A bill to provide incentives to physicians to practice in rural and medically underserved communities and for other purposes.

Summary: Conrad State 30 Improvement Act - Amends the Immigration and Nationality Technical Corrections Act of 1994 to make the J-1 visa waiver (Conrad state 30/medical services in underserved areas) program permanent.

Includes in the priority worker preference allocation for employment-based immigrants alien physicians who have completed service requirements of a state waiver or exemption, plus an additional two years at the waiver-identified location or in a health care shortage area (including alien physicians who completed such service prior to enactment of this Act).

Exempts H-1B nonimmigrant aliens seeking to enter the United States to pursue graduate medical education or training from specified entry limitations (including permitting extension of the six-year authorized period of admission under specified circumstances).

Increases the number of alien physicians that a state may be allocated from 30 to 35 per fiscal year under specified circumstances.

Permits an alien physician, after fulfilling a three-year service period with a health care employer, to apply for employment with a new health care employer in a health care shortage area.

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Conrad State 30 Improvement Act''.

SEC. 2. ELIMINATION OF SUNSET PROVISION OF CONRAD STATE 30 PROGRAM.

    Section 220(c) of the Immigration and Nationality Technical 
Corrections Act of 1994 (8 U.S.C. 1182 note) is amended by striking 
``and before September 30, 2012''.

SEC. 3. RETAINING PHYSICIANS IN MEDICALLY UNDERSERVED COMMUNITIES.

    Section 203(b)(1) of the Immigration and Nationality Act (8 U.S.C. 
1151(b)(1)) is amended--
            (1) in the matter preceding subparagraph (A), by striking 
        ``(A) through (C):'' and inserting a colon; and
            (2) by adding at the end the following:
                    ``(D) Certain physicians who have served in 
                medically underserved communities under section 
                214(l).--
                            ``(i) Physicians described.--An alien is 
                        described in this subparagraph if the alien has 
                        completed service requirements of a waiver or 
                        exemption requested under section 214(l), plus 
                        an additional 2 years at the location 
                        identified in the section 214(l) waiver or 
                        exemption or in an area or areas designated by 
                        the Secretary of Health and Human Services as 
                        having a shortage of health care professionals, 
                        including alien physicians who completed such 
                        service before the date of enactment of the 
                        Conrad State 30 Improvement Act.
                            ``(ii) Construction.--Nothing in this 
                        subparagraph may be construed--
                                    ``(I) to prevent the filing of a 
                                petition with the Secretary of Homeland 
                                Security for classification under 
                                section 204(a) or the filing of an 
                                application for adjustment of status 
                                under section 245 by an alien physician 
                                described in this subparagraph prior to 
                                the date by which such alien physician 
                                has completed the service described in 
                                section 214(l) or worked full-time as a 
                                physician for an aggregate of 5 years 
                                at the location identified in the 
                                section 214(l) waiver or exemption or 
                                in an area or areas designated by the 
                                Secretary of Health and Human Services 
                                as having a shortage of health care 
                                professionals; or
                                    ``(II) to permit the Secretary of 
                                Homeland Security to grant such a 
                                petition or application until the alien 
                                has satisfied all the requirements of 
                                the waiver or exemption received under 
                                section 214(l).''.

SEC. 4. INCENTIVES FOR PHYSICIANS TO PRACTICE IN MEDICALLY UNDERSERVED 
              COMMUNITIES.

    Section 214(g) of the Immigration and Nationality Act (8 U.S.C. 
1184(g)) is amended, by adding at the end the following:
    ``(12) An alien physician described in section 212(j)(2)(B) who 
entered or is seeking to enter the United States as a nonimmigrant 
described in section 101(a)(15)(H)(i)(b) to pursue graduate medical 
education or training shall not be subject to the limitations described 
in paragraph (1) or (4), provided that the period of authorized 
admission of such alien as an H-1B nonimmigrant may not extend beyond 
the 6-year period beginning on the date on which the alien receives the 
exemption described in subparagraph (A), other than extensions 
authorized by section 104 or 106 of the American Competitiveness in the 
Twenty-First Century Act of 2000 (Public Law 106-313; 114 Stat. 1251) 
or an amendment made by such section, if an interested State agency 
submits a request for an exemption under section 214(l)(1)(B), but not 
1 of the 10 waivers or exemptions described in subsection 
(l)(1)(D)(ii).''.

SEC. 5. RESTRICTIONS ON WAIVERS AND PHYSICIAN PROTECTIONS.

