80(R) SB 31 - 2nd reading F1 (S)



	
Amend CSSB 31 (Senate committee printing) by striking all 
below the enacting clause and substituting the following:
	SECTION 1.  Chapter 487, Government Code, is amended by 
adding Subchapter P to read as follows:

SUBCHAPTER P.  RURAL PHYSICIAN AND DENTIST
LOAN REPAYMENT PROGRAM
	Sec. 487.701.  DEFINITION.  In this subchapter, "rural 
medically or dentally underserved area" means a predominantly rural 
geographic area in this state that the office by rule designates as 
being underserved with respect to available medical or dental care.
	Sec. 487.702.  LOAN REPAYMENT PROGRAM.  In accordance with 
this subchapter and rules adopted by the executive committee, the 
office shall establish and administer a program to provide loan 
repayment assistance to physicians and dentists who agree to:
		(1)  practice medicine or dentistry, as applicable, in 
a rural medically or dentally underserved area; and
		(2)  provide medical or dental services, as applicable, 
in that area to children who are recipients under the medical 
assistance program operated under Chapter 32, Human Resources Code.
	Sec. 487.703.  ELIGIBILITY.  To be eligible to receive loan 
repayment assistance under this subchapter, a physician or dentist 
must:
		(1)  apply to the office;                                              
		(2)  be licensed to practice medicine or dentistry, as 
applicable, in this state; and
		(3)  enter into an agreement with the office as 
provided by Section 487.705.
	Sec. 487.704.  ELIGIBLE LOANS.  (a)  The office may provide 
repayment assistance for the repayment of any education loan 
received by the physician or dentist through any lender for 
education at any medical or dental school authorized by the Texas 
Higher Education Coordinating Board to award a degree that 
satisfies the medical or dental study requirements for licensure as 
a physician or dentist in this state.
	(b) The office may not provide repayment assistance for an 
education loan that is in default at the time of the physician's or 
dentist's application.
	Sec. 487.705.  AGREEMENT REQUIREMENTS.  (a)  To qualify for 
loan repayment assistance under this section, a person must enter 
into a written agreement with the office as provided by this 
section.  The agreement must:
		(1)  specify the conditions the person must satisfy to 
receive repayment assistance;
		(2)  require the person to practice medicine or 
dentistry for at least three years in a rural medically or dentally 
underserved area and to provide medical or dental services, as 
applicable, in that area during that period to children who are 
recipients under the medical assistance program operated under 
Chapter 32, Human Resources Code;
		(3)  provide that any repayment assistance the person 
receives under this subchapter constitutes a loan until the person 
completes the three years of practice and satisfies other 
applicable conditions of the agreement; and
		(4)  require the person to sign a promissory note 
acknowledging the conditional nature of the repayment assistance 
received and promising to repay the amount of that assistance plus 
applicable interest and reasonable collection costs if the person 
does not satisfy the applicable conditions.
	(b)  The office shall determine the terms of the promissory 
note required by Subsection (a)(4).  To the extent practicable, the 
terms must be the same as those applicable to state or federally 
guaranteed student loans made at the same time.
	(c)  The Health and Human Services Commission shall provide 
any information requested by the office necessary for the office to 
confirm a physician's or dentist's compliance with the requirement 
under Subsection (a)(2) that the physician or dentist provide 
services to children who are recipients of the medical assistance 
program operated under Chapter 32, Human Resources Code.
	Sec. 487.706.  REPAYMENT.  (a)  The office shall deliver any 
repayment assistance made under this subchapter in a lump sum 
payable to the lender and the physician or dentist, as applicable, 
and in accordance with any applicable federal law.
	(b)  Loan repayment assistance received under this 
subchapter may be applied to the principal amount of the loan and to 
interest that accrues.
	Sec. 487.707.  GRANTS, GIFTS, AND DONATIONS.  In addition to 
funds appropriated by the legislature, the office may solicit and 
accept grants, gifts, and donations from any public or private 
source for the purposes of this subchapter.
	Sec. 487.708.  RULES.  (a)  The executive committee shall 
adopt rules necessary to administer this subchapter.
	(b)  The office shall distribute to each medical or dental 
school of a public or private institution of higher education in 
this state a copy of the rules adopted under this section.
	SECTION 2.  Subchapter B, Chapter 531, Government Code, is 
amended by adding Section 531.02114 to read as follows:
	Sec. 531.02114.  ENHANCED REIMBURSEMENT RATES FOR CERTAIN 
MEDICAL ASSISTANCE PROVIDERS.  (a)  In this section, "rural 
medically or dentally underserved area" means an area so designated 
by the Office of Rural Community Affairs for purposes of Subchapter 
P, Chapter 487.
	(b)  In adopting rates for medical assistance payments under 
Chapter 32, Human Resources Code, as required by Section 
531.021(b)(2), the executive commissioner shall establish a 
program under which a physician or dentist who, for at least three 
consecutive years, has provided medical assistance services in a 
rural medically or dentally underserved area to children who are 
recipients under the medical assistance program is paid an enhanced 
reimbursement rate for medical assistance services the physician or 
dentist provides in that area to medical assistance recipients who 
are children.  The enhanced reimbursement rate must be a rate that 
is 10 percent higher than the reimbursement rate the physician or 
dentist would otherwise receive for providing the services if the 
physician or dentist did not qualify for the enhanced reimbursement 
rate under this section.
	SECTION 3.  It is the intent of the legislature that a 
portion of the amounts appropriated in the General Appropriations 
Act for the state fiscal biennium beginning September 1, 2007, to 
implement specialized targeted initiatives and any other 
requirements specified in the final settlement agreement in the 
case styled Frew, on behalf of her daughter, Frew, et al. v. 
Hawkins, Commissioner, Texas Health and Human Services Commission, 
et al., approved by the United States District Court, Eastern 
District of Texas, shall be used to implement the rural physician 
and dentist loan repayment program under Subchapter P, Chapter 487, 
Government Code, as added by this Act.
	SECTION 4.  The executive committee of the Office of Rural 
Community Affairs shall adopt rules for the rural physician and 
dentist loan repayment program under Subchapter P, Chapter 487, 
Government Code, as added by this Act, not later than December 31, 
2007.
	SECTION 5.  If before implementing any provision of this Act 
a state agency determines that a waiver or authorization from a 
federal agency is necessary for implementation of that provision, 
the agency affected by the provision shall request the waiver or 
authorization and may delay implementing that provision until the 
waiver or authorization is granted.
	SECTION 6.  (a)  Except as provided by Subsection (b) of this 
section, this Act takes effect immediately if it receives a vote of 
two-thirds of all the members elected to each house, as provided by 
Section 39, Article III, Texas Constitution.  If this Act does not 
receive the vote necessary for immediate effect, this Act takes 
effect September 1, 2007.
	(b)  Section 2 of this Act takes effect December 31, 2007.