[Federal Register Volume 85, Number 146 (Wednesday, July 29, 2020)]
[Rules and Regulations]
[Pages 45532-45537]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2020-15411]
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DEPARTMENT OF VETERANS AFFAIRS
38 CFR Part 17
RIN 2900-AQ63
Specialty Education Loan Repayment Program
AGENCY: Department of Veterans Affairs.
ACTION: Final rule.
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SUMMARY: The Department of Veterans Affairs (VA) is amending its
regulations that govern scholarship programs to certain health care
professionals. This rulemaking implements the mandates of the VA
MISSION Act of 2018 by establishing a Specialty Education Loan
Repayment Program, which will assist VA in meeting the staffing needs
of VA physicians in medical specialties for which VA has determined
that recruitment or retention of qualified personnel is difficult.
DATES: This rule is effective August 28, 2020.
FOR FURTHER INFORMATION CONTACT: Teresa Culpepper, Manager, Education
Loan Repayment Services, 810 Vermont Avenue NW, Washington, DC 20420,
(501) 687-4064. (This is not a toll-free number.)
SUPPLEMENTARY INFORMATION: On December 26, 2019, VA published a
proposed rule in the Federal Register (84 FR 70908) that called for the
establishment of a new student loan repayment program, the Specialty
Education Loan Repayment Program (SELRP). VA provided a 60-day comment
period, which ended on February 24, 2020. We received 4 comments on the
proposed rule.
On June 6, 2018, section 303 of Public Law 115-182, the John S.
McCain III, Daniel K. Akaka, and Samuel R. Johnson VA Maintaining
Internal Systems and Strengthening Integrated Outside Networks Act of
2018, or the VA MISSION Act of 2018, amended title 38 of the United
States Code (U.S.C.) by establishing new sections 7691 through 7697 and
created the SELRP. The SELRP serves as an incentive for physicians
starting or currently in residency programs in medical specialties, for
which VA has determined that recruitment and retention of qualified
personnel is difficult, to work at VA facilities that need more
physicians within that medical specialty after the individual completes
their residency program. VA will determine the anticipated needs for
medical specialties during a period of two to six years in the future.
In taking this proactive approach, VA will commence recruitment for
physicians in these specialties before the projected need to help
ensure adequate health care coverage for VA beneficiaries. This final
rule will establish the requirements for the SELRP in new 38 CFR 17.525
through 17.531.
One commenter requested that VA expand the individuals who qualify
for the SELRP to include certified registered nurse anesthetists
(CRNAs). The commenter stated that they understand there is
underutilization and staffing shortages of other types of providers,
including certified registered nurse anesthetists (CRNAs), and the
commenter asked that this loan
[[Page 45533]]
repayment program be broadened to include incentives for recruitment
and retention of advanced practice registered nurses (APRNs) in VA
medical facilities. Another commenter similarly stated that to
alleviate the primary care gap, a report recommends expanding the
Primary Care Services Corps, which repays loans of nurse practitioners
and physician assistants willing to work in underserved areas, and
creating more Medicare-funded or state-funded residency slots for
primary care doctors willing to work in upstate areas that need more
physicians. Another commenter recommended that VA provide flexibility
in the eligibility requirements to allow for fellows to be eligible.
Fellows could also benefit from the program and may only have one year
left of training. The current requirement for this program, however,
limits participation to physicians currently in training who have more
than two years remaining to complete such training. The commenter
further added that fellows could deepen the applicant pool for the
program, helping to facilitate participation by more psychiatrists
during this time of critical need.
We agree with the commenters in that VA's shortage of health care
professionals is not limited to physicians. However, 38 U.S.C. 7693
establishes the eligibility criteria for individuals who wish to
participate in the SELRP. This criteria states that eligible
individuals must be recently graduated from an accredited medical or
osteopathic school and matched to an accredited residency program in a
medical specialty described in section 7692 of this title; or a
physician in training in a medical specialty described in section 7692
of this title with more than 2 years remaining in such training. As
such, VA cannot extend the eligibility criteria to include individuals
who are not otherwise listed in section 7692. We are not making any
changes based on these comments.
A commenter requested that CRNAs be granted the ability to practice
to the full scope of their education, training, licensure, and
certification in VA medical facilities to allow veterans to receive
access to safe and timely anesthesia services. The commenter stated
that this step would make an anesthesia position within the VA more
attractive in its own right to prior active duty and civilian CRNAs.
