214(l) waiver 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 received under section 
214(l).’’. 
SEC. 4. EMPLOYMENT PROTECTIONS FOR PHYSICIANS. 
(a) IN GENERAL.—Section 214(l)(1)(C) of the Immi-
gration and Nationality Act (8 U.S.C. 1184(l)(1)(C)) is 
amended 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 employ-
ment has been determined by the Secretary 
of Homeland Security to be in the public 
interest; and 
‘‘(ii) the alien agrees to begin employ-
ment with the health facility or health care 
organization in a geographic area or areas 
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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 re-
ceiving such waiver, 90 days after com-
pleting graduate medical education or 
training under a program approved pursu-
ant to section 212(j)(1), or 90 days after 
receiving nonimmigrant status or employ-
ment authorization, and agrees to continue 
to work for a total of not less than 3 years 
in any status authorized for such employ-
ment under this subsection unless— 
‘‘(I) the Secretary determines 
that extenuating circumstances exist 
that justify a lesser period of employ-
ment at such facility or organization, 
in which case the alien shall dem-
onstrate another bona fide offer of 
employment at a health facility or 
health care organization, for the re-
mainder of such 3-year period; 
‘‘(II) the interested State agency 
that requested the waiver attests that 
extenuating circumstances exist that 
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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 or-
ganization so designated by the Sec-
retary of Health and Human Services, 
for the remainder of such 3-year pe-
riod; 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 termi-
nation, at another health facility or 
health care organization in a geo-
graphic area or areas which are des-
ignated by the Secretary of Health 
and Human Services as having a 
shortage of health care professionals; 
and’’. 
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(b) CONTRACT REQUIREMENTS.—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) An alien granted a waiver under para-
graph (1)(C) shall enter into an employment agree-
ment 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 re-
ceive for on-call time; 
‘‘(B) specifies whether the contracting fa-
cility 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 insur-
ance 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 ap-
proval of the Federal agency or State agency 
that requested the waiver; and 
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‘‘(D) does not include a non-compete provi-
sion. 
‘‘(5) An alien granted a waiver under para-
graph (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 begin-
ning on the date of such termination of employ-
ment to submit to the Secretary of Homeland 
Security applications or petitions to commence 
employment with another contracting health fa-
cility or health care organization in a geo-
graphic 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).’’. 
SEC. 5. ALLOTMENT OF CONRAD 30 WAIVERS. 
(a) IN GENERAL.—Section 214(l) of the Immigration 
and Nationality Act (8 U.S.C. 1184(l)), as amended by 
section 4(b), is further amended by adding at the end the 
following: 
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‘‘(6)(A)(i) All States shall be allotted a total of 
35 waivers under paragraph (1)(B) for a fiscal year 
if 90 percent of the waivers available to the States 
receiving at least 5 waivers were used in the pre-
vious fiscal year. 
‘‘(ii) When an allocation has occurred 
under clause (i), all States shall be allotted 
an additional 5 waivers under paragraph 
(1)(B) for each subsequent fiscal year if 90 
percent of the waivers available to the 
States receiving at least 5 waivers were 
used in the previous fiscal year. If the 
States are allotted 45 or more waivers for 
a fiscal year, the States will only receive an 
additional increase of 5 waivers the fol-
lowing fiscal year if 95 percent of the waiv-
ers available to the States receiving at 
least 1 waiver were used in the previous 
fiscal year. 
‘‘(B) Any increase in allotments under sub-
paragraph (A) shall be maintained indefinitely, 
unless in a fiscal year, the total number of such 
waivers granted is 5 percent lower than in the 
last year in which there was an increase in the 
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