Hospitals looking to fill physician shortages may want to recruit J-1 visa waiver practitioners. But as recent developments in Nevada illustrate, your organization must adhere to national and state regulations before delving into its own recruitment and credentialing process.
J-1 visa waiver practitioners are typically foreign citizens who have graduated from an American residency program and are seeking work in this country. Without the waiver, these graduates must return to their home country for two years before returning here to find work and possibly to begin the citizenship process. The waiver allows them to skip the two-year gap, as long as they work in a designated area, such as one with a medically underserved population.
In Nevada, some facilities that didn't qualify to use the J-1 visa practitioners were allegedly bringing them on staff and, in some cases, overworking them. The Nevada State Medical Association lacked the resources to stop this exploitation until a series of new laws were enacted earlier this summer.
Numerous problems, including contract irregularities and misleading information about where the practitioners would work, were brought to the public's attention by a series of articles in the Las Vegas Sun starting in fall 2007.
"Over the years, the [Nevada State Medical Association (NSMA)] concerns were primarily about filling the need for primary care physicians in our rural and frontier areas and the difficulties in having them licensed in the state because of procedural issues between the medical licensing board and the federal government regarding the timing of visas," says Lawrence P. Matheis, executive director of the NSMA. "Nevada has rarely recruited anywhere near the maximum number of J-1 [H1B] visa waiver physicians to which we are entitled under the program."
However, after identifying the problems, the state decided to enact regulations.
Not only does the J-1 recruitment process take up a lot of time for hospitals, it can also be costly for medical staffs to pay for primary source verifications, criminal background checks, and other common credentialing verifications. Before you begin that convoluted process, know what questions to ask to ensure that your organization is authorized to contract with these practitioners.
Some U.S. government agencies may apply for a J-1 visa waiver on behalf of a foreign medical graduate. These agencies include:
- Appalachian and Delta Regional Commissions
- U.S. Department of Health and Human Services
- Department of Veterans Affairs
- Department of Interior for Indian Reservations
Another popular option for foreign medical graduates is to apply for a J-1 visa waiver through an individual state's department of health "Conrad 30" program (also known as the J-1 visa waiver program). Since 1994, when this program was established, states have been able to accept up to 30 J-1 visa waiver practitioners per year to work in underserved areas.
Recently, a flex waiver program was added whereby 10 of these 30 slots may be used by organizations that aren't in underserved areas, but that treat a significant number of patients who live in underserved areas.
Many practitioners apply for the waivers while they are still in their residency programs because it can take months to process the necessary paperwork.