The commenter's request that VA grant CRNAs full practice authority is
beyond the scope of the proposed rule. We are not making any changes
based on this comment.
Another commenter recommended expanding the Doctors Across New
York, or DANY, program that, as one of its features, forgives up to
$150,000 of student loan debt for young physicians who commit to
practicing medicine in certain parts of the state for at least five
years. The commenter stated that medical school graduates from the
class of 2012 left school with an average student loan debt of
$166,750, according to the Association of American Medical Colleges.
The commenter added that in the most recent round of the DANY program,
26 young doctors in 2013 received the full, five-year awards. The SELRP
is not a loan forgiveness program. Section 7494(c)(1) of 38 U.S.C.
states that the amount of payments made for a participant under the
SELRP may not exceed $160,000 over a total of four years of
participation in the Program, of which not more than $40,000 of such
payments may be made in each year of participation in the Program. If
an individual participates in the SELRP for four years, the total
amount of repayment of the individual's educational loan would be more
than the $150,000 that the commenter stated that is repaid under the
DANY. Also, VA does not have the statutory authority to adopt any
provision of the DANY and any such adoption is beyond the scope of the
proposed rule. We are not making any changes based on this comment.
Several comments proposed opening new physician or medical schools,
with some comments offering a specific number of schools to be opened,
and some comments offering specific reasons why such schools should be
opened or current failings to open such schools. The opening of new
physician or medical schools is beyond the scope of the proposed rule
and is not within VA's authority to do under section 303 of Public Law
115-182. We are not making any changes based on these comments.
A commenter referred to a HANYS survey and stated that they agree
with this survey in that the survey recommends greater use of
telemedicine to allow certain specialists to remotely provide a
consultation or other medical service to patients in underserved areas
of the state. The commenter did not provide more details on the source
of the survey or the date of the study, so we are not clear what this
survey might refer or relate to. Although the provision of telehealth
services is beyond the scope of the proposed rule, we generally respond
that VA has regulations in place that grant VA health care
professionals the ability to provide telehealth services, within their
scope of practice, functional statement, and/or in accordance with
privileges granted to them by VA, irrespective of the State or location
within a State where the health care provider or the beneficiary is
physically located. See 38 CFR 17.417. VA also has statutory authority
under 38 U.S.C. 1730C for the provision of telehealth services by VA
health care professionals. We are not making any changes based on this
comment.
A commenter stated that incentives for medical students to pursue a
career in primary care by helping with student loans is not enough to
change what the commenter stated was a trend in which less than 10
percent of medical students are going into primary care. The commenter
added that Medicare needs to restructure the reimbursement system now
so current family practitioners, internists and pediatricians will have
higher pay. The restructuring of Medicare's reimbursement system is
beyond the scope of the proposed rulemaking. We are not making any
changes based on this comment.
Another commenter indicated that they have long advocated for
better recruitment of psychiatrists in the VA through the Clay Hunt
Suicide Prevention for American Veterans Act, which included a pilot
project encouraging more psychiatrists to choose a career with the VA
by offering medical school loan repayments on par with those offered by
other government agencies and private practices. The commenter added
that the program was never implemented, but they are encouraged by the
release of the SELRP and its potential to incentivize more
psychiatrists to pursue careers with the VA. VA established into
regulations the Program for the Repayment of Educational Loans for
Certain VA Psychiatrists (PREL), which was established by Public Law
114-2, section 4, the Clay Hunt Suicide Prevention for American
Veterans Act (Clay Hunt SAV Act). See 81 FR 66820, Sept. 29, 2016. VA
is planning to implement the PREL in the near future and agrees with
the commenter that the PREL will help alleviate the shortage of VA
psychiatrists and increase veterans' access to needed mental health
care. We are not making any changes based on this comment.
A commenter recommended that the SELRP be portable to sites where
specialty is needed instead of the recipient being placed in one
location. We believe the commenter intended to recommend that the SELRP
be portable to VA facilities where a resident's specialty is needed, to
enable rotations or other multiple assignments of such residents. As
previously stated in this rulemaking, the SELRP serves as an
[[Page 45534]]
incentive for physicians starting or currently in residency programs in
medical specialties for which VA has determined that recruitment and
retention of qualified personnel is difficult, to work for VA at VA
facilities that need more physicians with that medical specialty after
the individual completes their residency program. VA will continuously
monitor locations where there is the greatest need for physician
specialties and appoint qualified individuals to these locations. To
the extent the commenter recommends that VA enable rotations of
residents in the SELRP, such administrative matters could be addressed
outside of regulation and do not relate to the aspects of the SELRP
that were proposed. We are not making any changes based on this
comment.
