Thinking Outside the Country: Recruiting Foreign Physicians

In recruiting doctors, hospitals must navigate several minefields which include Stark law and the Anti-Kickback Statute. Yet, a rarely considered issue when recruiting physicians is whether immigration laws have been violated. Generally, non-resident aliens who have completed a residency or fellowship training program in the United States must return to their home country for two years before they can work in the United States.

The Louisiana Department of Health and Hospitals (“DHH”) created the Louisiana Conrad State 30 (J-1 Visa Waiver) Program to overcome this requirement. This program allows thirty qualified physicians to waive the requirement to return home for two years “in exchange for providing primary and/or specialty medical care in designated Health Professional Shortage Areas (“HPSAs”) or to residents of designated HPSAs for a period of at least three years.” By allowing primary care physicians and specialists to remain in Louisiana, DHH hopes to “improve access to primary health care in areas where there is a shortage of physicians, and secondarily, to improve access to needed specialty care.” Applications for these waivers open on October 1 of each year and the waivers are awarded on a first-come, first-serve basis.

However, like most federal programs, participation in the Louisiana Conrad State 30 Program carries a significant administrative burden, including detailed forms, checklists, application packets, etc. Further, in order to apply for a waiver, the site must have a written policy declaring the provider accepts all patients regardless of their ability to pay, a notice stating such posted in the waiting room, an indigent-care policy of uninsured/underinsured patients, and proof of provision of services to Medicare and Medicaid patients. These requirements must be in place at least ninety days prior to a request for waiver. While applying for the Louisiana Conrad State 30 Program may be difficult, the program provides significant benefits to both the physicians who are allowed to stay and the populations they serve.

Written by: Danielle L. Borel

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