---
kind: "section"
citation: "25 U.S.C. § 1616a"
title: "25"
title_heading: "Indians"
number: "1616a"
heading: "Indian Health Service Loan Repayment Program"
release: "119-102"
date: "2026-07-12"
url: "https://uscodex.org/usc/25/1616a"
units:
  - "Chapter 18 — Indian Health Care"
  - "Subchapter I — Indian Health Professional Personnel"
---

# §1616a. Indian Health Service Loan Repayment Program

- (a) **Establishment—**
  - (1) The [Secretary](/usc/25/1603.md?p=17), acting through the [Service](/usc/25/1603.md?p=18), shall establish a program to be known as the [Indian](/usc/25/1603.md?p=13) Health [Service](/usc/25/1603.md?p=18) Loan Repayment Program (hereinafter referred to as the “Loan Repayment Program”) in order to assure an adequate supply of trained health professionals necessary to maintain accreditation of, and provide health care [services](/usc/25/1603.md?p=18) to [Indians](/usc/25/1603.md?p=13) through, [Indian health programs](/usc/25/1603.md?p=12).
  - (2) For the purposes of this section—
    - (A) the term “[Indian health program](/usc/25/1603.md?p=12)” means any health program or facility funded, in whole or part, by the [Service](/usc/25/1603.md?p=18) for the benefit of [Indians](/usc/25/1603.md?p=13) and administered—
      - (i) directly by the [Service](/usc/25/1603.md?p=18);
      - (ii) by any [Indian tribe](/usc/25/1603.md?p=14) or tribal or [Indian](/usc/25/1603.md?p=13) organization pursuant to a contract under—
        - (I) the [Indian](/usc/25/1603.md?p=13) Self-Determination Act [[25 U.S.C. 5321](/usc/25/5321.md) et seq.], or
        - (II) section 23 of the Act of April 30, 1908[^1] ([25 U.S.C. 47](/usc/25/47.md)), popularly known as the “Buy-[Indian](/usc/25/1603.md?p=13)” Act; or
      - (iii) by an [urban Indian organization](/usc/25/1603.md?p=29) pursuant to subchapter IV of this chapter; and
    - (B) the term “State” has the same meaning given such term in section 254d(i)(4)[^1] of title 42.
- (b) **Eligibility—** To be eligible to participate in the Loan Repayment Program, an individual must—
  - (1)
    - (A) be enrolled—
      - (i) in a course of study or program in an accredited institution, as determined by the [Secretary](/usc/25/1603.md?p=17), within any State and be scheduled to complete such course of study in the same year such individual applies to participate in such program; or
      - (ii) in an approved graduate training program in a [health profession](/usc/25/1603.md?p=10); or
    - (B) have—
      - (i) a degree in a [health profession](/usc/25/1603.md?p=10); and
      - (ii) a license to practice a [health profession](/usc/25/1603.md?p=10) in a State;
  - (2)
    - (A) be eligible for, or hold, an appointment as a commissioned officer in the Regular or Reserve Corps[^2] of the Public Health [Service](/usc/25/1603.md?p=18);
    - (B) be eligible for selection for civilian [service](/usc/25/1603.md?p=18) in the Regular or Reserve Corps[^2] of the Public Health [Service](/usc/25/1603.md?p=18);
    - (C) meet the professional standards for civil [service](/usc/25/1603.md?p=18) employment in the [Indian](/usc/25/1603.md?p=13) Health [Service](/usc/25/1603.md?p=18); or
    - (D) be employed in an [Indian health program](/usc/25/1603.md?p=12) without a [service](/usc/25/1603.md?p=18) obligation; and
  - (3) submit to the [Secretary](/usc/25/1603.md?p=17) an application for a contract described in [subsection (f)](#f).
- (c) **Application and contract forms—**
  - (1) In disseminating application forms and contract forms to individuals desiring to participate in the Loan Repayment Program, the [Secretary](/usc/25/1603.md?p=17) shall include with such forms a fair summary of the rights and liabilities of an individual whose application is approved (and whose contract is accepted) by the [Secretary](/usc/25/1603.md?p=17), including in the summary a clear explanation of the damages to which the United States is entitled under [subsection (l)](#l) in the case of the individual’s breach of the contract. The [Secretary](/usc/25/1603.md?p=17) shall provide such individuals with sufficient information regarding the advantages and disadvantages of [service](/usc/25/1603.md?p=18) as a commissioned officer in the Regular or Reserve Corps[^2] of the Public Health [Service](/usc/25/1603.md?p=18) or a civilian employee of the [Indian](/usc/25/1603.md?p=13) Health [Service](/usc/25/1603.md?p=18) to enable the individual to make a decision on an informed basis.
