Bill S1318-2013

Enhances enforcement of primary care physician loan and scholarship programs

Enhances enforcement of primary care physician loan and scholarship programs by authorizing the commissioner of health to initiate proceedings to suspend the license of a loan repayment award or scholarship recipient who has failed to provide the required primary care service in an underserved area; also authorizes the commissioner to report the amount of such award or scholarship to the department of taxation and finance as income of the recipient.

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  • Jan 8, 2014: REFERRED TO HEALTH
  • Jan 9, 2013: REFERRED TO HEALTH

Memo

BILL NUMBER:S1318

TITLE OF BILL: An act to amend the public health law, in relation to enhanced enforcement of the primary care physician loan and scholarship programs

PURPOSE OR GENERAL IDEA OF BILL: To enforce the provisions of loan and scholarship programs against doctors who are found to have violated agreements to serve as primary care physicians in under-served areas in exchange for subsidized tuition.

SUMMARY OF SPECIFIC PROVISIONS: Subdivision 4 of section 903 of the public health law as amended by chapter 639 of the laws of 1996, is amended to state that any loan or scholarship money shall become due and shall be paid in full upon a determination that the recipient failed to comply with the conditions of the program. The Commissioner of Health shall initiate proceedings that could lead to the suspension of the recipients license to practice medicine in the State of New York and shall file a report with the New York State Department of Taxation and Finance indicating the total amount of a recipient's unearned loan repayment award so that such award may be considered income for the purpose of article twenty-two of the tax law.

Section 903 of the public health law is amended by adding a new subdivision 4-a that states: The recipient of a loan repayment award shall report annually to the NYS Higher Education Services Corporation as to the performance of the required services, beginning with the calendar year in which the recipient begins to provide primary care services in an under served area and continuing until the recipient completes, or until it is determined that he or she is not obligated to complete, the required service. If the recipient fails to file any required report within 30 days of written notice, the president of HESC may impose a fine of up to $5,000. The president shall have the discretion to waive the filing of a report, excuse a delay in filing or failure to report, or waive or reduce any fine imposed for good cause.

Every two years when the recipient of an award registers with the NYS Education Department's Division of Professional Licensing, as required by law, he or she shall file a report as to the performance of the required services.

Subdivisions 6 and 7 of section 904 of the public health law, as amended by chapter 255 of the laws of 1994, are amended to address if the recipient fails to comply fully with such conditions, a formula is provided for determining the repayment of all or part of the loan/scholarship which is due and shall be paid in full upon a determination that the recipient failed to comply with the service condition.

The Commissioner of Public Health shall promulgate regulations necessary to effectuate the provisions and purposes of this section.

JUSTIFICATION: This legislation was drafted as a result of a large number of "deadbeat doctors" who graduated from the Sophie B. Davis School of Biomedical Education of the City university of New York, It has been estimated that as many as one third of the participants have failed to fulfill their public service commitments. As a stipulation of the loan/scholarship they are required to serve for two years as a primary care physician in an under served urban neighborhood. Each participant signs an agreement in which he or she acknowledges an obligation to repay the cost of medical education that has been subsidized by the taxpayers. If the student has failed to meet the public service requirements, the city and state are to be reimbursed for the actual cost of the education. It also states in the agreement that the student understands that failure to serve or repay the obligation shall be "considered by the New York State Board of Regents as unprofessional conduct in the practice of medicine."

These doctors have taken the benefits of a state subsidized medical education and ignored their obligations. At a time when the state's resources are stretched to the breaking point the violators of this program should be forced to make financial restitution. The individual tuition subsidies range from a minimum of $25,000 to as much as $75,000 and the state could recoup up to $10 million from these doctors.

Many of the physicians are believed to have opened offices in affluent communities or are practicing as specialists for substantially higher fees than are available in primary care treatment. Individuals who were helped to become doctors through an enlightened taxpayer-supported program have shown hypocritical indifference to their legal and ethical obligations.

PRIOR LEGISLATIVE HISTORY: Previously introduced.

FISCAL IMPLICATIONS: None.

EFFECTIVE DATE: This act shall take effect on the one hundred twentieth day after it shall have become a law, except that any rule or regulation necessary for the timely implementation of this act shall be promulgated on or before such date.


