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Articles Posted in J Waiver

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The Chicago immigration attorneys of Zneimer & Zneimer follow closely regulatory changes in the J waiver process and learned that recently the U.S. Department of Health and Human Services (HHS) has revised its guidelines for J Waivers for physicians subject to the 2-years foreign residency requirement.  HHS will now process applications for waivers from any facility in or with a health professional shortage area (HPSA) score of 7 or higher for foreign physicians to practice in a primary care specialty (family medicine, general internal medicine, general pediatrics, obstetrics & gynecology) or general psychiatry.

HHS acts as an Interested Government Agency (IGA) on behalf of  foreign physicians subject to the 2-years foreign residency requirement who agree to work for 3 years in certain areas.  Previously, the HHS only processed applications for facilities which were either:

  • A health center as defined under Section 330 of the Public Health Service Act, and  which is receiving a grant from the U.S. Health Resources and Services  Administration under this section;
  • A rural health clinic as defined under Sections 1102 and 1871 of the Social Security Act; or
  • A Native American/Alaskan Native tribal medical facility as defined by the Indian Self-Determination and Education Assistance Act (P.L. 93-638)

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            International physicians who are in J-1 status in the United States become subject to 2 years home residency requirement. Physicians wishing to remain in the United States may be eligible to apply for a J-1 Visa Waiver if an Interested Government Agency agrees to recommend them for the waiver. Through this waiver, a physician may remain in the U.S. under a commitment to work for at least 3 years in a medically underserved area or the Veterans Administration.  J-1 Waiver is a prerequisite for foreign physicians to begin their path to permanent residency as without the waiver they would be inadmissible.

Physicians will work with the U.S. Department of State, USCIS, and their local health agency in order to request the J-1 Waiver. The U.S. State Department permits any US government agency to request a waiver. Some agencies have special programs to sponsor doctors. In many cases, this agency will be a state health department. Agencies sponsoring applicants for J-1 Waivers are known as Interested Government Agencies (IGA).

Of the major governmental agencies that sponsor J-1 Waivers, the Delta Regional Authority (DRA) is recognized as independent, and is unlimited in number of physicians they can recommend to receive waivers.  By contrast, the Conrad State 30 Waiver Program (administered in Illinois by the Center for Rural Health – Illinois Department of Public Health) recommends only 30 physicians per year to receive waivers.

The Delta Regional Authority sponsors both primary care physicians (including “general or family practice, general internal medicine, pediatrics, obstetrics/gynecology, and psychiatry) and specialty medicine physicians. (For specialty medicine physicians, DRA requires additional documentation.)  It serves communities in the Delta Region of the U.S., spanning Alabama, Arkansas, Kentucky, Louisiana, Mississippi, Missouri, and Tennessee. In Illinois, the DRA serves 16 counties in the state’s southern region.

Through the Delta Doctors Program, the DRA places physicians in Health Professional Shortage Areas, Medically Underserved Populations/Medically Underserved Areas, and Mental Health Professional Shortage Areas which are located within its service counties. However, the DRA will consider applications for J-1 waiver placements if the employer can prove that the communities of a location outside of the established service areas will be better served.

Full-time, primary care physicians in rural clinics in this region are eligible for J-1 Waiver requests by the Delta Doctors Program. The DRA provides comprehensive information of the process on their website .  It is advisable to read the J-1 Visa Waiver Program Guidelines, found above, in its entirety. Applicants must follow all specified guidelines and submit the packet, in duplicate, to the DRA. The non-refundable filing fee for the J-1 Waiver application is $3,000.00. If an application is withdrawn within 20 days after it is received by the DRA, the applicant will be issued a 50% refund. Continue reading →

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