[Federal Register Volume 68, Number 113 (Thursday, June 12, 2003)]
[Notices]
[Pages 35226-35227]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 03-14882]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Office of the Secretary


Applications Available To Request Waiver of the Two-Year Foreign 
Residence Requirement for Physicians with J-1 Visa Who Will Deliver 
Health Care Service

ACTION: Notice of Availability of Applications.

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SUMMARY: The HHS Exchange Visitor Program announces the availability of 
applications to request waiver of the two-year foreign residency 
requirement for physicians with J-1 visas who agree to deliver health 
care services for three years in primary care or mental health 
Professional Shortage Areas (HPSAs) or medically underserved areas or 
populations (MUA/Ps).

FOR FURTHER INFORMATION CONTACT: Michael Berry, Bureau of Health 
Professions, 5600 Fishers Lane, Rm. 8-67, Rockville, MD 20857. 
Telephone: 301-443-4154; Fax: 301-443-7904; [email protected].

ADDRESSES: Applications to request waivers to deliver health care 
services are available at http://www.globalhealth.gov and the Office of 
Global Health Affairs, 200 Independence Ave., SW., Room 639-H, 
Washington, DC 20201. Telephone: 202-690-6174; Fax: 202-690-7127.

SUPPLEMENTARY INFORMATION: On December 19, 2002, the Department of 
Health and Human Services (HHS) published in the Federal Register (67 
FR 77692) an interim-final rule amending the regulations at 45 CFR part 
50 governing the HHS Exchange Visitor Program. Under this program, HHS 
acts as an Interested Government Agency (IGA) to request waivers, on 
the Exchange Visitors' behalf, of the two-year foreign residency 
requirement. The amendments expanded the program to permit institutions 
and health care facilities to submit to HHS requests for waiver of the 
two-year home-country physical presence requirement for physician 
Exchange Visitors to deliver primary health care services in 
underserved areas, in addition to waivers to perform research.
    In determining whether to request a waiver for an Exchange Visitor 
to deliver primary health care services, HHS will consider information 
from and coordinate with State Departments of Public Health (or the 
equivalent), other IGAs, HHS programs such as the National Health 
Service Corps, and other relevant government agencies.
    HHS will process applications in the order received. Please note 
that HHS will not accept applications submitted by Exchange Visitors. 
Applications for waiver requests must be submitted by private or non-
federal institutions, organizations, or agencies or by a component 
agency of HHS.
    In brief, the criteria for a waiver recommendation by HHS acting as 
an IGA are as follows:
    1. Eligibility to apply for HHS waiver requests is limited to 
primary care physicians, and general psychiatrists who have completed 
their primary care or psychiatric residency training programs. Primary 
care physicians are defined as: physicians practicing general internal 
medicine, pediatrics, family practice or obstetrics/gynecology and who 
are willing to work in a primary care HPSA or MUA/P; and general 
psychiatrists willing to work in a Mental Health HPSA.

    Note: The regulations restrict eligibility to primary care 
physicians, and general psychiatrists who have completed their 
primary care or psychiatric residency training programs no more than 
12 months before the date of commencement of employment under the 
contract described below. 45 CFR 50.5(b). For applications submitted 
prior to October 1, 2003, HHS will ease this12-month eligibility 
condition to enable physicians who completed their training programs 
in June 2002 to be eligible to apply for a waiver. Without this 
modification, physicians who completed their training programs in 
June 2002 would be unable to begin employment by the required date, 
July 2003, and thus would be ineligible to seek waivers. 
Accordingly, for applications received prior to October 1, 2003, the 
physician seeking a waiver must have completed a primary care or 
general psychiatric residency no earlier than June 1, 2002.

    2. The petitioning health care facility must establish that it has 
recruited actively and in good faith for U.S. physicians in the recent 
past, but has been unable to recruit a qualified U.S. physician.
    3. The head of a petitioning health care facility must execute a 
statement to confirm that the facility is located in a specific, 
designated HPSA or MUA/P, and that it provides medical care to Medicaid 
and Medicare eligible patients and the uninsured indigent.
    4. The Exchange Visitor must execute a statement that he or she 
does not have pending, and will not submit, other IGA waiver requests 
while HHS processes the waiver request.
    5. The employment contract must require the Exchange Visitor to 
practice a specific primary care discipline or general psychiatry for a 
minimum of three years, 40 hours per week in a specified HPSA or MUA/P. 
It may not include a non-compete clause that limits the Exchange 
Visitor's ability to continue to practice in any HHS-designated primary 
care or mental health HPSA or MUA/P after the period of obligation. The 
contract must be terminable only for cause and not terminable by mutual 
agreement until completion of the three-year commitment, except that 
the contract may be assigned to another eligible employer, subject to 
approval by HHS

[[Page 35227]]

and consistent with all applicable INS and Department of Labor 
requirements.

    Dated: June 5, 2003.
William R. Steiger,
Director, Office of Global Health Affairs.
[FR Doc. 03-14882 Filed 6-11-03; 8:45 am]
BILLING CODE 4165-15-P