    (a) In General.--Section 214(l)(1) of the Immigration and 
Nationality Act (8 U.S.C. 1184(l)(1)) is amended--
            (1) by amending the matter preceding subparagraph (A) to 
        read as follows:
    ``(1) In the case of a request by an interested State agency, or by 
an interested Federal agency, for a waiver by the Secretary of Homeland 
Security of the 2-year foreign residence requirement under section 
212(e) on behalf of an alien described in clause (iii) of such section 
or in the case of a request to the Secretary of State for certification 
of an exemption from the limitation described in paragraphs (1) and (4) 
of subsection (g) on behalf of an alien described in paragraph (12) of 
such subsection, the Secretary of Homeland Security and the Secretary 
of State shall not grant such waiver or exemption certification 
unless--'';
            (2) in subparagraph (A), by striking ``United States 
        Information Agency'' and inserting ``Secretary of State'';
            (3) in subparagraph (B), by striking ``would not cause the 
        number of waivers allotted for that State for that fiscal year 
        to exceed 30;'' and inserting ``or exemption would not cause 
        the total number of waivers plus the total number of exemptions 
        allotted for that State for that fiscal year to exceed 30, 
        unless such allotment is increased pursuant to paragraph 
        (4);'';
            (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 care organization, 
                which employment has been determined by the Secretary 
                of Homeland Security to be in the public interest;
                    ``(ii) the alien agrees to begin 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 by the later of 
                the date that is 90 days after receiving such waiver or 
                exemption, 90 days after completing graduate medical 
                education or training under a program approved pursuant 
                to section 212(j)(1), or 90 days after receiving 
                nonimmigrant status or employment authorization, and 
                agrees to continue to work for a total of not less than 
                3 years in any status authorized for such employment 
                under this subsection unless--
                            ``(I) the Secretary determines that 
                        extenuating circumstances exist that justify a 
                        lesser period of employment at such facility or 
                        organization, in which case the alien shall 
                        demonstrate another bona fide offer of 
                        employment at a health facility or health care 
                        organization, for the remainder of such 3-year 
                        period;
                            ``(II) the interested State agency that 
                        requested the waiver or exemption attests that 
                        extenuating circumstances exist that justify a 
                        lesser period of employment at such facility or 
                        organization in which case the alien shall 
                        demonstrate another bona fide offer of 
                        employment at a health facility or health care 
                        organization so designated by the Secretary of 
                        Health and Human services, for the remainder of 
                        such 3-year period; or
                            ``(III) if the alien elects not to pursue a 
                        determination of extenuating circumstances 
                        pursuant to subclause (I) or (II), the alien 
                        terminates the alien's employment relationship 
                        with such facility or organization, in which 
                        case the alien shall be employed for the 
                        remainder of such 3-year period, and 1 
                        additional year for each termination, at 
                        another 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;''; and
            (5) in subparagraph (D)--
                    (A) in clause (ii), by striking ``would not cause 
                the number of the waivers'' and inserting ``or 
                exemption would not cause the total number of waivers 
                and exemptions''; and
                    (B) in clause (iii), by inserting ``or exemption'' 
                after ``waiver''.
    (b) Change of Status.--Section 214(l)(2)(A) of the Immigration and 
Nationality Act (8 U.S.C. 1184(l)(2)(A)) is amended--
            (1) by striking ``Attorney General'' and inserting 
        ``Secretary of Homeland Security''; and
            (2) by inserting ``described in section 212(e)(iii)'' after 
        ``status of an alien''.

SEC. 6. ALLOTMENT OF WAIVERS AND EXTENSIONS; LIMITATION OF WAIVERS OF 
              PERIOD OF AUTHORIZED ADMISSION; OTHER PHYSICIAN 
              PROTECTIONS.

    Section 214(l) of the Immigration and Nationality Act (8 U.S.C. 
1184(l)) is amended by adding at the end the following:
    ``(4)(A)(i) All States shall be allotted a total of 35 waivers and 
exemptions under paragraph (1)(B) for a fiscal year if, during the 
previous fiscal year, the total number of waivers and exemptions 
awarded to all the States is at least 90 percent of the total number of 
the waivers and exemptions available to the States that received 5 or 
more such waivers or exemptions.
    ``(ii) When an allocation has occurred under clause (i), all States 
shall be allotted an additional 5 waivers and exemptions under 
paragraph (1)(B) for each subsequent fiscal year if, during the 
previous fiscal year, the total number of waivers and exemptions 
awarded to all the States is at least 90 percent of the total number of 
the waivers and exemptions available to the States that received 5 or 
more such waivers or exemptions.
    ``(B) Any increase in allotments under subparagraph (A) shall be 
maintained indefinitely, unless in a fiscal year, the total number of 
such waivers and exemptions granted is 5 percent lower than in the last 
year in which there was an increase in the number of waivers and 
exemptions allotted pursuant to this paragraph, in which case--
            ``(i) the number of waivers and exemptions allotted shall 
        be decreased by 5 for all States beginning in the next fiscal 
        year; and
            ``(ii) each additional 5 percent decrease in such waivers 
        and exemptions granted from the last year in which there was an 
        increase in the allotment, shall result in an additional 
        decrease of 5 waivers and exemptions allotted for all States, 
        provided that the number of waivers and exemptions allotted for 
        all States shall not drop below 30.
    ``(5) An alien granted a waiver or exemption 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 whether the contracting facility or 
        organization will pay for the alien's malpractice insurance 
        premiums, including whether the employer will provide 
        malpractice insurance and, if so, the amount of such insurance 
        that will be provided;
            ``(C) describes all of the work locations that the alien 
        will work and 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 or exemption; and
            ``(D) does not include a non-compete provision.
    ``(6) An alien granted a waiver or exemption under paragraph (1)(C) 
whose employment relationship with a health facility or health care 
organization terminates during the 3-year service period required by 
such paragraph--
            ``(A) shall have a period of 120 days beginning on the date 
        of such termination of employment to submit to the Secretary of 
        Homeland Security applications or petitions to commence 
        employment with another contracting 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; and
            ``(B) shall be considered to be maintaining lawful status 
        in an authorized stay during the 120-day period referred to in 
        subsection (A).
    ``(7) Notwithstanding paragraph (1)--
            ``(A) an alien that terminates the alien's employment 
        relationship with a health facility or health care 
        organization, except under paragraph (1)(C)(ii)(III), shall not 
        be eligible for an exemption from the limitations described in 
        paragraphs (1) and (4) of subsection (g); and
            ``(B) if such an alien was previously granted such 
        exemption, the Secretary of Homeland Security shall rescind 
        such exemption.''.