BILL ANALYSIS

H.B. 4324

By: Chisum

Public Health

Committee Report (Unamended)

BACKGROUND AND PURPOSE

Over a hundred Texas counties are considered full primary care health professional shortage areas and nearly 20 more are partial shortage areas, with approximately one in five Texans living in a full or partial shortage area. The national average for the ratio of primary care physicians to people is 81 per 100,000; in Texas the ratio is 68 per 100,000. By 2015, Texas will need more than 45,000 additional primary care physicians and other health care providers to care for the state's underserved population.

H.B. 4324 increases access to the physician education loan repayment assistance program administered by the Texas Higher Education Coordinating Board.  Specifically the bill increases eligibility to include physicians who provide services at either a hospital or clinic where at least half of the patients are uninsured or receive Medicaid, or at a public hospital, thus adding a new group to the existing list of eligible physicians.

RULEMAKING AUTHORITY

It is the committee's opinion that rulemaking authority is expressly granted to the Texas Higher Education Coordinating Board in SECTIONS 1, 2, and 4 of this bill.

ANALYSIS

H.B. 4324 amends the Education Code to add an eligibility category for student loan repayment assistance for a physician who has completed at least one year of medical practice in primary care or in a medical specialty of acute physician shortage, as determined by the Texas Higher Education Coordinating Board in consultation with the Department of State Health Services, and in a hospital or clinic with a patient population of whom at least 50 percent are uninsured or receive Medicaid or a public hospital.  The bill adds as a condition for physician eligibility for student loan repayment assistance that the physician graduated from a medical school of an institution of higher education.   The bill adds physicians practicing on a part time basis in primary care or in a medical specialty of acute physician shortage in certain facilities to the physicians for which the Texas Higher Education Coordinating Board is authorized to adopt rules to provide for student loan repayment assistance on a pro rata basis.

H.B. 4324 clarifies that rules adopted by the coordinating board relating to the maximum amount of repayment assistance that may be received by a physician in one year provide that the maximum amount of repayment assistance that may be received in one year by a physician who establishes eligibility as a physician in primary care or in a medical specialty of acute physician shortage and in certain facilities may not exceed 33 percent of the total amount of the physician's eligible loans, or $35,000, whichever amount is less.  The bill clarifies that the rules adopted by the coordinating board authorizing the Family Practice Residency Advisory Committee to establish priorities among eligible physicians for repayment assistance include consideration of whether the physician is or will be providing service in an economically depressed or rural medically underserved area or in primary care or in a medical specialty of acute physician shortage and in certain facilities.  The bill adds to the rules the coordinating board is required to adopt rules that will administer the student loan repayment assistance program in a manner that maximizes any matching funds available through the National Health Service Corps program of the United States Department of Health and Human Services. The bill makes conforming changes.

H.B. 4324 requires the coordinating board to adopt rules necessary to administer provisions of the bill as soon as practicable after the effective date of the bill.

EFFECTIVE DATE

On passage, or, if the act does not receive the necessary vote, the act takes effect September 1, 2009.