Chapter 530. Regulations Governing the Virginia Medical Scholarship Program
Part I
General Information
12VAC5-530-10. Purpose.
This chapter sets forth the criteria for eligibility, circumstances under which awards will be made, and the process for awarding Virginia medical scholarships to medical students; the general terms and conditions applicable to the obligation of each recipient of a medical scholarship to practice medicine in a medically underserved area of Virginia, as identified by the Board of Health by regulation, or to practice medicine in a designated state facility as defined in this chapter regulations; and penalties for a recipient's failure to fulfill the practice requirements of the Virginia Medical Scholarship Program.
Statutory Authority
§§ 32.1-12, 32.1-122.5, 32.1-122.5:1, 32.1-122.6, and 32.1-122.6:01 of the Code of Virginia.
Historical Notes
Derived from VR355-40-400 § 1.2, eff. July 3, 1991; amended, Virginia Register Volume 10, Issue 21, eff. August 10, 1994.
12VAC5-530-20. Administration.
The State Health Commissioner, as executive officer of the Board of Health, shall administer this program. Any requests for variance from this chapter shall be considered on an individual basis by the board in regular session.
Statutory Authority
§§ 32.1-12, 32.1-122.5, 32.1-122.5:1, 32.1-122.6, and 32.1-122.6:01 of the Code of Virginia.
Historical Notes
Derived from VR355-40-400 § 1.3, eff. July 3, 1991; amended, Virginia Register Volume 11, Issue 10, eff. August 10, 1994.
12VAC5-530-30. Applicability.
This chapter shall apply to all recipients who begin fulfillment of their scholarship obligation on July 1, 1990, or later; provided that approval given by the commissioner prior to the effective date of this chapter shall remain in full force and effect.
Statutory Authority
§§ 32.1-12, 32.1-122.5, 32.1-122.5:1, 32.1-122.6, and 32.1-122.6:01 of the Code of Virginia.
Historical Notes
Derived from VR355-40-400 § 1.4, eff. July 3, 1991; amended, Virginia Register Volume 10, Issue 21, eff. August 10, 1994.
Part II
Definitions
12VAC5-530-40. Definitions.
Unless the context clearly indicates a contrary interpretation, the words and terms used in this chapter shall have the following meanings:
"Accredited residency" means a graduate medical education program in family practice medicine, general internal medicine, pediatric medicine or obstetrics and gynecology accredited by the Liaison Committee on Graduate Medical Education.
"Approved by the medical school that nominated him for the scholarship" means that medical school affirms that the graduate has accepted placement in an accredited residency or internship at a hospital or institution located in Virginia, or affirms that such placement has been accepted in a program not located in Virginia due to such placement through the match.
"Board" or "Board of Health" means the State Board of Health.
"Commissioner" means the State Health Commissioner.
"Designated state facility" means a facility operated by the Virginia Departments of Corrections, Youth and Family Services, or Mental Health, Mental Retardation and Substance Abuse Services.
"First year resident" means a graduate of a participating medical school who has been accepted by an accredited primary care residency program approved by the medical school that nominated him for the scholarship.
"Interest at the prevailing bank rate for unsecured debt" means the prime lending rate as published in the Wall Street Journal on the last day of the month in which the decision to repay is communicated to the commissioner by the recipient, plus two percentage points.
"The match" means the National Resident Matching Program, a nationwide system by which medical school graduates are placed in graduate medical education programs by mutual agreement.
"Medically underserved area" means a geographic area in Virginia designated by the State Board of Health in accordance with the rules and regulations for the identification of medically underserved areas.
"Participating medical school" means the Eastern Virginia Medical School of the Medical College of Hampton Roads, or the Medical College of Virginia of the Virginia Commonwealth University, or the School of Medicine of the University of Virginia, or the James H. Quillen College of Medicine of East Tennessee State University.
"Penalty" means an amount of money equal to two times the amount of all monetary scholarship awards paid to the scholarship recipient.
"Practice" means the practice of medicine by a recipient in one of the designated primary care specialties in a specific geographic area determined to be fulfillment of the recipient's scholarship obligation.
"Primary care" means the specialties of family practice medicine, general internal medicine, pediatric medicine, or obstetrics and gynecology.
"Recipient" or "scholarship recipient" means an eligible medical student or graduate medical student who enters into a contract with the commissioner and receives one or more scholarship awards via the Virginia Medical Scholarship Program.
"Restitution" means the amount of monetary reimbursement, including repayment of all pertinent scholarship awards plus penalty and applicable interest as set forth in this chapter, that will be owed to the Commonwealth of Virginia by a scholarship recipient who is in default of his contractual obligation as provided for in this chapter.