  - (2) The application form, contract form, and all other information furnished by the [Secretary](/usc/25/1603.md?p=17) under this section shall be written in a manner calculated to be understood by the average individual applying to participate in the Loan Repayment Program.
  - (3) The [Secretary](/usc/25/1603.md?p=17) shall make such application forms, contract forms, and other information available to individuals desiring to participate in the Loan Repayment Program on a date sufficiently early to ensure that such individuals have adequate time to carefully review and evaluate such forms and information.
- (d) **Vacancies; priority—**
  - (1) Consistent with [paragraph (3)](#d-3), the [Secretary](/usc/25/1603.md?p=17), acting through the [Service](/usc/25/1603.md?p=18) and in accordance with [subsection (k)](#k), shall annually—
    - (A) identify the positions in each [Indian health program](/usc/25/1603.md?p=12) for which there is a need or a vacancy, and
    - (B) rank those positions in order of priority.
  - (2) Consistent with the priority determined under [paragraph (1)](#d-1), the [Secretary](/usc/25/1603.md?p=17), in determining which applications under the Loan Repayment Program to approve (and which contracts to accept), shall give priority to applications made by—
    - (A) [Indians](/usc/25/1603.md?p=13); and
    - (B) individuals recruited through the efforts of [Indian tribes](/usc/25/1603.md?p=14) or tribal or [Indian](/usc/25/1603.md?p=13) organizations.
  - (3)
    - (A) Subject to [subparagraph (B)](#d-3-B), of the total amounts appropriated for each of the fiscal years 1993, 1994, and 1995 for loan repayment contracts under this section, the [Secretary](/usc/25/1603.md?p=17) shall provide that—
      - (i) not less than 25 percent be provided to applicants who are nurses, nurse practitioners, or nurse midwives; and
      - (ii) not less than 10 percent be provided to applicants who are mental health professionals (other than applicants described in [clause (i)](#d-3-A-i)).
    - (B) The requirements specified in clause (i) or [clause (ii)](#d-3-A-ii) of subparagraph (A) shall not apply if the [Secretary](/usc/25/1603.md?p=17) does not receive the number of applications from the individuals described in [clause (i)](#d-3-A-i) or [clause (ii)](#d-3-A-ii), respectively, necessary to meet such requirements.
- (e) **Approval—**
  - (1) An individual becomes a participant in the Loan Repayment Program only upon the [Secretary](/usc/25/1603.md?p=17) and the individual entering into a written contract described in [subsection (f)](#f).
  - (2) The [Secretary](/usc/25/1603.md?p=17) shall provide written notice to an individual promptly on—
    - (A) the [Secretary](/usc/25/1603.md?p=17)’s approving, under [paragraph (1)](#e-1), of the individual’s participation in the Loan Repayment Program, including extensions resulting in an aggregate period of obligated [service](/usc/25/1603.md?p=18) in excess of 4 years; or
    - (B) the [Secretary](/usc/25/1603.md?p=17)’s disapproving an individual’s participation in such Program.
- (f) **Contract terms—** The written contract referred to in this section between the [Secretary](/usc/25/1603.md?p=17) and an individual shall contain—
  - (1) an agreement under which—
    - (A) subject to [paragraph (3)](#f-3), the [Secretary](/usc/25/1603.md?p=17) agrees—
      - (i) to pay loans on behalf of the individual in accordance with the provisions of this section, and
      - (ii) to accept (subject to the availability of appropriated funds for carrying out this section) the individual into the [Service](/usc/25/1603.md?p=18) or place the individual with a tribe or [Indian](/usc/25/1603.md?p=13) organization as provided in [subparagraph (B)(iii)](#f-1-B-iii), and
