PRINTER'S NO. 400 THE GENERAL ASSEMBLY OF PENNSYLVANIA HOUSE BILL No.425 Session of 2025 INTRODUCED BY MARCELL, VENKAT, KHAN AND GREEN, JANUARY 31, 2025 REFERRED TO COMMITTEE ON HEALTH, JANUARY 31, 2025 AN ACT Amending the act of April 9, 1929 (P.L.343, No.176), entitled "An act relating to the finances of the State government; providing for cancer control, prevention and research, for ambulatory surgical center data collection , for the Joint Underwriting Association, for entertainment business financial management firms, for private dam financial assurance and for reinstatement of item vetoes; providing for the settlement, assessment, collection, and lien of taxes, bonus, and all other accounts due the Commonwealth, the collection and recovery of fees and other money or property due or belonging to the Commonwealth, or any agency thereof, including escheated property and the proceeds of its sale, the custody and disbursement or other disposition of funds and securities belonging to or in the possession of the Commonwealth, and the settlement of claims against the Commonwealth, the resettlement of accounts and appeals to the courts, refunds of moneys erroneously paid to the Commonwealth, auditing the accounts of the Commonwealth and all agencies thereof, of all public officers collecting moneys payable to the Commonwealth, or any agency thereof, and all receipts of appropriations from the Commonwealth, authorizing the Commonwealth to issue tax anticipation notes to defray current expenses, implementing the provisions of section 7(a) of Article VIII of the Constitution of Pennsylvania authorizing and restricting the incurring of certain debt and imposing penalties; affecting every department, board, commission, and officer of the State government, every political subdivision of the State, and certain officers of such subdivisions, every person, association, and corporation required to pay, assess, or collect taxes, or to make returns or reports under the laws imposing taxes for State purposes, or to pay license fees or other moneys to the Commonwealth, or any agency thereof, every State depository and every debtor or creditor of the Commonwealth," providing for J-1 Visa Waiver Primary Care 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 Physician Grant Program; and making an appropriation. The General Assembly of the Commonwealth of Pennsylvania hereby enacts as follows: Section 1. The act of April 9, 1929 (P.L.343, No.176), known as The Fiscal Code, is amended by adding an article to read: ARTICLE I-M J-1 VISA WAIVER PRIMARY CARE PHYSICIAN GRANT PROGRAM Section 101-M. Scope of article. This article relates to the J-1 Visa Waiver Primary Care Physician Grant Program. Section 102-M. Definitions. The following words and phrases when used in this article shall have the meanings given to them in this section unless the context clearly indicates otherwise: "Conrad 30 waiver." A waiver established under 8 U.S.C. § 1184(l) (relating to admission of nonimmigrants) that authorizes an individual with a J-1 visa to apply for a waiver of the two- year foreign residence requirement upon completion of the J-1 Exchange Visitor Program under Federal law. "Department." The Department of Health of the Commonwealth. "Designated medically underserved area." The term shall mean the same as under section 1301 of the act of December 2, 1992 (P.L.741, No.113), known as the Children's Health Care Act. "Employer." A person, firm, partnership, association or corporation that: (1) employs a physician; and (2) is not owned, under contract or otherwise affiliated with a health system. "Flex 10 waiver." The waiver authorized under 8 U.S.C. § 20250HB0425PN0400 - 2 - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 1184(l)(1)(D) that allows the department to recommend approval of up to 10 requests from employers that: (1) are not physically located in a designated medically underserved area or primary care health professional shortage area, but that serves patients from one or more designated areas; and (2) employ physicians to serve patients in those designated areas. "Grant." An award of money by the department under the program. "J-1 visa." The classification of individuals authorized to participate in an approved program for the purpose of teaching, instructing or lecturing, studying, observing, conducting research, consulting, demonstrating special skills, receiving training or to receive graduate medical education or training. "Physician." A medical doctor or doctor of osteopathy who primarily provides medical services in any one or more of the following practice areas: (1) Family medicine. (2) Osteopathic general practice. (3) General pediatrics. (4) Geriatric medicine. (5) Emergency medicine. (6) Psychiatry. (7) Obstetrics. (8) General internal medicine. "Primary care health professional shortage area." A designation used to identify areas and population groups within this Commonwealth that are experiencing a shortage of physicians. 