A commenter stated that special protections or a continuation of
eligibility should also be included for parental leave to encourage
women to participate. The commenter added that given that this is early
career, such protections are necessary to support applicants. The
commenter also stated that Federal guidelines on parental leave should
be followed as a minimum. VA agrees with the commenter. Because the
participants of the SELRP are appointed VA employees, all Federal rules
regarding parental leave apply. We are not making any changes based on
this comment.
A commenter recommended that VA ensure that they coordinate with
local VAs to announce and connect potential loan repayment recipients
with local vacancies. The proposed rule stated in Sec. 17.527(a)(1)
that in determining staffing needs, VA will consider the anticipated
needs of VA for a period of two to six years in the future. VA will
publish these vacancies in a notice in the Federal Register on an
annual basis until vacancies are filled. Also, under Sec.
17.530(b)(2), VA will provide SELRP participants a list of qualifying
medical facility locations from which a participant may select a
service location. However, VA reserves the right to make final
decisions on the location and position of the obligated service. All
placements will be coordinated and verified with local VA medical
centers, including preliminary identification position need and medical
center participation through selection and placement of eligible
candidates. We are not making any changes based on this comment.
A commenter also recommended that VA develop a process to
comprehensively evaluate and track the application and placement
process for accountable and equitable disbursement among the
applicants, to ensure that psychiatrists are receiving equivalent
consideration for this program among the specialties. The commenter
added that this process could also include a mechanism to ensure the
application process is not too burdensome for prospective candidates,
thus streamlining the process overall. VA is leveraging existing
programs and technologies to meet the lengthy application requirements
while minimizing redundant requests for information. For example, VA
will utilize approved VA forms to collect personnel and job application
information instead of creating new program forms. We are not making
any changes based on this comment.
We are making technical edits to Sec. 17.529(c)(2)(i) for clarity.
Proposed Sec. 17.528(c)(2)(i) stated that a summary of the applicant's
educational debt, which includes the total debt amount and when the
debt was acquired, would be one piece of information that must be
provided to VA. Proposed Sec. 17.528(c)(2)(i) further stated that the
health professional debt covered the loan must be specific to education
that was required, used, and qualified the applicant for appointment as
a physician. We have amended this paragraph to now state a summary of
the applicant's educational loan, which includes the total loan amount
and when the loan was acquired. The educational loan must be specific
to the education that was required and used to qualify the applicant
for appointment as a physician. VA always intended the meaning of the
educational loan in this paragraph to clearly state that the eligible
loan would only be that which was required and used to qualify an
applicant for the SELRP. This change does not result in any substantive
change in meaning and is only intended to be a technical change.
Based on the rationale set forth in the Supplementary Information
to the proposed rule and in this final rule, VA is adopting the
proposed rule with the edits discussed in this rule.
Paperwork Reduction Act
The Paperwork Reduction Act of 1995 (at 44 U.S.C. 3507) requires
that VA consider the impact of paperwork and other information
collection burdens imposed on the public. According to the 1995
amendments to the Paperwork Reduction Act (5 CFR 1320.8(b)(2)(vi)), an
agency may not collect or sponsor the collection of information, nor
may it impose an information collection requirement unless it displays
a currently valid Office of Management and Budget (OMB) control number.
This rule includes provisions constituting new collections of
information under the Paperwork Reduction Act of 1995 that require
approval by the OMB. Accordingly, under 44 U.S.C. 3507(d), VA has
submitted a copy of this rulemaking action to OMB for review.
38 CFR 17.528 contains collections of information under the
Paperwork Reduction Act of 1995. If OMB does not approve the
collections of information as requested, VA will immediately remove the
provisions containing a collection of information or take such other
action as is directed by the OMB.
The collections of information contained in 38 CFR 17.528 are
described immediately following this paragraph.
Title: Specialty Education Loan Repayment Program.
Summary of collection of information: The information required
determines the eligibility or suitability of an applicant desiring to
participate in the SELRP under the provisions of 38 U.S.C. 7691 through
7697. The purpose of the SELRP would be to repay educational loans to
individuals who pursued a program of study leading to a degree in
medicine and who are seeking employment in VA. VA considers this
program as a hiring incentive to meet the staffing needs for physicians
in medical specialties for which VA determines that recruitment and
retention of qualified personnel is difficult.