    - (B) subject to [paragraph (3)](#f-3), the individual agrees—
      - (i) to accept loan payments on behalf of the individual;
      - (ii) in the case of an individual described in [subsection (b)(1)](#b-1)—
        - (I) to maintain enrollment in a course of study or training described in [subsection (b)(1)(A)](#b-1-A) until the individual completes the course of study or training, and
        - (II) while enrolled in such course of study or training, to maintain an acceptable level of academic standing (as determined under regulations of the [Secretary](/usc/25/1603.md?p=17) by the educational institution offering such course of study or training);
      - (iii) to serve for a time period (hereinafter in this section referred to as the “period of obligated [service](/usc/25/1603.md?p=18)”) equal to 2 years or such longer period as the individual may agree to serve in the full-time clinical practice of such individual’s profession in an [Indian health program](/usc/25/1603.md?p=12) to which the individual may be assigned by the [Secretary](/usc/25/1603.md?p=17);
  - (2) a provision permitting the [Secretary](/usc/25/1603.md?p=17) to extend for such longer additional periods, as the individual may agree to, the period of obligated [service](/usc/25/1603.md?p=18) agreed to by the individual under [paragraph (1)(B)(iii)](#f-1-B-iii);
  - (3) a provision that any financial obligation of the United States arising out of a contract entered into under this section and any obligation of the individual which is conditioned thereon is contingent upon funds being appropriated for loan repayments under this section;
  - (4) a statement of the damages to which the United States is entitled under [subsection (l)](#l) for the individual’s breach of the contract; and
  - (5) such other statements of the rights and liabilities of the [Secretary](/usc/25/1603.md?p=17) and of the individual, not inconsistent with this section.
- (g) **Loan repayment purposes; maximum amount; tax liability reimbursement; schedule of payments—**
  - (1) A loan repayment provided for an individual under a written contract under the Loan Repayment Program shall consist of payment, in accordance with [paragraph (2)](#g-2), on behalf of the individual of the principal, interest, and related expenses on government and commercial loans received by the individual regarding the undergraduate or graduate education of the individual (or both), which loans were made for—
    - (A) tuition expenses;
    - (B) all other reasonable educational expenses, including fees, books, and laboratory expenses, incurred by the individual; and
    - (C) reasonable living expenses as determined by the [Secretary](/usc/25/1603.md?p=17).
  - (2)
    - (A) For each year of obligated [service](/usc/25/1603.md?p=18) that an individual contracts to serve under [subsection (f)](#f) the [Secretary](/usc/25/1603.md?p=17) may pay up to $35,000 (or an amount equal to the amount specified in [section 254l–1(g)(2)(A)](/usc/42/254l–1.md?p=g-2-A) of title 42) on behalf of the individual for loans described in [paragraph (1)](#g-1). In making a determination of the amount to pay for a year of such [service](/usc/25/1603.md?p=18) by an individual, the [Secretary](/usc/25/1603.md?p=17) shall consider the extent to which each such determination—
      - (i) affects the ability of the [Secretary](/usc/25/1603.md?p=17) to maximize the number of contracts that can be provided under the Loan Repayment Program from the amounts appropriated for such contracts;
      - (ii) provides an incentive to serve in [Indian health programs](/usc/25/1603.md?p=12) with the greatest shortages of health professionals; and
      - (iii) provides an incentive with respect to the health professional involved remaining in an [Indian health program](/usc/25/1603.md?p=12) with such a health professional shortage, and continuing to provide primary health [services](/usc/25/1603.md?p=18), after the completion of the period of obligated [service](/usc/25/1603.md?p=18) under the Loan Repayment Program.
