a rural community experiencing a shortage of specialty medicine physicians.
(2)
Program for non-physician specialty health care providers
The Secretary, acting through the Administrator of the Health Resources and Services Administration, may carry out a program under which—
(A)
the Secretary enters into agreements with non-physician specialty health care providers to make payments in accordance with subsection (b) on the principal of and interest on any eligible loans described in subsection (c); and
(B)
the non-physician specialty health care providers each agree to complete a period of obligated service described in subsection (d) as a non-physician specialty health care provider in the United States in a rural community experiencing a shortage of such providers.
(b)
Payments
For each year of obligated service by a specialty medicine physician pursuant to an agreement under subsection (a)(1) or by a non-physician specialty health care provider pursuant to an agreement under subsection (a)(2), the Secretary shall make a payment to such physician or provider as follows:
(1)
Service in shortage area
The Secretary shall pay—
(A)
for each year of obligated service by a specialty medicine physician or non-physician specialty health care provider pursuant to an agreement under paragraph (1) or (2) of subsection (a),  1/6  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 agreement; and
(B)
for completion of the sixth and final year of such service, the remainder of such principal and interest.
(2)
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 $250,000.
(c)
Eligible loans
The loans eligible for repayment under this section are each of the following:
(1)
Any loan for education in specialty medicine or specialty health care.
(2)
Any Federal Direct Stafford Loan, Federal Direct PLUS Loan, Federal Direct Unsubsidized Stafford Loan, or Federal Direct Consolidation Loan (as such terms are used in section 455 of the Higher Education Act of 1965).
(3)
Any Federal Perkins Loan under part E of title I of the Higher Education Act of 1965.
(4)
Any other Federal loan as determined appropriate by the Secretary.
(d)
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 (1) or (2) of subsection (a) shall agree to a 6-year commitment to full-time employment, with no more than 1 year passing between any 2 years of covered employment, as a specialty medicine physician or non-physician specialty health care provider, as applicable, in the United States in a rural community experiencing a shortage of specialty medicine physicians or non-physician specialty health care providers, as applicable.
(e)
Ineligibility for double benefits
No borrower may, for the same service, receive a reduction of loan obligations or a loan repayment under both—
(1)
this section; and
(2)
any federally supported loan forgiveness program, including under section 338B, 338I, or 846 of this Act, or section 428J, 428L, 455(m), or 460 of the Higher Education Act of 1965.
(f)
Breach
(1)
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 (1) or (2) of subsection (a).
(2)
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 agreement, taken alone, shall not constitute a breach of the agreement, 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 section.
(g)
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 providers. Not more than 15 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 providers.
(h)
Reports to Congress
Not later than 5 years after the date of enactment of this section, and not less than every other year thereafter through fiscal year 2033, the Secretary shall report to Congress on—
(1)
the practice location of special medicine physicians and non-physician specialty health care providers participating, or who have participated, in the loan repayment program under this section; and
(2)
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 providers.
(i)
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 providers, as appropriate.
(j)
Definitions
In this section:
(1)
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 services.
(2)
Specialty medicine physician
The term  specialty medicine physician  means a physician practicing in an area of medicine other than primary care.
(k)
Authorization of appropriations
To carry out this section, there are authorized to be appropriated such sums as may be necessary for fiscal years 2025 through 2034.
  .