No. 31779 (Amendment): R434-100. Physician Visa Waivers

DAR File No.: 31779
Filed: 07/30/2008, 07:41
Received by: NL

RULE ANALYSIS

Purpose of the rule or reason for the change:

The change will allow Utah to take advantage of changes in the federal Conrad 30 J-1 Visa Waiver program that allows for subspecialty physicians to receive waivers by serving the subspecialty needs of medically underserved populations in a state. This change would currently allow Utah to approve up to ten subspecialty physicians to serve medically underserved populations.

Summary of the rule or change:

The change amends the current Physician Visa Waiver rule to include subspecialty physicians (current rule only allows for primary care physicians) as defined for placement under the Conrad 30 J-1 Visa waiver program.

State statutory or constitutional authorization for this rule:

Section 26-1-18

Anticipated cost or savings to:

the state budget:

Minimal cost to process and review applications and requests, and write letters in support of these waivers to the U.S. Department of State. A potential for savings exists when medically underserved populations can receive services without having to resort to emergency rooms.

local governments:

No costs anticipated and no savings anticipated.

small businesses and persons other than businesses:

No impact unless a small business chooses to become an employer of a J-1 physician approved under this waiver program. In such a case, the small business would likely benefit from being able to bill for the services of this physician as those billings are likely to exceed the cost to employ the physician.

Compliance costs for affected persons:

The J-1 physician and employing agency must comply with the applicable federal and state regulations regarding physician waivers. This does require the services of an attorney for the physician and/or employing agency to complete the paperwork and application.

Comments by the department head on the fiscal impact the rule may have on businesses:

The opportunity to employ noncitizen physicians in underserved areas where employment of citizen physicians has been attempted but has been unsuccessful, will have a positive fiscal impact on both businesses and citizens. Participation in the program is voluntary and this rule change will make it more available where it is needed. David N. Sundwall, MD, Executive Director

The full text of this rule may be inspected, during regular business hours, at the Division of Administrative Rules, or at:

Health
Health Systems Improvement, Primary Care and Rural Health
3760 S HIGHLAND DR
SALT LAKE CITY UT 84106

Direct questions regarding this rule to:

Erin Olsen at the above address, by phone at 801-273-6618, by FAX at 801-273-4146, or by Internet E-mail at [e-mail]

Interested persons may present their views on this rule by submitting written comments to the address above no later than 5:00 p.m. on:

09/15/2008

This rule may become effective on:

09/22/2008

Authorized by:

David N. Sundwall, Executive Director

RULE TEXT

R434. Health, Health Systems Improvement, Primary Care and Rural Health.

R434-100. Physician Visa Waivers.

R434-100-2. Definitions.

As used in this rule:

(1) "Department" means the Utah Department of Health.

(2) "Health care facility" means a doctor's office, local health department, clinic or licensed health care facility where a J-1 visa waiver physician may work under the supervision of the sponsoring physician.

(3) "Primary care physician" means a physician who specializes in general internal medicine, family medicine, general pediatrics, obstetrics and gynecology, or psychiatry.

(4) "Principal" means any person who owns 10% or more beneficial or equitable interest in the health care facility.

(5) "Subspecialty care physician" means a physician who specializes in a specialty other than general internal medicine, family medicine, general pediatrics, obstetrics and gynecology, or psychiatry.

 

R434-100-4. Physician Eligibility.

[(1) ]A physician is eligible to apply for a J-1 visa waiver recommendation if he:

([a]1) is enrolled in or has completed a minimum three year postgraduate training program in the United States accredited by the Accreditation Committee on Graduate Medical Education or the American Osteopathic Association Bureau of Professional Education prior to submitting an application;

([b]2) has passed the examination requirements for licensure as a physician or surgeon or osteopathic physician or surgeon in Utah, pursuant to rule established by the Division of Occupational and Professional Licensing; and

([c]3) has the specialty training and previous work experience that corresponds to the health care facility's recruitment descriptions.

 

R434-100-5. Requests.

The health care facility or the physician must submit to the Department a written request for the J-1 visa waiver.

(1) The request must include from the health care facility:

(a) the speciality of physician that the facility has been unable to recruit;

(b) documentation of its recruitment efforts to hire a qualified United States citizen for at least one immediate prior year for the position the J-1 visa waiver physician seeks to fill;

([b]c) documentation that it implements a sliding fee scale, payment schedule, or similar method that demonstrates that it provides discounts to medically indigent patients; and

([c]d) an assurance letter that the health care facility and its principals are not under investigation for, under probation for, or under restriction for:

(i) Children's Health Insurance Program, Medicaid, or Medicare fraud;

(ii) violations of Division of Occupational and Professional Licensing statute or rules; or

(iii) other violations of law that may indicate that it may not be in the public interest that a waiver of the two-year home residency requirement be granted.

(2) The request must include from the physician:

(a) a completed application that includes all professional experience, education, licenses and certificates, specialty or specialties, research, honors, professional memberships, and three professional references;

(b) a copy of all IAP-66 forms "Certificate of Eligibility for Exchange Visitor (J-1) Status" and INS forms I-94 for the physician and his or her spouse and children; and

(c) the case number issued by the United States Department of State indicating payment of the federal fee required to apply for the visa waiver.

(3) The request must also include:

(a) a copy of the complete contract between the J-1 visa waiver physician and the health care facility;

(b) any required processing fees; and

(c) other information requested by the Department as may be reasonably necessary to determine whether it is in the public interest that a waiver of the two-year home residency requirement be granted.

 

R434-100-6. Contract Requirements.

To obtain a state recommendation that the visa waiver is in the public interest, the contract that the applicant submits must meet the following criteria:

(1) The contract must be for employment at a health care facility:

(a) to work as a primary care physician located within a federally designated primary care Health Professional Shortage Area or to work as a subspecialty care physician serving medically needy population;

(b) that has been operating for at least one year;

(c) whose principals are free from default on any federal or state scholarship or loan repayment program offered by the National Health Service Corps or by the state under Title 26, Chapter 46;

(d) that it or its principals are not under investigation for, under probation for, or under restriction for:

(i) Medicaid or Medicare fraud;

(ii) violations of Division of Occupational and Professional Licensing statute or rules; or

(iii) other violations of law that may indicate that it may not be in the public interest that a waiver of the two-year home residency requirement be granted.

(e) that accepts all Medicaid, Medicare, Children's Health Insurance Program, Primary Care Network and Utah Medical Assistance Program eligible patients; and

(f) that implements a sliding fee scale, payment schedule, or similar method that demonstrates that it provides discounts to medically indigent patients.

(2) The contract must provide:

(a) that the physician agrees to meet the requirements set forth in section 214(k) of the Immigration and Nationality Act, 8 USC 1184(k);

(b) the specific address of the health care facility where the physician will practice medicine;

(c) a description of the geographic area that will be served by the physician;

(d) that the physician agrees to work an annual full-time equivalency [or]of 40 hours in patient care per week;

(e) for an obligation committing both parties to three years of employment; and

(f) that the physician agrees to begin employment at the health care facility within ninety (90) days of the waiver being granted;

(3) The contract shall not contain a "non competition" clause or other provision that would discourage or inhibit the physician from working anywhere in the state upon termination of his employment with the health care facility.

 

KEY: waivers, underserved, physicians

Date of Enactment or Last Substantive Amendment: [October 31, 2005]2008

Authorizing, and Implemented or Interpreted Law: 26-1-18