    - (B) Any arrangement made by the [Secretary](/usc/25/1603.md?p=17) for the making of loan repayments in accordance with this subsection shall provide that any repayments for a year of obligated [service](/usc/25/1603.md?p=18) shall be made no later than the end of the fiscal year in which the individual completes such year of [service](/usc/25/1603.md?p=18).
  - (3) For the purpose of providing reimbursements for tax liability resulting from payments under [paragraph (2)](#g-2) on behalf of an individual, the [Secretary](/usc/25/1603.md?p=17)—
    - (A) in addition to such payments, may make payments to the individual in an amount not less than 20 percent and not more than 39 percent of the total amount of loan repayments made for the taxable year involved; and
    - (B) may make such additional payments as the [Secretary](/usc/25/1603.md?p=17) determines to be appropriate with respect to such purpose.
  - (4) The [Secretary](/usc/25/1603.md?p=17) may enter into an agreement with the holder of any loan for which payments are made under the Loan Repayment Program to establish a schedule for the making of such payments.
- (h) **Effect on employment ceiling of Department of Health and Human Services—** Notwithstanding any other provision of law, individuals who have entered into written contracts with the [Secretary](/usc/25/1603.md?p=17) under this section, while undergoing academic training, shall not be counted against any employment ceiling affecting the [Department](/usc/25/1603.md?p=6) of Health and Human [Services](/usc/25/1603.md?p=18).
- (i) **Recruiting programs—** The [Secretary](/usc/25/1603.md?p=17) shall conduct recruiting programs for the Loan Repayment Program and other health professional programs of the [Service](/usc/25/1603.md?p=18) at educational institutions training health professionals or specialists identified in [subsection (a)](#a).
- (j) **Prohibition of assignment to other government departments—** [Section 215 of title 42](/usc/42/215.md) shall not apply to individuals during their period of obligated [service](/usc/25/1603.md?p=18) under the Loan Repayment Program.
- (k) **Staff needs of health programs administered by Indian tribes—** The [Secretary](/usc/25/1603.md?p=17), in assigning individuals to serve in [Indian health programs](/usc/25/1603.md?p=12) pursuant to contracts entered into under this section, shall—
  - (1) ensure that the staffing needs of [Indian health programs](/usc/25/1603.md?p=12) administered by an [Indian tribe](/usc/25/1603.md?p=14) or tribal or health organization receive consideration on an equal basis with programs that are administered directly by the [Service](/usc/25/1603.md?p=18); and
  - (2) give priority to assigning individuals to [Indian health programs](/usc/25/1603.md?p=12) that have a need for health professionals to provide health care [services](/usc/25/1603.md?p=18) as a result of individuals having breached contracts entered into under this section.
- (l) **Voluntary termination of study or dismissal from educational institution; collection of damages—**
  - (1) An individual who has entered into a written contract with the [Secretary](/usc/25/1603.md?p=17) under this section and who—
    - (A) is enrolled in the final year of a course of study and who—
      - (i) fails to maintain an acceptable level of academic standing in the educational institution in which he is enrolled (such level determined by the educational institution under regulations of the [Secretary](/usc/25/1603.md?p=17));
      - (ii) voluntarily terminates such enrollment; or
      - (iii) is dismissed from such educational institution before completion of such course of study; or
    - (B) is enrolled in a graduate training program, fails to complete such training program, and does not receive a waiver from the [Secretary](/usc/25/1603.md?p=17) under [subsection (b)(1)(B)(ii)](#b-1-B-ii),