"Southwest Virginia" means those cities and counties in Virginia that are located in Planning Districts 1, 2, and 3; they include Bland County, City of Bristol, Buchanan County, Carroll County, Dickenson County, City of Galax, Grayson County, Lee County, City of Norton, Russell County, Scott County, Smyth County, Tazewell County, Washington County, Wise County, and Wythe County.
"Virginia medical scholarship" means an award of an amount specified by the General Assembly in the Appropriations Act made to a student enrolled in a participating medical school or to a graduate student of a participating medical school pursuing the first year of graduate training at a hospital or institution approved by the participating medical school that nominated him for the scholarship and for which the medical student or graduate medical student entered a contractual obligation to repay.
Statutory Authority
§§ 32.1-12, 32.1-122.5, 32.1-122.5:1, 32.1-122.6, and 32.1-122.6:01 of the Code of Virginia.
Historical Notes
Derived from VR355-40-400 § 2.1, eff. July 3, 1991; amended, Virginia Register Volume 10, Issue 21, eff. August 10, 1994.
Part III
Scholarship Awards
12VAC5-530-50. Eligible applicants.
Any currently enrolled student in full-time attendance at a participating medical school or a graduate of such school who has accepted placement in, but not entered the first year of an accredited internship or accredited residency approved by the medical school that nominated him for the scholarship, shall be eligible for the Virginia medical scholarship. Preference for the scholarship award shall be given to: residents of the Commonwealth, students whose period of residence in one or more medically underserved areas is deemed by the participating medical school to indicate a high likelihood that the student would fulfill his contractual obligation to practice in a medically underserved area, and students from economically disadvantaged backgrounds over nonresidents. Additionally, preference shall be given to graduates accepted by approved primary care residencies in Virginia over graduates in approved out-of-state residencies. Virginia medical scholarships are available for medical students who are enrolled at the James H. Quillen College of Medicine of East Tennessee State University when such individuals are determined to be committed to practicing in a medically underserved area in Southwest Virginia. Preference for the scholarship award shall be given to residents of Southwest Virginia.
Statutory Authority
§§ 32.1-12, 32.1-122.5, 32.1-122.5:1, 32.1-122.6, and 32.1-122.6:01 of the Code of Virginia.
Historical Notes
Derived from VR355-40-400 § 3.1, eff. July 3, 1991; amended, Virginia Register Volume 10, Issue 21, eff. August 10, 1994.
12VAC5-530-60. Scholarship award.
A Virginia medical scholarship award shall be awarded to the recipient upon or following the recipient's execution of a contract with the commissioner for scholarship repayment.
Statutory Authority
§§ 32.1-12, 32.1-122.5, 32.1-122.5:1, 32.1-122.6, and 32.1-122.6:01 of the Code of Virginia.
Historical Notes
Derived from VR355-40-400 § 3.2, eff. July 3, 1991; amended, Virginia Register Volume 10, Issue 21, eff. August 10, 1994.
12VAC5-530-70. Distribution of scholarships.
Annually, by May 1 of each calendar year, the commissioner shall inform the deans of the participating medical schools of the number as provided by the General Assembly by appropriation of medical school scholarships that are available for the schools' medical students during the next academic year. The annual number of medical scholarships available for award at each participating medical school shall be uniformly distributed among the schools, and shall be equal, and shall be based upon funds appropriated by the Virginia General Assembly, except that the number of Virginia medical scholarships available for medical students from Southwest Virginia attending the James H. Quillen College of Medicine of East Tennessee State University shall be limited to the number established by the Virginia General Assembly by appropriation. The deans of the respective participating medical schools shall annually nominate qualified students or first-year residents, in accordance with the criteria for preference enumerated in 12VAC5-530-50, to receive scholarships. The number of nominees submitted to the commissioner at this time will not exceed the number of scholarships that are available for each medical school. The State Health Commissioner shall award scholarships to the nominees of the deans at the participating medical schools in accordance with the number of scholarships available for each medical school. Any scholarships that have not been awarded following the initial annual distribution among the medical schools shall be available for redistribution to qualified students in any of the medical schools at the discretion of an awards committee consisting of the commissioner, who shall serve as chairman and ex officio member without vote, and the deans of the medical schools or their designees. The awards committee shall convene for this purpose only when the scholarships available to one or more of the medical schools exceed the number of qualified nominees by the dean(s). Scholarships shall be awarded to qualified students based upon majority vote of the awards committee. Individual scholarship recipients may be nominated for and receive a maximum of five scholarships.
