12/16/2004

The House, on November 17, passed legislation that extends and modifies the "Conrad 30" J waiver program for foreign-born physicians. The Senate already passed the measure (S. 2302) on October 11, so the bill now goes to President Bush, who is expected to sign it. Under the program, aliens who participate in medical residencies in the United States on exchange program (J) visas are exempted from the two-year foreign residence requirement of INA § 212(e) if they agree to practice medicine for three years in an area designated by the Secretary of Health and Human Services (HHS) as having a shortage of health care professionals. 

The program has been extended several times, most recently via the 21st Century Department of Justice Appropriations Authorization Act , which extended the program until June 1, 2004. S. 2302 extends it for another two years, until June 1, 2006.

The bill also makes several important changes to the J waiver program. First, S. 2302 specifies that physicians who are sponsored for a waiver by either a federal or state agency will be exempt from the H-1B cap. In addition, the bill allows five of each state's 30 waivers to go to doctors that practice medicine in areas not designated by the Secretary of HHS as having a shortage of health care professionals, if the doctors receiving the waivers practice in facilities that serve patients who reside in areas designated by the Secretary as having a shortage of health care professionals.

Finally, the measure permits foreign doctors receiving a waiver to work in medically-underserved areas in either primary care or specialty medicine. Under current law, only state agencies and the Veteran's Administration are permitted to sponsor specialists. To request a waiver for a specialist, however, the interested agency would be required to demonstrate a shortage of doctors able to provide the appropriate medical specialty in the designated geographical area.

Exemption from the H-1B Limitation: Annual cap does not apply to IMG whose status is changed under the preceding sentence, if the IMG obtained a waiver of the 2-year foreign residence requirement upon a request by an interested Federal agency or an interested State agency. 

Limitation on Medical Practice Areas: Must agree to practice primary care or specialty medicine. Exemptions: 

(1) in the case of a request by the Department of Veterans Affairs, the alien shall not be required to practice medicine in a geographic area designated by the Secretary; 

(2) in the case of a request by an interested State agency, the head of such State agency determines that the alien is to practice medicine under such agreement in a facility that serves patients who reside in one or more geographic areas so designated by the Secretary of Health and Human Services without regard to whether such facility is located within such a designated geographic area, and the grant of such waiver would not cause the number of the waivers granted on behalf of aliens for such State for a fiscal year in accordance with the conditions of this clause to exceed 5; and 

(3) in the case of a request by an interested Federal agency or by an interested State agency for a waiver for an alien who agrees to practice specialty medicine in a facility located in a geographic area so designated by the Secretary of Health and Human Services, the request shall demonstrate, based on criteria established by such agency, that there is a shortage of health care professionals able to provide services in the appropriate medical specialty to the patients who will be served by the alien.

 

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