    shall be liable, in lieu of any [service](/usc/25/1603.md?p=18) obligation arising under such contract, to the United States for the amount which has been paid on such individual’s behalf under the contract.

  - (2) If, for any reason not specified in [paragraph (1)](#l-1), an individual breaches his written contract under this section by failing either to begin, or complete, such individual’s period of obligated [service](/usc/25/1603.md?p=18) in accordance with [subsection (f)](#f), the United States shall be entitled to recover from such individual an amount to be determined in accordance with the following formula:

  A=3Z(t-s/t)

  in which—

  - (A) “A” is the amount the United States is entitled to recover;
  - (B) “Z” is the sum of the amounts paid under this section to, or on behalf of, the individual and the interest on such amounts which would be payable if, at the time the amounts were paid, they were loans bearing interest at the maximum legal prevailing rate, as determined by the Treasurer of the United States;
  - (C) “t” is the total number of months in the individual’s period of obligated [service](/usc/25/1603.md?p=18) in accordance with [subsection (f)](#f); and
  - (D) “s” is the number of months of such period served by such individual in accordance with this section.

  Amounts not paid within such period shall be subject to collection through deductions in Medicare payments pursuant to [section 1395ccc of title 42](/usc/42/1395ccc.md).

  - (3)
    - (A) Any amount of damages which the United States is entitled to recover under this subsection shall be paid to the United States within the 1-year period beginning on the date of the breach or such longer period beginning on such date as shall be specified by the [Secretary](/usc/25/1603.md?p=17).
    - (B) If damages described in [subparagraph (A)](#l-3-A) are delinquent for 3 months, the [Secretary](/usc/25/1603.md?p=17) shall, for the purpose of recovering such damages—
      - (i) utilize collection agencies contracted with by the Administrator of the General [Services](/usc/25/1603.md?p=18) [Administration](/usc/25/1667a.md?p=1); or
      - (ii) enter into contracts for the recovery of such damages with collection agencies selected by the [Secretary](/usc/25/1603.md?p=17).
    - (C) Each contract for recovering damages pursuant to this subsection shall provide that the contractor will, not less than once each 6 months, submit to the [Secretary](/usc/25/1603.md?p=17) a status report on the success of the contractor in collecting such damages. [Section 3718 of title 31](/usc/31/3718.md) shall apply to any such contract to the extent not inconsistent with this subsection.
- (m) **Cancellation or waiver of obligations; bankruptcy discharge—**
  - (1) Any obligation of an individual under the Loan Repayment Program for [service](/usc/25/1603.md?p=18) or payment of damages shall be canceled upon the death of the individual.
  - (2) The [Secretary](/usc/25/1603.md?p=17) shall by regulation provide for the partial or total waiver or suspension of any obligation of [service](/usc/25/1603.md?p=18) or payment by an individual under the Loan Repayment Program whenever compliance by the individual is impossible or would involve extreme hardship to the individual and if enforcement of such obligation with respect to any individual would be unconscionable.
  - (3) The [Secretary](/usc/25/1603.md?p=17) may waive, in whole or in part, the rights of the United States to recover amounts under this section in any case of extreme hardship or other good cause shown, as determined by the [Secretary](/usc/25/1603.md?p=17).
  - (4) Any obligation of an individual under the Loan Repayment Program for payment of damages may be released by a discharge in bankruptcy under [title 11](/usc/11.md) only if such discharge is granted after the expiration of the 5-year period beginning on the first date that payment of such damages is required, and only if the bankruptcy court finds that nondischarge of the obligation would be unconscionable.
- (n) **Annual report—** The [Secretary](/usc/25/1603.md?p=17) shall submit to the President, for inclusion in each report required to be submitted to the Congress under [section 1671 of this title](/usc/25/1671.md), a report concerning the previous fiscal year which sets forth—
  - (1) the health professional positions maintained by the [Service](/usc/25/1603.md?p=18) or by tribal or [Indian](/usc/25/1603.md?p=13) organizations for which recruitment or retention is difficult;
  - (2) the number of Loan Repayment Program applications filed with respect to each type of [health profession](/usc/25/1603.md?p=10);
  - (3) the number of contracts described in [subsection (f)](#f) that are entered into with respect to each [health profession](/usc/25/1603.md?p=10);
  - (4) the amount of loan payments made under this section, in total and by [health profession](/usc/25/1603.md?p=10);
  - (5) the number of scholarship grants that are provided under [section 1613a of this title](/usc/25/1613a.md) with respect to each [health profession](/usc/25/1603.md?p=10);
  - (6) the amount of scholarship grants provided under [section 1613a of this title](/usc/25/1613a.md), in total and by [health profession](/usc/25/1603.md?p=10);
  - (7) the number of providers of health care that will be needed by [Indian health programs](/usc/25/1603.md?p=12), by location and profession, during the three fiscal years beginning after the date the report is filed; and
  - (8) the measures the [Secretary](/usc/25/1603.md?p=17) plans to take to fill the health professional positions maintained by the [Service](/usc/25/1603.md?p=18) or by tribes or tribal or [Indian](/usc/25/1603.md?p=13) organizations for which recruitment or retention is difficult.