Statutory Authority
§§ 32.1-12, 32.1-122.5, 32.1-122.5:1, 32.1-122.6, and 32.1-122.6:01 of the Code of Virginia.
Historical Notes
Derived from VR355-40-400 § 3.3, eff. July 3, 1991; amended, Virginia Register Volume 10, Issue 21, eff. August 10, 1994.
Part IV
Contracts
12VAC5-530-80. Contractual practice obligation.
Prior to the payment of money to a scholarship awardee, the commissioner shall enter into a contract with the recipient. The contract shall:
1. Provide that the recipient will pursue the medical course of the school nominating the recipient for the award until the recipient's graduation or will pursue the recipient's first year of primary care graduate training in an accredited residency program approved by the school nominating the recipient for the award and, upon completing a term not to exceed three* years as a resident in an approved program, will promptly begin and thereafter continuously engage in full-time primary care practice in a medically underserved area of Virginia, or in a designated state facility, for a period of years equal to the number of annual scholarships received. At any time prior to entering practice, the scholarship recipient shall be allowed to select a future practice location from the listing of medically underserved areas maintained by the board, and the recipient shall be allowed to fulfill the scholarship repayment obligation in the preselected medically underserved area. However, after making an initial selection of a medically underserved area in which to practice, the recipient may not alter the decision until the recipient is fully prepared to enter practice, at which time the recipient must choose from the current list of medically underserved areas maintained by the board or the preselected medically underserved area.
2. Provide that the recipient shall notify the commissioner in writing of his proposed practice location not more than 30 days after completing his approved residency program. After receiving written approval of his practice location from the commissioner, the recipient shall begin his approved practice not more than 90 days after completing his primary care residency program.
3. Provide that the recipient may request approval of a change of practice location. The commissioner in his discretion may approve such a request, but only if the change is to a practice location in a medically underserved area or a state facility designated by the Board of Health.
4. Provide that the recipient shall repay the scholarship obligation by practicing primary care medicine on a full-time basis in a medically underserved area, will maintain office hours convenient for the population of the area to have access to the recipient's services and will participate in all government sponsored insurance programs designed to assure access of covered persons to medical care services such as Medicare and Medicaid, and will not selectively place limits on the numbers of such patients admitted to the practice, and will charge the usual and customary fees prevailing in the area in which service is provided, except that if the patient is unable to pay the charge, such a patient will be charged a reduced rate or will not be charged at all. This stipulation may be waived at the commissioner's discretion in cases where it places undue financial burden on the part of the primary care medical practice.
5. Provide that the recipient repaying the scholarship obligation by practicing primary care medicine on a full-time basis in a medically underserved area will maintain office hours convenient for the population of the area to have access to the recipient's services.
6. Provide that the recipient shall not voluntarily obligate himself for more than the minimum period of military service required of physicians by the laws of the United States and that upon completion of the minimum period of military service, the recipient will promptly begin and thereafter continuously engage in full-time primary care practice in a medically underserved area of Virginia, or in a designated state facility, for the period of years equal to the number of scholarships received.
7. Provide that the recipient shall receive credit toward fulfillment of his contractual obligation at the rate of 12 months of medical practice for each scholarship award paid to the recipient. The recipient may be absent from the place of approved practice for a total of seven weeks in each 12-month period for personal reasons. Absence for a period in excess of seven weeks without the written permission of the commissioner shall result in proportional reduction of the period of credit toward fulfillment of the contractual obligation.
*NOTE: A variance (of one additional year) to the maximum three-year residency limitation will be available to medical scholarship recipients who choose to complete an obstetrics/gynecology residency program or a certificate of added qualification in primary care upon their request.
Statutory Authority
§§ 32.1-12, 32.1-122.5, 32.1-122.5:1, 32.1-122.6, and 32.1-122.6:01 of the Code of Virginia.
Historical Notes
Derived from VR355-40-400 § 4.1, eff. July 3, 1991; amended, Virginia Register Volume 10, Issue 21, eff. August 10, 1994.
12VAC5-530-90. Default.
With respect to default, the contract shall:
1. Provide that a recipient who fails to fulfill his obligation to practice primary care medicine as provided for in this chapter shall be deemed to be in default and shall forfeit all monetary scholarship payments made to him, and shall make restitution of those funds to the Commonwealth of Virginia as provided for in subdivisions 2 through 6 of this section.
2. Provide that if the recipient defaults while still in medical school or residency, by voluntarily notifying the commissioner in writing that he will not practice primary care in a Virginia medically underserved area as required by his contract, by voluntarily not proceeding to the next year of medical education or residency, or by withdrawing from medical school or residency, he shall make restitution to the Commonwealth of Virginia by repayment of all monetary scholarship awards plus interest on the amount of the restitution.