20250HB0425PN0400 - 3 - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 "Program." The J-1 Visa Waiver Primary Care Physician Grant Program established under section 103-M. Section 103-M. Establishment. The J-1 Visa Waiver Primary Care Physician Grant Program is established in and shall be administered by the department. Section 104-M. Use of funds. The department shall award grants in accordance with this article from money appropriated to the program by the General Assembly. Section 105-M. Application. The following shall apply to applications for grants: (1) Applications shall be on a form and submitted in a manner determined by the department. (2) Applications shall contain documentation as required by the department. (3) Applications shall be available electronically. (4) The department shall receive and consider applications on a rolling basis until funding for grants have been completely disbursed or until December 31, 2030, whichever occurs first. Section 106-M. Certification. An employer that applies for a grant shall certify in good faith all of the following: (1) The employer employs a physician to work in a designated medically underserved area, a primary care health professional shortage area or a designated area that has been approved for a Flex 10 waiver. (2) The employed physician has been approved for a Conrad 30 waiver. (3) The grant will be used to assist the employer in 20250HB0425PN0400 - 4 - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 paying the salary of the employed physician. (4) The grant will not be used for more than one physician per calendar year. (5) The employer agrees to comply with the program requirements established by the department. (6) Acknowledgment that failure to comply with the program requirements established by the department: (i) shall result in removal from the program; and (ii) may result in recoupment of grant money as authorized by law. (7) That the information provided in the application and all supporting documents and forms is true and accurate in all material aspects. An applicant, or an authorized representative of the applicant, that knowingly makes a false statement to obtain a grant shall be subject to 18 Pa.C.S. § 4904 (relating to unsworn falsification to authorities). Section 107-M. Review of application. (a) Determination.--The department shall approve or disapprove an application for a grant. The department shall provide reasons for a disapproval or for a grant award less than the amount requested in an application. (b) Grant agreement.--After approval of an application, the department shall enter into a grant agreement with the employer. A fully executed grant agreement shall be required before the disbursement of a grant. The following shall apply to a grant agreement: (1) The grant agreement shall explain the terms and conditions of the grant, including the applicable laws of this Commonwealth and the United States, and reporting requirements. 20250HB0425PN0400 - 5 - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 (2) The grant agreement shall explain the department's policies and procedures related to the Conrad 30 waiver, the Flex 10 waiver and other policies and procedures that must be followed under Federal or State regulations. (3) The grant agreement may be electronically signed by all applicable parties. (c) Awards.-- (1) The department shall distribute a grant award to an employer in accordance with this article no later than 60 days after approval of a grant application by the department. (2) An employer may receive up to $100,000 a year for a period of three years. The employer and physician must continue to meet the requirements under this article to receive an award each year. The department may require documentation from the employer and physician each year. (3) The department may award grants in increments of $10,000, not to exceed the limitation under paragraph (2). (d) Priority of grant awards.--The department shall give priority in the awarding of a grant to employers that have not previously been awarded a grant for another physician during the same calendar year. Section 108-M. Reports. (a) Contents.--No later than December 31 of each year, the department shall publish a report on its publicly accessible Internet website that contains the following information: (1) A list of grants awarded. (2) The name and address of each employer awarded a grant. (3) The amount of the grant, the purpose of the grant and a description of the financial impact on the grant 20250HB0425PN0400 - 6 - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 recipient. (4) The total amount of the appropriation under section 109-M that has been distributed each calendar year. (b) Submission.--The department shall submit the report under subsection (a) to the following: (1) The chair and minority chair of the Appropriations Committee of the Senate. (2) The chair and minority chair of the Appropriations Committee of the House of Representatives. (3) The chair and minority chair of the Health and Human Services Committee of the Senate. (4) The chair and minority chair of the Health Committee of the House of Representatives. (c) Final report.--Upon disbursement of all money appropriated for the program or December 31, 2030, whichever is earlier, the department shall publish a final report under the requirements of this section within six months. Section 109-M. Appropriation. The sum of $10,000,000 is appropriated from the General Fund to the department for the program and payment of grants under this article. This appropriation shall lapse on June 30, 2031. Section 110-M. Tax applicability. Grants awarded under this article may not be considered taxable income to an employer or physician for purposes of Article III of the act of March 4, 1971 (P.L.6, No.2), known as the Tax Reform Code of 1971. Section 111-M. Compliance. The employer and physician shall permit the department to determine compliance with the requirements of this article. If the employer or physician fails to comply with the requirements 20250HB0425PN0400 - 7 - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 of this article, the employer, physician or both shall reimburse the Commonwealth for the amount of the grant received, including interest accrued, as determined by the department based on a determination of which party violated this article. The employer, physician and the department shall make every effort to resolve conflicts in order to prevent a breach of program requirements established by the department. Section 2. This act shall take effect in 180 days. 20250HB0425PN0400 - 8 - 1 2 3 4 5 6 7 8