Description of the need for information and proposed use of
information: The information is needed to apply for the SELRP. VA will
use this information to select qualified candidates to participate in
this program.
Description of likely respondents: Potential participants of the
SELRP.
Estimated number of respondents per month/year: 200 per year.
Estimated frequency of responses per month/year: 1 time per year.
Estimated average burden per response: 90 minutes.
Estimated total annual reporting and recordkeeping burden: 80
hours.
Estimated cost to respondents per year: VA estimates the total cost
to all respondents to be $8,130 per year.
Regulatory Flexibility Act
The Secretary hereby certifies that this final rule will not have a
significant economic impact on a substantial number of small entities
as they are defined in the Regulatory Flexibility Act, 5 U.S.C. 601-
612. The provisions associated with this rulemaking are not processed
by any other entities outside of VA. Therefore, pursuant to 5 U.S.C.
[[Page 45535]]
605(b), the initial and final regulatory flexibility analysis
requirements of 5 U.S.C. 603 and 604 do not apply.
Executive Orders 12866, 13563 and 13771
Executive Orders 12866 and 13563 direct agencies to assess the
costs and benefits of available regulatory alternatives and, when
regulation is necessary, to select regulatory approaches that maximize
net benefits (including potential economic, environmental, public
health and safety effects, and other advantages; distributive impacts;
and equity). Executive Order 13563 (Improving Regulation and Regulatory
Review) emphasizes the importance of quantifying both costs and
benefits, reducing costs, harmonizing rules, and promoting flexibility.
The Office of Information and Regulatory Affairs has determined that
this rule is not a significant regulatory action under Executive Order
12866.
VA's impact analysis can be found as a supporting document at
http://www.regulations.gov, usually within 48 hours after the
rulemaking document is published. Additionally, a copy of the
rulemaking and its impact analysis are available on VA's website at
http://www.va.gov/orpm/, by following the link for ``VA Regulations
Published From FY 2004 Through Fiscal Year to Date.''
This final rule is not expected to be an E.O. 13771 regulatory
action because this final rule is not significant under E.O. 12866.
Unfunded Mandates
The Unfunded Mandates Reform Act of 1995 requires, at 2 U.S.C.
1532, that agencies prepare an assessment of anticipated costs and
benefits before issuing any rule that may result in the expenditure by
State, local, and tribal governments, in the aggregate, or by the
private sector, of $100 million or more (adjusted annually for
inflation) in any one year. This final rule will have no such effect on
State, local, and tribal governments, or on the private sector.
Congressional Review Act
Pursuant to the Congressional Review Act (5 U.S.C. 801 et seq.),
the Office of Information and Regulatory Affairs designated this rule
as not a major rule, as defined by 5 U.S.C. 804(2).
Catalog of Federal Domestic Assistance
There are no Catalog of Federal Domestic Assistance numbers and
titles for this rule.
List of Subjects in 38 CFR Part 17
Administrative practice and procedure, Health care, Health
facilities, Health professions, Health records, Medical and dental
schools, Scholarships and fellowships, Veterans.
Signing Authority
The Secretary of Veterans Affairs, or designee, approved this
document and authorized the undersigned to sign and submit the document
to the Office of the Federal Register for publication electronically as
an official document of the Department of Veterans Affairs. Brooks D.
Tucker, Acting Chief of Staff, Department of Veterans Affairs, approved
this document on July 13, 2020, for publication.
Consuela Benjamin,
Regulations Development Coordinator, Office of Regulation Policy &
Management, Office of the Secretary, Department of Veterans Affairs.
For the reasons stated in the preamble, the Department of Veterans
Affairs amends 38 CFR part 17 as follows:
PART 17--MEDICAL
0
1. The authority citation for part 17 is amended as follows:
Authority: 38 U.S.C. 501, and as noted in specific sections.
* * * * *
Sections 17.525 through 17.531 are also issued under 38 U.S.C.
7691 through 7697.
* * * * *
0
2. Adding an undesignated center heading immediately following Sec.
17.511 and new Sec. Sec. 17.525 through 17.531 to read as follows.
Specialty Education Loan Repayment Program
Sec.
17.525 Purpose.
17.526 Definitions.
17.527 Eligibility.
17.528 Application.
17.529 Award procedures.
17.530 Agreement and obligated service.
17.531 Failure to comply with terms and conditions of agreement.
Sec. 17.525 Purpose.