Text

STATE OF NEW YORK ________________________________________________________________________ 1318 2013-2014 Regular Sessions IN SENATE (PREFILED) January 9, 2013 ___________
Introduced by Sen. STAVISKY -- read twice and ordered printed, and when printed to be committed to the Committee on Health AN ACT to amend the public health law, in relation to enhanced enforce- ment of the primary care physician loan and scholarship programs THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM- BLY, DO ENACT AS FOLLOWS: Section 1. Subdivision 4 of section 903 of the public health law, as amended by chapter 639 of the laws of 1996, is amended to read as follows: 4. Within such time as the commissioner shall by regulation provide, a recipient of an award shall have practiced as a primary care physician in an underserved area in the state of New York or, in the case of a recipient of an award after completion of residency training, the recip- ient shall have practiced in an underserved area for that number of months calculated by multiplying by twelve the number of annual awards received by the recipient. If a recipient fails to comply fully with such conditions[,]: (A) the president shall be entitled to receive from such recipient an amount to be determined by the formula: A = 2B(t-s) ----- t In which "A" is the amount the president is entitled to recover, "B" is the sum of all payments made to the recipient and the interest on such amount which would be payable if at the times such awards were paid they were loans bearing interest at the maximum prevailing rate; "t" is the total number of months in the recipient's period of obligated services; and "s" is the number of months of services actually rendered by the
recipient. Any amount which the president is entitled to recover under this subdivision SHALL BECOME DUE AND shall be paid [within the five- year period beginning on the date] IN FULL UPON A DETERMINATION that the recipient failed to comply with this condition. Any obligation to comply with such provisions shall be canceled upon the death of the recipient. The commissioner [of health] shall promulgate regulations to provide for the waiver or suspension of any financial obligation when compliance would involve extreme hardship; (B) THE COMMISSIONER SHALL INITIATE PROCEEDINGS FOR THE SUSPENSION OF THE RECIPIENT'S LICENSE TO PRACTICE MEDICINE IN THE STATE OF NEW YORK; (C) THE COMMISSIONER SHALL FILE A REPORT WITH THE NEW YORK STATE DEPARTMENT OF TAXATION AND FINANCE INDICATING THE TOTAL AMOUNT OF A RECIPIENT'S UNEARNED LOAN REPAYMENT AWARD SO THAT SUCH AWARD MAY BE CONSIDERED INCOME FOR THE PURPOSE OF ARTICLE TWENTY-TWO OF THE TAX LAW. S 2. Section 903 of the public health law is amended by adding a new subdivision 4-a to read as follows: 4-A. (A) A RECIPIENT OF A LOAN REPAYMENT AWARD SHALL REPORT ANNUALLY TO THE NEW YORK STATE HIGHER EDUCATION SERVICES CORPORATION, ON FORMS PRESCRIBED BY THE PRESIDENT, AS TO THE PERFORMANCE OF THE REQUIRED SERVICES, COMMENCING WITH THE CALENDAR YEAR IN WHICH THE RECIPIENT BEGINS TO PROVIDE PRIMARY CARE SERVICES IN AN UNDERSERVED AREA AND CONTINUING UNTIL THE RECIPIENT SHALL HAVE COMPLETED, OR UNTIL IT IS DETERMINED THAT HE OR SHE SHALL NOT BE OBLIGATED TO COMPLETE, THE REQUIRED SERVICES. IF THE RECIPIENT SHALL FAIL TO FILE ANY REPORT REQUIRED HEREUNDER WITHIN THIRTY DAYS OF WRITTEN NOTICE TO THE RECIPI- ENT, MAILED TO THE ADDRESS SHOWN ON THE LAST APPLICATION FOR AN AWARD OR LAST REPORT FILED, WHICHEVER IS LATER, THE PRESIDENT OF THE CORPORATION MAY IMPOSE A FINE OF UP TO FIVE THOUSAND DOLLARS. THE PRESIDENT SHALL HAVE THE DISCRETION TO WAIVE THE FILING OF A REPORT, EXCUSE A DELAY IN FILING OR A FAILURE TO FILE A REPORT, OR WAIVE OR REDUCE ANY FINE IMPOSED FOR GOOD CAUSE SHOWN. (B) IN ADDITION TO THE REPORTING REQUIREMENTS SET FORTH IN PARAGRAPH (A) OF THIS SUBDIVISION, A RECIPIENT OF AN AWARD SHALL SUBMIT TO THE DEPARTMENT AT EACH BIENNIAL REGISTRATION PERIOD PROVIDED IN SUBDIVISION EIGHT OF SECTION