Policy Alerts
Immigration policy changes that affect physicians · Updated weekly
Curated feed of H-1B, Conrad 30, green card, and USCIS changes specifically relevant to physician immigration. Every alert links to the official source.
H-1B Premium Processing Fee Increased to $2,965
USCIS increased the premium processing fee from $2,805 to $2,965 effective March 1, 2026. Premium processing guarantees 15-business-day adjudication for H-1B petitions. Still strongly recommended for physician petitions to avoid 3-6 month regular processing delays.
CY 2026 Medicare Conversion Factor: $33.40/RVU
CMS established two conversion factors for the first time: $33.57/RVU for qualifying APM participants, $33.40/RVU standard. Includes 2.5% statutory bump but a -2.5% efficiency adjustment on non-timed procedural wRVUs may reduce procedural specialty reimbursement despite the higher headline number.
USCIS Processing Freeze Affects 39 Countries
USCIS froze processing for work authorization renewals affecting physicians from 39 countries in winter 2025-2026. Hospitals in OH, PA, MI cancelled clinics. Doctors forced into unpaid absences. 20+ federal lawsuits filed. An estimated 900+ patients left without care from a single affected physician's practice.
H-1Bs for Physicians and Healthcare Workforce Act Introduced
Bipartisan bill introduced to exempt physicians and healthcare workers from the $100,000 H-1B fee. Supported by AMA and 55+ medical specialty societies. Bill status: introduced, not yet passed.
H-4 EAD Automatic Extension Settlement Expired
The settlement that required bundled processing of H-4 EAD applications expired January 2025. Standalone H-4 EAD applications now take 6-12+ months. Spouses losing work authorization during gaps. Affects nearly every physician family on H-1B.
$100,000 H-1B Supplemental Filing Fee Signed Into Law
Presidential Proclamation 10973 imposes a $100,000 fee on new H-1B petitions requiring consular processing. Applies to cap-exempt employers including hospitals and universities. Does NOT apply to change-of-status (already in US), extensions, or many transfers. Expires September 2026 unless renewed. Only ~85 employers have paid it so far, causing a dramatic drop in new H-1B filings.
FHA Loans No Longer Available to Non-Permanent Residents
HUD Mortgagee Letter 2025-09 (published March 26, 2025, mandatory for case numbers assigned on or after May 25, 2025) made FHA-insured loans unavailable to non-permanent residents. This directly affects H-1B physicians trying to buy homes during their waiver service. Conventional and physician mortgage loans remain available but often at higher rates or with adjustable terms.
Conrad State 30 Reauthorization Act (H.R. 1585 / S. 709) Introduced
Bipartisan bill would extend Conrad 30 for 3 years, increase slots from 30 to 35 per state, add automatic escalation if 90% used nationally, create slot recapture when physicians leave states, and add a 6-month status extension for denied applicants. Currently in Senate Judiciary Committee. Without passage, physicians who acquired J-1 status after October 1, 2025 may not be eligible.
Alerts curated from official government sources (USCIS, DOS, CMS, Congress.gov), immigration law firm analyses, and physician advocacy organizations (AMA, AILA). Every alert links to its source. This feed is updated weekly. Not legal advice — consult your immigration attorney for guidance specific to your situation.