The purpose of Sec. Sec. 17.525 through 17.531 is to establish the
Specialty Education Loan Repayment Program (SELRP). The SELRP is an
incentive program for certain individuals to meet VA's need for
physicians in medical specialties for which VA determines that
recruitment and retention of qualified personnel is difficult.
Assistance under the SELRP may be in addition to other assistance
available to individuals under the Educational Assistance Program under
38 U.S.C. 7601.
Sec. 17.526 Definitions.
The following definitions apply to Sec. Sec. 17.525 through
17.530:
Educational loan means a loan, government or commercial, made for
educational purposes by institutions that are subject to examination
and supervision in their capacity as lending institutions by an agency
of the United States or of the state in which the lender has its
principal place of business. Loans must be for the actual costs paid
for tuition, and other reasonable educational expenses such as living
expenses, fees, books, supplies, educational equipment and materials,
and laboratory expenses. Loans must be obtained from a government
entity, a private financial institution, a school, or any other
authorized entity stated in this definition. The following loans do not
qualify for the SELRP:
(1) Loans obtained from family members, relatives, or friends;
(2) Loans made prior to, or after, the individual's qualifying
education;
(3) Any portion of a consolidated loan that is not specifically
identified with the education and purposes for which the SELRP may be
authorized, such as home or auto loans merged with educational loans;
(4) Loans for which an individual incurred a service obligation for
repayment or agreed to service for future cancellation;
(5) Credit card debt;
(6) Parent Plus Loans;
(7) Loans that have been paid in full;
(8) Loans that are in default, delinquent, not in a current payment
status, or have been assumed by a collection agency;
(9) Loans not obtained from a bank, credit union, savings and loan
association, not-for-profit organization, insurance company, school,
and other financial or credit institution which is subject to
examination and supervision in its capacity as a lending institution by
an agency of the United States or of the state in which the lender has
its principal place of business;
(10) Loans for which supporting documentation is not available;
(11) Loans that have been consolidated with loans of other
individuals, such as spouses, children, friends, or other family
member; or
(12) Home equity loans or other noneducational loans.
SELRP means the Specialty Education Loan Repayment Program
established in Sec. Sec. 17.525 through 17.530.
State means a State as defined in 38 U.S.C. 101(20), or a political
subdivision of such a State.
[[Page 45536]]
VA means the Department of Veterans Affairs.
Sec. 17.527 Eligibility.
(a) General. An individual must meet the following requirements to
be eligible to participate in the SELRP:
(1) Will be eligible for appointment under 38 U.S.C. 7401 to work
as a physician in a medical specialty for which VA determines that
recruitment or retention of qualified personnel is difficult. In
determining staffing needs, VA will consider the anticipated needs of
VA for a period of two to six years in the future. VA will publish
these vacancies in a notice in the Federal Register on a yearly basis
until vacancies are filled.
(2) Owes any amount of principal or interest for an educational
loan where the proceeds were used by or on behalf of the individual to
pay costs relating to a course of medical education or training that
leads to employment as a physician and;
(3) Is:
(i) Recently graduated from an accredited medical or osteopathic
school and matched to an accredited residency program in a medical
specialty designated by VA; or
(ii) A physician in training with more than 2 years remaining in
such training.
(b) Applicants without a residency match. An applicant may apply
for the SELRP before receiving a residency match during the applicant's
senior year of medical or osteopathic school. Once the applicant is
matched with a residency specialty stated in Sec. 17.525 and upon
selection of the SELRP, VA must offer the applicant participation in
the SELRP no later than 28 days after:
(1) The applicant is matched with the residency; and
(2) VA has published the residency in a Notice in the Federal
Register. Such notices are published on a yearly basis until vacancies
are filled.
(c) Preferences. VA will give preference to eligible participants
who:
(1) Are, or will be, participating in residency programs in health
care facilities that are:
(i) Located in rural areas;
(ii) Operated by Indian tribes, tribal organizations, or the Indian
Health Services; or
(iii) Are affiliated with underserved health care facilities of VA;
or
(2) Veterans.
Sec. 17.528 Application.
(a) General. A complete application for the SELRP consists of a
completed application form, letters of reference, and personal
statement.
(b) References. The applicant must provide the following letters of
reference and sign a release of information form for VA to contact such
references:
(1) One letter of reference from the Program Director of the core
program in which the applicant is training, which indicates that the
applicant is in good to excellent standing, or, for individuals who
have yet to initiate training, a letter of reference from a faculty
member or dean;
(2) One or more letters of reference from faculty members under
which the applicant trained; and
(3) One letter of reference from a peer colleague who is familiar
with the practice and character of the applicant.
