
From the U.S. Code Online via GPO Access
[wais.access.gpo.gov]
[Laws in effect as of January 23, 2000]
[Document not affected by Public Laws enacted between
  January 23, 2000 and December 4, 2001]
[CITE: 42USC292s]

 
                 TITLE 42--THE PUBLIC HEALTH AND WELFARE
 
                    CHAPTER 6A--PUBLIC HEALTH SERVICE
 
               SUBCHAPTER V--HEALTH PROFESSIONS EDUCATION
 
                          Part A--Student Loans
 
           subpart ii--federally-supported student loan funds
 
Sec. 292s. Medical schools and primary health care


(a) Requirements for students

                           (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 the school will make a loan from such fund to a 
    student only if the student agrees--
            (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 through the date on which the 
        loan is repaid in full.

               (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) 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 18 percent per year beginning on the date of such noncompliance.

                             (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; \1\ 
    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.
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    \1\ So in original. The semicolon probably should be a comma.
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                    (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.

(c) Definitions

    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) of this section.
        (3) The term ``exempt school contribution'' means a school 
    contribution described in subclause (II) of subsection (a)(2)(A)(ii) 
    of this section.
        (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.

(July 1, 1944, ch. 373, title VII, Sec. 723, as added Pub. L. 102-408, 
title I, Sec. 102, Oct. 13, 1992, 106 Stat. 2015; amended Pub. L. 103-
43, title XX, Sec. 2014(c), June 10, 1993, 107 Stat. 216; Pub. L. 105-
392, title I, Sec. 131, Nov. 13, 1998, 112 Stat. 3574.)


                            Prior Provisions

    A prior section 723 of act July 1, 1944, was classified to section 
293c of this title prior to the general revision of this subchapter by 
Pub. L. 102-408.


                               Amendments

    1998--Subsec. (a)(3). Pub. L. 105-392, Sec. 131(b), reenacted 
heading without change and amended text of par. (3) generally. Prior to 
amendment, text read as follows: ``Each agreement entered into with a 
student pursuant to paragraph (1) shall provide that, if the student 
fails to comply with the agreement--
        ``(A) the balance due on the loan involved will be immediately 
    recomputed from the date of issuance at an interest rate of 12 
    percent per year, compounded annually; and
        ``(B) the recomputed balance will be paid not later than the 
    expiration of the 3-year period beginning on the date on which the 
    student fails to comply with the agreement.''
    Subsec. (b)(1). Pub. L. 105-392, Sec. 131(a), substituted ``4 years 
before'' for ``3 years before''.
    Subsecs. (c), (d). Pub. L. 105-392, Sec. 131(c), redesignated 
subsec. (d) as (c) and struck out heading and text of subsec. (c). Text 
read as follows: ``The Secretary shall each fiscal year submit to the 
Committee on Energy and Commerce of the House of Representatives, and 
the Committee on Labor and Human Resources of the Senate, a report 
regarding the administration of this section, including the extent of 
compliance with the requirements of this section, during the preceding 
fiscal year.''
    1993--Subsec. (a)(4). Pub. L. 103-43, Sec. 2014(c)(1), added par. 
(4).
    Subsec. (b)(1). Pub. L. 103-43, Sec. 2014(c)(2)(A), substituted 
``1997;'' for ``1994,'' and ``3 years before'' for ``4 years before''.
    Subsec. (b)(2)(B). Pub. L. 103-43, Sec. 2014(c)(2)(B), substituted 
``25 percent'' for ``15 percent''.
    Subsec. (b)(4)(B). Pub. L. 103-43, Sec. 2014(c)(2)(C), substituted 
``1997'' for ``1994'' in cl. (i) and ``1998'' for ``1995'' in cl. (ii).

                  Section Referred to in Other Sections

    This section is referred to in sections 292r, 292t, 292y, 295o-1 of 
this title.
