I 
117TH CONGRESS 
1ST SESSION H. R. 3541 
To provide incentives to physicians to practice in rural and medically 
underserved communities, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
MAY 25, 2021 
Mr. SCHNEIDER (for himself, Mr. BACON, Mr. DELGADO, Mr. MCKINLEY, 
Mrs. AXNE, Mr. BABIN, Mr. BERA, Ms. BLUNT ROCHESTER, Mr. 
BUTTERFIELD, Mr. CASTEN, Mr. CLEAVER, Mr. COSTA, Mr. DEFAZIO, 
Mr. FITZPATRICK, Mr. GARAMENDI, Ms. GARCIA
of Texas, Miss 
GONZA´LEZ-COLO´N, Mr. HICE of Georgia, Mr. KELLER, Ms. KELLY of Il-
linois, Mr. KILDEE, Mr. KILMER, Mr. KRISHNAMOORTHI, Mr. LAWSON 
of Florida, Mr. LONG, Mr. LUCAS, Mr. MAST, Mr. MULLIN, Mr. NOR-
MAN, Mr. PANETTA, Mr. PETERS, Mr. POCAN, Mr. PRICE of North Caro-
lina, Mr. RUSH, Mr. RYAN, Mr. SOTO, Ms. SPEIER, Mr. VAN DREW, and 
Ms. WILLIAMS of Georgia) introduced the following bill; which was re-
ferred to the Committee on the Judiciary 
A BILL 
To provide incentives to physicians to practice in rural and 
medically underserved communities, and for other purposes. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Conrad State 30 and 
Physician Access Reauthorization Act’’. 
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SEC. 2. CONRAD STATE 30 PROGRAM. 
(a) EXTENSION.—Section 220(c) of the Immigration 
and Nationality Technical Corrections Act of 1994 (Public 
Law 103–416; 8 U.S.C. 1182 note) is amended by striking 
‘‘September 30, 2015’’ and inserting ‘‘on the date that 
is 3 years after the date of the enactment of the Conrad 
State 30 and Physician Access Reauthorization Act’’. 
(b) EFFECTIVE DATE.—The amendment made by 
subsection (a) shall take effect as if enacted on September 
30, 2018. 
SEC. 3. RETAINING PHYSICIANS WHO HAVE PRACTICED IN 
MEDICALLY UNDERSERVED COMMUNITIES. 
Section 201(b)(1) of the Immigration and Nationality 
Act (8 U.S.C. 1151(b)(1)) is amended by adding at the 
end the following: 
‘‘(F)(i) Alien physicians who have completed 
service requirements of a waiver requested under 
section 203(b)(2)(B)(ii), including— 
‘‘(I) alien physicians who completed such 
service before the date of the enactment of the 
Conrad State 30 and Physician Access Act; and 
‘‘(II) the spouse or children of an alien 
physician described in subclause (I). 
‘‘(ii) Nothing in this subparagraph may be con-
strued— 
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‘‘(I) to prevent the filing of a petition with 
the Secretary of Homeland Security for classi-
fication under section 204(a) or the filing of an 
application for adjustment of status under sec-
tion 245 by an alien physician described in this 
subparagraph before the date by which such 
alien physician has completed the service de-
scribed 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 in an area or areas designated by the Sec-
retary of Health and Human Services as having 
a shortage of health care professionals; or 
‘‘(II) to permit the Secretary of Homeland 
Security to grant a petition or application de-
scribed in subclause (I) until the alien has sat-
isfied all of the requirements of the waiver re-
ceived under section 214(l).’’. 
SEC. 4. 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 ‘‘Sec-
retary of Homeland Security’’; 
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(2) in subparagraph (A), by striking ‘‘Director 
of the United States Information Agency’’ and in-
serting ‘‘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 facil-
ity or 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— 
‘‘(I) has accepted employment with 
the health facility or health care organiza-
tion 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; 
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‘‘(bb) 120 days after completing 
graduate medical education or train-
ing under a program approved pursu-
ant 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 com-
pletes his or her graduate medical 
education or training under a pro-
gram 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 sta-
tus authorized for such employment under 
this subsection, except as provided in para-
graph (8).’’; and 
(5) in subparagraph (D), in the matter pre-
ceding clause (i), by inserting ‘‘(except as provided 
in paragraph (8))’’. 
(b) ALLOWABLE VISA STATUS FOR PHYSICIANS FUL-
FILLING WAIVER REQUIREMENTS IN MEDICALLY UNDER-
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SERVED 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 rec-
ommendation 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 Sec-
retary of Homeland Security may change the status 
of such physician to any status authorized for em-
ployment under this Act. The numerical limitations 
contained in subsection (g)(1)(A) shall not apply to 
any alien whose status is changed under this sub-
paragraph.’’. 
(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’’ be-
fore ‘‘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 fol-
lowing: 
‘‘(4)(A) If an interested State agency denies an appli-
cation for a waiver under paragraph (1)(B) from a physi-
cian pursuing graduate medical education or training pur-
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‘‘(iv) in the case of a request by an inter-
ested State agency— 
‘‘(I) the head of such agency deter-
mines that the alien is to practice medicine 
in, or be on the faculty of a residency pro-
gram at, an academic medical center (as 
that 
term 
is 
defined 
in 
section 
411.355(e)(2) of title 42, Code of Federal 
Regulations, or similar successor regula-
tion), without regard to whether such facil-
ity is located within an area designated by 
the Secretary of Health and Human Serv-
ices as having a shortage of health care 
professionals; and 
‘‘(II) the head of such agency deter-
mines that— 
‘‘(aa) the alien physician’s work 
is in the public interest; and 
‘‘(bb) the grant of such waiver 
would not cause the number of the 
waivers granted on behalf of aliens for 
such State for a fiscal year (within 
the limitation in subparagraph (B) 
and subject to paragraph (6)) in ac-
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