Employment protections for physicians

(a) Exceptions to 2-Year foreign residency requirement Section 214(l)(1) of the Immigration and Nationality Act (8 U.S.C. 1184(l)(1)) is amended— (1) in the matter preceding subparagraph (A), by striking Attorney General and inserting Secretary of Homeland Security; (2) in subparagraph (A), by striking Director of the United States Information Agency and inserting Secretary of State; (3) in subparagraph (B), by inserting, except as provided in paragraphs (7) and (8) before the semicolon at the end; (4) in subparagraph (C), by striking clauses (i) and (ii) and inserting the following: (i) the alien demonstrates a bona fide offer of full-time employment at a health facility or health care organization, which employment has been determined by the Secretary of Homeland Security to be in the public interest; and (ii) the alien— (I) has accepted employment with the health facility or health care organization in a geographic area or areas which are designated by the Secretary of Health and Human Services as having a shortage of health care professionals; (II) begins employment by the later of the date that is— (aa) 120 days after receiving such waiver; (bb) 120 days after completing graduate medical education or training under a program approved pursuant to section 212(j)(1); or (cc) 120 days after receiving nonimmigrant status or employment authorization, if the alien or the alien’s employer petitions for such nonimmigrant status or employment authorization not later than 120 days after the date on which the alien completes his or her graduate medical education or training under a program approved pursuant to section 212(j)(1); and (III) agrees to continue to work for a total of not less than 3 years in the status authorized for such employment under this subsection, except as provided in paragraph (8).; and (5) in subparagraph (D), in the matter preceding clause (i), by inserting (except as provided in paragraph (8)) after 3 years. (b) Allowable visa status for physicians fulfilling waiver requirements in medically underserved areas Section 214(l)(2)(A) of such Act (8 U.S.C. 1184(l)(2)(A)) is amended to read as follows: (A) Upon the request of an interested Federal agency or an interested State agency for recommendation of a waiver under this section by a physician who is maintaining valid nonimmigrant status under section 101(a)(15)(J) and a favorable recommendation by the Secretary of State, the Secretary of Homeland Security may change the status of such physician to any status authorized for employment under this Act. The numerical limitations contained in subsection (g)(1)(A) shall not apply to any alien whose status is changed under this subparagraph.. (c) Violation of agreements Section 214(l)(3)(A) of such Act (8 U.S.C. 1184(l)(3)(A)) is amended by inserting substantial requirement of an before agreement entered into. (d) Physician employment in underserved areas Section 214(l) of such Act, as amended by this section, is further amended by adding at the end the following: (4) (A) If an interested State agency denies an application for a waiver under paragraph (1)(B) from a physician pursuing graduate medical education or training pursuant to section 101(a)(15)(J) because the State has requested the maximum number of waivers permitted for that fiscal year, the physician’s nonimmigrant status shall be extended for up to 6 months if the physician agrees to seek a waiver under this subsection (except for paragraph (1)(D)(ii)) to work for an employer described in paragraph (1)(C) in a State that has not yet requested the maximum number of waivers. (B) Such physician shall be authorized to work only for the employer referred to in subparagraph (A) during the period beginning on the date on which a new waiver application is filed with such State and ending on the earlier of— (i) the date on which the Secretary of Homeland Security denies such waiver; or (ii) the date on which the Secretary approves an application for change of status under paragraph (2)(A) pursuant to the approval of such waiver.. (e) Contract requirements Section 214(l) of such Act, as amended by this section, is further amended by adding at the end the following: (5) An alien granted a waiver under paragraph (1)(C) shall enter into an employment agreement with the contracting health facility or health care organization that— (A) specifies the maximum number of on-call hours per week (which may be a monthly average) that the alien will be expected to be available and the compensation the alien will receive for on-call time; (B) specifies— (i) whether the contracting facility or organization— (I) has secured medical malpractice liability protection for the alien under section 224(g) of the Public Health Service Act (42 U.S.C. 233(g)); or (II) will pay the alien’s malpractice insurance premiums; (ii) whether the employer will provide malpractice insurance for the alien; and (iii) the amount of such liability protection that will be provided; (C) describes all of the work locations that the alien will work and includes a statement that the contracting facility or organization will not add additional work locations without the approval of the Federal agency or State agency that requested the waiver; and (D) does not include a non-compete provision. (6) An alien granted a waiver under this subsection whose employment relationship with a health facility or health care organization terminates under paragraph (1)(C)(ii) during the 3-year service period required under paragraph (1) shall be considered to be maintaining lawful status in an authorized period of stay during the 120-day period referred to in items (aa) and (bb) of subclause (III) of paragraph (1)(C)(ii) or the 45-day period referred to in subclause (III)(cc) of such paragraph.. (f) Recapturing waiver slots lost to other States Section 214(l) of such Act, as amended by this section, is further amended by adding at the end the following: (7) If a recipient of a waiver under this subsection terminates the recipient’s employment with a health facility or health care organization pursuant to paragraph (1)(C)(ii), including termination of employment because of circumstances described in paragraph (1)(C)(ii)(III), and accepts new employment with such a facility or organization in a different State, the State from which the alien is departing may be accorded an additional waiver by the Secretary of State for use in the fiscal year in which the alien’s employment was terminated.. (g) Exception to 3-Year work requirement Section 214(l) of such Act, as amended by this section, is further amended by adding at the end the following: (8) The 3-year work requirement set forth in subparagraphs (C) and (D) of paragraph (1) shall not apply if— (A) (i) the Secretary of Homeland Security determines that extenuating circumstances, including violations by the employer of the employment agreement with the alien or of labor and employment laws, exist that justify a lesser period of employment at such facility or organization; and (ii) the alien demonstrates, not later than 120 days after the employment termination date (unless the Secretary determines that extenuating circumstances would justify an extension), another bona fide offer of employment at a health facility or health care organization in a geographic area or areas which are designated by the Secretary of Health and Human Services as having a shortage of health care professionals, for the remainder of such 3-year period; (B) (i) the interested State agency that requested the waiver attests that extenuating circumstances, including violations by the employer of the employment agreement with the alien or of labor and employment laws, exist that justify a lesser period of employment at such facility or organization; and (ii) the alien demonstrates, not later than 120 days after the employment termination date (unless the Secretary determines that extenuating circumstances would justify an extension), another bona fide offer of employment at a health facility or health care organization in a geographic area or areas which are designated by the Secretary of Health and Human Services as having a shortage of health care professionals, for the remainder of such 3-year period; or (C) the alien— (i) elects not to pursue a determination of extenuating circumstances pursuant to subclause (A) or (B); (ii) terminates the alien’s employment relationship with the health facility or health care organization at which the alien was employed; (iii) demonstrates, not later than 45 days after the employment termination date, another bona fide offer of employment at a health facility or health care organization in a geographic area or areas, in the State that requested the alien’s waiver, which are designated by the Secretary of Health and Human Services as having a shortage of health care professionals; and (iv) agrees to be employed for the remainder of such 3-year period, and 1 additional year for each termination under clause (ii)..