SIXTY-FIVE HUNDRED TWENTY-FOUR OF THE EDUCATION LAW, A REPORT AS TO THE PERFORMANCE OF THE REQUIRED SERVICES. S 3. Subdivisions 6 and 7 of section 904 of the public health law, as amended by chapter 255 of the laws of 1994, are amended to read as follows: 6. If a recipient fails to comply fully with such conditions[,]: (A) the president shall be entitled to receive from such recipient an amount to be determined by the formula: A = 2B(t-s) ----- t in which "A" is the amount the president is entitled to recover, "B" is the sum of all awards made to the recipient and the interest on such amount which would be payable if at the times such awards were paid they were loans bearing interest at the maximum prevailing rate; "t" is the total number of months in the recipient's period of obligated services; and "s" is the number of months of service actually rendered by the recipient. Any amount which the president is entitled to recover under this [paragraph] SUBDIVISION SHALL BECOME DUE AND shall be paid [within the five-year period beginning on the date] IN FULL UPON A DETERMINATION that the recipient failed to comply with this service condition. Nothing
in the written agreement shall affect the terms of employment of the individual who shall negotiate, separate and apart from the program, his or her salary and other forms of employment with an agency, institution or a program in which he or she shall be employed. Any obligation to comply with such provisions as outlined in this section shall be canceled upon the death of the recipient. The commissioner shall promul- gate regulations to provide for the waiver or suspension of any finan- cial obligation when compliance would involve extreme hardship; (B) THE COMMISSIONER SHALL INITIATE PROCEEDINGS FOR THE SUSPENSION OF THE RECIPIENT'S LICENSE TO PRACTICE MEDICINE IN THE STATE OF NEW YORK; (C) THE COMMISSIONER SHALL FILE A REPORT WITH THE NEW YORK STATE DEPARTMENT OF TAXATION AND FINANCE INDICATING THE TOTAL AMOUNT OF A RECIPIENT'S UNEARNED LOAN REPAYMENT AWARD SO THAT SUCH AWARD MAY BE CONSIDERED INCOME FOR THE PURPOSES OF ARTICLE TWENTY-TWO OF THE TAX LAW. 7. (A) A recipient of an award shall report annually to the New York state higher education services corporation, on forms prescribed by the president, as to the performance of the required services, commencing with the calendar year in which the recipient begins to provide primary care services in an underserved area and continuing until the recipient shall have completed, or until it is determined that he or she shall not be obligated to complete, the required services. If the recipient shall fail to file any report required hereunder within thirty days of written notice to the recipient, mailed to the address shown on the last appli- cation for an award or last report filed, whichever is later, the presi- dent of the corporation may impose a fine of up to [one] FIVE thousand dollars. The president shall have the discretion to waive the filing of a report, excuse a delay in filing or a failure to file a report, or waive or reduce any fine imposed for good cause shown. (B) IN ADDITION TO THE REPORTING REQUIREMENTS SET FORTH IN PARAGRAPH (A) OF THIS SUBDIVISION, A RECIPIENT OF AN AWARD SHALL SUBMIT TO THE DEPARTMENT AT EACH BIENNIAL REGISTRATION PERIOD PROVIDED IN SUBDIVISION EIGHT OF SECTION SIXTY-FIVE HUNDRED TWENTY-FOUR OF THE EDUCATION LAW, A REPORT AS TO THE PERFORMANCE OF THE REQUIRED SERVICES. S 4. Section 904 of the public health law is amended by adding a new subdivision 9 to read as follows: 9. THE COMMISSIONER, IN CONSULTATION WITH THE COUNCIL, SHALL PROMUL- GATE REGULATIONS NECESSARY TO EFFECTUATE THE PROVISIONS AND PURPOSES OF THIS SECTION. S 5. This act shall take effect on the one hundred twentieth day after it shall have become a law, except that any rule or regulation necessary for the timely implementation of this act shall be promulgated on or before such date.

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