3. Provide that the recipient who defaults by failing to maintain satisfactory academic progress, or by reason of his dismissal from medical school for any reason, shall make restitution to the Commonwealth of Virginia by repayment of all monetary scholarship awards plus interest on the amount of such restitution to the Commonwealth.
4. Provide that if the recipient is in default due to death or permanent disability so as not to be able to engage in primary care practice, the recipient or his personal representative shall make restitution to the Commonwealth by repayment of all monetary scholarship awards plus interest on the amount of restitution. Partial fulfillment of the recipient's contractual obligation by the practice of medicine as provided for in this contract prior to death or permanent disability shall reduce the amount of restitution plus interest due by a proportionate amount of money, such proportion being determined as the ratio of the number of whole months that a recipient has practiced primary care medicine in an approved location to the total number of months of the contractual obligation the recipient has incurred.
5. Provide that individual cases of extraordinary hardship may be considered by the commissioner for forgiveness or partial forgiveness of payment or service.
6. Provide that any recipient of a scholarship, who defaults by evasion or refusal to fulfill the obligation to practice primary care medicine in a medically underserved area or designated state facility for a period of years equal to the number of annual scholarships received at any time following completion of medical school and residency training, shall make restitution by repaying all monetary scholarship awards, plus penalty, plus interest on such restitution to the Commonwealth of Virginia. A recipient will be considered to be in such default on the date:
a. The commissioner is notified in writing by the recipient that he does not intend to fulfill his contractual obligation;
b. The recipient has not accepted a placement and commenced his period of obligated practice as provided for in subdivision 2 of this section; or
c. The recipient absents himself without the consent of the commissioner from the place of medical practice which the commissioner has approved for fulfillment of his contractual obligation.
Statutory Authority
§§ 32.1-12, 32.1-122.5, 32.1-122.5:1, 32.1-122.6, and 32.1-122.6:01 of the Code of Virginia.
Historical Notes
Derived from VR355-40-400 § 4.2, eff. July 3, 1991; amended, Virginia Register Volume 10, Issue 21, eff. August 10, 1994.
Part V
Repayment
12VAC5-530-100. Repayment.
Repayment requirements for scholarship recipients are as follows:
1. Payment of restitution plus interest shall be due on the date that the recipient is deemed by the commissioner to be in default.
2. The commissioner in his discretion may permit extension of the period of payment of restitution plus interest for up to 24 months from the date that the recipient is deemed to be in default.
3. Partial fulfillment of the recipient's contractual obligation by the practice of medicine as provided for in this contract, shall reduce the amount of restitution plus interest due by an amount of money equal to the same percentage of all monetary awards as the number of whole months that the recipient has practiced primary care medicine in an approved location is as a percentage of the total number of months of the contractual obligation the recipient has incurred.
4. Failure of a recipient to make any payment on his debt of restitution plus interest when it is due shall be cause for the commissioner to refer the debt to the Attorney General of the Commonwealth of Virginia for collection. The recipient shall be responsible for any costs of collection as may be provided in Virginia law.
Statutory Authority
§§ 32.1-12, 32.1-122.5, 32.1-122.5:1, 32.1-122.6, and 32.1-122.6:01 of the Code of Virginia.
Historical Notes
Derived from VR355-40-400 § 5.1, eff. August 10, 1994; amended, Virginia Register Volume 10, Issue 21, eff. August 10, 1994.
Part VI
Records and Reporting
12VAC5-530-110. Reporting requirements.
Reporting requirements of medical schools and scholarship recipients are as follows:
1. Each participating medical school shall maintain accurate records of the status of scholarship recipients until the recipients graduate from medical school and during any postgraduate year that a scholarship is awarded. The medical schools shall provide a report listing the status of each recipient annually to the commissioner.
2. Each scholarship recipient shall at any time provide information as requested by the commissioner to verify compliance with the practice requirements of the scholarship contract. The recipient shall report any changes of mailing address, change of academic standing, change of intent to fulfill his contractual obligation and any other information which may be relevant to the contract at such time as changes or information may occur. The recipient shall promptly respond with such information as may from time to time be requested by the commissioner.
Statutory Authority
§§ 32.1-12, 32.1-122.5, 32.1-122.5:1, 32.1-122.6, and 32.1-122.6:01 of the Code of Virginia.
Historical Notes
Derived from VR355-40-400 § 5.1, eff. July 3, 1991; amended, Virginia Register Volume 10, Issue 21, eff. August 10, 1994.