## Footnotes

[^1]: See References in Text note below.
[^2]: See Change of Name note below.

## Source credit

(Pub. L. 94–437, title I, § 108, as added Pub. L. 100–713, title I, § 108, Nov. 23, 1988, 102 Stat. 4789; amended Pub. L. 102–573, title I, §§ 106(a)–(g)(1), (h), (i), 117(b)(3), title IX, § 902(2)(C), (D), Oct. 29, 1992, 106 Stat. 4535–4537, 4544, 4591.)

## Notes

### Editorial Notes

### References in Text

The Indian Self-Determination Act, referred to in subsec. (a)(2)(A)(ii)(I), is title I of Pub. L. 93–638, Jan. 4, 1975, 88 Stat. 2206, which is classified principally to subchapter I (§ 5321 et seq.) of chapter 46 of this title. For complete classification of this Act to the Code, see Short Title note set out under section 5301 of this title and Tables.

Section 23 of the Act of April 30, 1908, referred to in subsec. (a)(2)(A)(ii)(II), probably should be a reference to section 23 of act June 25, 1910, ch. 431, 36 Stat. 861, which is popularly known as the “Buy Indian Act”, and is classified to section 47 of this title. Act Apr. 30, 1908, ch. 153, 35 Stat. 70, does not contain a section 23 but does have provisions (at 35 Stat. 71) similar to those in section 23 of act June 25, 1910, ch. 431, 36 Stat. 861.

Section 254d(i)(4) of title 42, referred to in subsec. (a)(2)(B), was redesignated section 254d(j)(4) of title 42 by Pub. L. 107–251, title III, § 310(b)(1), Oct. 26, 2002, 116 Stat. 1643.

### Amendments

1992—Subsec. (a)(1). Pub. L. 102–573, § 106(a)(1), substituted “health professionals” for “physicians, dentists, nurses, nurse practitioners, physician assistants, clinical and counseling psychologists, graduates of schools of public health, graduates of schools of social work, and other health professionals”.

Subsec. (b)(1)(A)(i). Pub. L. 102–573, § 106(a)(2)(A)(i), amended cl. (i) generally. Prior to amendment, cl. (i) read as follows: “as a full-time student in the final year of a course of study or program in an accredited institution, as determined by the Secretary, within any State; or”.

Subsec. (b)(1)(A)(ii). Pub. L. 102–573, § 106(a)(2)(A)(ii), substituted “a health profession” for “medicine, osteopathy, dentistry, or other health profession”.

Subsec. (b)(1)(B). Pub. L. 102–573, § 106(a)(2)(B), in cl. (i), substituted “a degree in a health profession; and” for “a degree in medicine, osteopathy, dentistry, or other health profession;”, redesignated cl. (iii) as (ii) and substituted “a health profession” for “medicine, osteopathy, dentistry, or other health profession”, and struck out former cl. (ii) which read as follows: “completed an approved graduate training program in medicine, osteopathy, dentistry, or other health profession in a State, except that the Secretary may waive the completion requirement of this clause for good cause; and”.

