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Union Calendar No. 450 

108TH CONGRESS 

2D SESSION H. R. 4453 

[Report No. 108–730] 

To improve access to physicians in medically underserved areas. 

IN THE HOUSE OF REPRESENTATIVES 

MAY 20, 2004 

Mr. MORAN of Kansas introduced the following bill; which was referred to the 

Committee on the Judiciary 

OCTOBER 5, 2004 

Additional sponsors: Mr. TURNER of Texas, Mr. STENHOLM, Mr. FROST, Ms. 

JACKSON-LEE of Texas, and Mr. POMEROY

OCTOBER 5, 2004 

Reported with an amendment, committed to the Committee of the Whole 

House on the State of the Union, and ordered to be printed 

[Strike out all after the enacting clause and insert the part printed in italic] 

A BILL 

To improve access to physicians in medically underserved 

areas. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 
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1 SECTION 1. SHORT TITLE. 

2 This Act may be cited as the ‘‘Access to Rural Physi3 cians Improvement Act of 2004’’. 

4 SEC. 2. WAIVER OF FOREIGN COUNTRY RESIDENCE RE5 QUIREMENT WITH RESPECT TO INTER6 NATIONAL MEDICAL GRADUATES. 

7 (a) EXTENSION OF DEADLINE.— 

8 (1) IN GENERAL.—Section 220(c) of the Immi9 gration and Nationality Technical Corrections Act of 

10 1994 (8 U.S.C. 1182 note) (as amended by section 

11 11018 of Public Law 107–273) is amended by strik12 ing ‘‘and before June 1, 2004.’’ and inserting ‘‘and 

13 before the date that is 1 year after the date of the 

14 enactment of the Access to Rural Physicians Im15 provement Act of 2004.’’. 

16 (2) EFFECTIVE DATES.— 

17 (A) IN GENERAL.—Except as provided in 

18 subparagraph (B), the amendment made by 

19 paragraph (1) shall take effect on the date of 

20 the enactment of this Act. 

21 (B) SPECIAL EFFECTIVE DATE.—With re22 spect only to aliens admitted to the United 

23 States under section 101(a)(15)(J) of the Im24 migration and Nationality Act (8 U.S.C. 

25 1101(a)(15)(J)), or acquiring status under such 

26 section after admission, during the period be-
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1 ginning on June 1, 2004, and ending on the 

2 date of the enactment of this Act, the amend3 ment made by paragraph (1) shall take effect 

4 as if this Act were enacted on May 31, 2004. 

5 (b) EXEMPTION FROM H1B NUMERICAL LIMITA6 TIONS.— 

7 (1) IN GENERAL.—Section 214(l)(2)(A) of the 

8 Immigration and Nationality Act (8 U.S.C. 

9 1184(1)(2)(A) is amended by adding at the end the 

10 following: 

11 ‘‘The numerical limitations contained in subsection 

12 (g)(1)(A) shall not apply to any alien whose status is 

13 changed under the preceding sentence, if the alien ob14 tained a waiver of the 2-year foreign residence require15 ment upon a request by an interested State agency.’’. 

16 (2) EFFECTIVE DATE.—The amendment made 

17 by paragraph (1) shall take effect as if this Act were 

18 enacted on September 30, 2003. 

19 SECTION 1. MODIFICATION OF VISA REQUIREMENTS WITH 

20 RESPECT TO INTERNATIONAL MEDICAL 

21 GRADUATES. 

22 (a) EXTENSION OF DEADLINE.— 

23 (1) IN GENERAL.—Section 220(c) of the Immi24 gration and Nationality Technical Corrections Act of 

25 1994 (8 U.S.C. 1182 note) (as amended by section 
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1 11018 of Public Law 107–273) is amended by strik2 ing ‘‘2004.’’ and inserting ‘‘2006.’’. 

3 (2) EFFECTIVE DATE.—The amendment made by 

4 paragraph (1) shall take effect as if enacted on May 

5 31, 2004. 

6 (b) EXEMPTION FROM H–1B NUMERICAL LIMITA7 TIONS.—Section 214(l)(2)(A) of the Immigration and Na8 tionality Act (8 U.S.C. 1184(l)(2)(A)) is amended by add9 ing at the end the following: ‘‘The numerical limitations 

10 contained in subsection (g)(1)(A) shall not apply to any 

11 alien whose status is changed under the preceding sentence, 

12 if the alien obtained a waiver of the 2-year foreign residence 

13 requirement upon a request by an interested Federal agency 

14 or an interested State agency.’’. 

15 (c) LIMITATION ON MEDICAL PRACTICE AREAS.—Sec16 tion 214(l)(1)(D) of the Immigration and Nationality Act 

17 (8 U.S.C. 1184(l)(1)(D)) is amended by striking ‘‘agrees to 

18 practice medicine’’ and inserting ‘‘agrees to practice pri19 mary care or specialty medicine’’. 

20 (d) EXEMPTION FROM GEOGRAPHIC LIMITATIONS.— 

21 Section 214(l)(1)(D) of the Immigration and Nationality 

22 Act (8 U.S.C. 1184(l)(1)(D)), as amended by subsection (c), 

23 is further amended— 
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1 (1) by striking ‘‘except that,’’ and all that follows 

2 through the period at the end and inserting ‘‘except 

3 that—’’; and 

4 (2) by adding at the end the following: 

5 ‘‘(i) in the case of a request by the Depart6 ment of Veterans Affairs, the alien shall not be 

7 required to practice medicine in a geographic 

8 area designated by the Secretary; and 

9 ‘‘(ii) in the case of a request by an inter10 ested State agency, the head of such State agency 

11 determines that the alien is to practice medicine 

12 under such agreement in a facility that serves 

13 patients who reside in one or more geographic 

14 areas so designated by the Secretary of Health 

15 and Human Services (without regard to whether 

16 such facility is within such a designated geo17 graphic area), and the grant of such waiver 

18 would not cause the number of the waivers 

19 granted on behalf of aliens for such State for a 

20 fiscal year (within the limitation described in 

21 subparagraph (B)) in accordance with the condi22 tions of this clause to exceed 5.’’. 
Union Calendar No. 450 

108TH CONGRESS 

2D SESSION H. R. 4453 

[Report No. 108–730] 

A BILL 

To improve access to physicians in medically 

underserved areas. 

OCTOBER 5, 2004 

Reported with an amendment, committed to the Comand ordered to be printed mittee of the Whole House on the State of the Union,