(c) Personal statement. The personal statement must include the
following documentation:
(1) A cover letter that provides the following information:
(i) Why the applicant is interested in VA employment;
(ii) The applicant's interest in working at a particular medical
specialty and underserved area;
(iii) Likely career goals, including career goals in VA; and
(iv) A brief summary of past employment or training and
accomplishments, including any particular clinical areas of interest
(e.g., substance abuse).
(2) The following information must be provided on a VA form or
online collection system and is subject to VA verification:
(i) A summary of the applicant's educational loan, which includes
the total loan amount and when the loan was acquired. The educational
loan must be specific to the education that was required and used to
qualify the applicant for appointment as a physician.
(ii) The name of the lending agency that provided the educational
loan.
(3) A full curriculum vitae.
(The Office of Management and Budget has approved the information
collection requirements in this section under control number XXXX-
XXXX.)
Sec. 17.529 Award procedures.
(a) Repayment amount. (1) VA may pay no more than $40,000 in
educational loan repayment for each year of obligated service for a
period not to exceed four years for a total payment of $160,000.00.
(2) An educational loan repayment may not exceed the actual amount
of principal and interest on an educational loan or loans.
(b) Payment. VA will pay the participant, or the lending
institution on behalf of the participant, directly for the principal
and interest on the participant's educational loans. Payments will be
made monthly or annually for each applicable service period, depending
on the terms of the agreement. Participants must provide VA
documentation that shows the amounts that were credited or posted by
the lending institution to a participant's educational loan during an
obligated service period. VA will issue payments after the participant
commences the period of obligated service. Payments are exempt from
Federal taxation.
(c) Waiver of maximum amount of payment. VA may waive the
limitations under paragraph (a)(1) of this section to participants of
the SELRP if VA determines that there is a shortage of qualified
employees due to either the location of where the participant will
serve the period of obligated service or the requirements of the
position that the participant will hold in VA. However, the waiver may
not exceed the actual amount of the principal and the interest on the
participant's loans payable to or for that participant.
Sec. 17.530 Agreement and obligated service.
(a) General. In addition to any requirements under section 5379(c)
of title 5, a participant in the SELRP must agree, in writing, to the
following:
(1) Obtain a license to practice medicine in a State;
(2) Successfully complete postgraduate training leading to
eligibility for board certification in a medical specialty;
(3) Serve as a full-time clinical practice employee of VA for 12
months for every $40,000.00 that the participant receives payment
through the SELRP, however, the participant must serve for a period of
no fewer than 24 months; and
(4) Except as provided in paragraph (b) of this section, begin
obligated service as a full-time VA employee no later than 60 days
after completing residency in the medical specialty described in Sec.
17.527(a)(1).
(b) Obligated service. (1) General provision. A participant's
obligated service will begin on the date on which the participant
begins full-time permanent employment with VA in the qualifying field
of medicine in a location determined by VA. Obligated service must be
full-time permanent employment and does not include any period of
temporary or contractual employment.
(2) Location and position of obligated service. VA will provide
SELRP participants a list of qualifying medical facility locations. A
participant may select a service location from that list.
[[Page 45537]]
However, VA reserves the right to make final decisions on the location
and position of the obligated service.
(c) Exception to commencement of obligated service. If a
participant receives an accredited fellowship in a medical specialty
other than the specialty described in Sec. 17.27(a)(1), the
participant may request, in writing, a delayed commencement of the
period of obligated service until after the participant completes the
fellowship. However, the period of obligated service will begin no
later than 60 days after completion of such fellowship in the medical
specialty described in Sec. 17.527(a)(1).
Sec. 17.531 Failure to comply with terms and conditions of
agreement.
A participant of the SELRP who fails to satisfy the period of
obligated service will owe the United States government an amount
determined by the formula A = B x ((T-S) / T)), where:
(a) ``A'' is the amount the participant owes the United States
government.
(b) ``B'' is the sum of all payments to or for the participant
under the SELRP.
(c) ``T'' is the number of months in the period of obligated
service of the participant.
(d) ``S'' is the number of whole months of such period of obligated
service served by the participant.
[FR Doc. 2020-15411 Filed 7-28-20; 8:45 am]
BILLING CODE 8320-01-P