Subsec. (b)(2) to (4). Pub. L. 102–573, § 106(a)(2)(C), inserted “and” at end of par. (2)(D), added par. (3), and struck out former pars. (3) and (4) which read as follows:

“(3) submit an application to participate in the Loan Repayment Program; and

“(4) sign and submit to the Secretary, at the time of submission of such application, a written contract (described in subsection (f) of this section) to accept repayment of educational loans and to serve (in accordance with this section) for the applicable period of obligated service in an Indian health program.”

Subsec. (d)(1). Pub. L. 102–573, § 106(b)(1), substituted “Consistent with paragraph (3), the” for “The”.

Subsec. (d)(1)(A). Pub. L. 102–573, § 902(2)(C), substituted “Indian health” for “Indian Health”.

Subsec. (d)(3). Pub. L. 102–573, § 106(b)(2), added par. (3).

Subsec. (e)(1). Pub. L. 102–573, § 106(c), amended par. (1) generally. Prior to amendment, par. (1) read as follows: “An individual becomes a participant in the Loan Repayment Program only on the Secretary’s approval of the individual’s application submitted under subsection (b)(3) of this section and the Secretary’s acceptance of the contract submitted by the individual under subsection (b)(4) of this section.”

Subsec. (e)(2)(A). Pub. L. 102–573, § 106(d), inserted “, including extensions resulting in an aggregate period of obligated service in excess of 4 years” before “; or”.

Subsec. (g)(1). Pub. L. 102–573, § 106(e), in introductory provisions, substituted “loans received by the individual regarding the undergraduate or graduate education of the individual (or both), which loans were made for” for “loans received by the individual for”.

Subsec. (g)(2)(A). Pub. L. 102–573, § 106(f), amended subpar. (A) generally. Prior to amendment, subpar. (A) read as follows: “Except as provided in subparagraph (B) and paragraph (3), for each year of obligated service for which an individual contracts to serve under subsection (f) of this section, the Secretary may pay up to $25,000 on behalf of the individual for loans described in paragraph (1).”

Subsec. (g)(3). Pub. L. 102–573, § 106(g)(1), amended par. (3) generally. Prior to amendment, par. (3) read as follows: “In addition to payments made under paragraph (2), in any case in which payments on behalf of an individual under the Loan Repayment Program result in an increase in Federal, State, or local income tax liability for such individual, the Secretary may, on the request of such individual, make payments to such individual in a reasonable amount, as determined by the Secretary, to reimburse such individual for all or part of the increased tax liability of the individual.”

Subsec. (i). Pub. L. 102–573, § 902(2)(D), substituted “health professional programs of the Service” for “Service manpower programs”.

Subsec. (k). Pub. L. 102–573, § 106(h), amended subsec. (k) generally. Prior to amendment, subsec. (k) read as follows: “The Secretary shall ensure that the staffing needs of Indian health programs administered by any Indian tribe or tribal or Indian organization receive consideration on an equal basis with programs that are administered directly by the Service.”

Subsec. (n). Pub. L. 102–573, § 106(i), amended subsec. (n) generally. Prior to amendment, subsec. (n) consisted of pars. (1) and (2) requiring submission of annual reports to Congress by the first of March and the first of July of each year.

Subsec. (o). Pub. L. 102–573, § 117(b)(3), struck out subsec. (o) which read as follows: “There are authorized to be appropriated such sums as may be necessary for each fiscal year to carry out the provisions of this section.”

### Statutory Notes and Related Subsidiaries

### Change of Name

Reference to Reserve Corps of the Public Health Service deemed to be a reference to the Ready Reserve Corps, see section 204(c)(3) of Title 42, The Public Health and Welfare.

### Effective Date of 1992 Amendment

Pub. L. 102–573, title I, § 106(g)(2), Oct. 29, 1992, 106 Stat. 4537, provided that: “The amendment made by paragraph (1) [amending this section] shall apply only with respect to contracts under section 108 of the Indian Health Care Improvement Act [this section] entered into on or after the date of enactment of this Act [Oct. 29, 1992].”