A bill to improve access to physicians in medically underserved areas.
PL 108-441 (S.2302), enacted 12/03/2004

118 STAT. 2630
PUBLIC LAW 108–441—DEC. 3, 2004
Public Law 108–441
108th Congress
An Act
To improve access to physicians in medically underserved areas.
Be it enacted by the Senate and House of Representatives of
the United States of America in Congress assembled,
SECTION 1. MODIFICATION OF VISA REQUIREMENTS WITH RESPECT
TO INTERNATIONAL MEDICAL GRADUATES.
(a) EXTENSION OF DEADLINE.—
(1) IN GENERAL.—Section 220(c) of the Immigration and
Nationality Technical Corrections Act of 1994 (8 U.S.C. 1182
note) (as amended by section 11018 of Public Law 107–273)
is amended by striking ‘‘2004.’’ and inserting ‘‘2006.’’.
(2) EFFECTIVE DATE.—The amendment made by paragraph
(1) shall take effect as if enacted on May 31, 2004.
(b) EXEMPTION FROM H–1B NUMERICAL LIMITATIONS.—Section
214(l)(2)(A) of the Immigration and Nationality Act (8 U.S.C.
1184(l)(2)(A)) is amended by adding at the end the following: ‘‘The
numerical limitations contained in subsection (g)(1)(A) shall not
apply to any alien whose status is changed under the preceding
sentence, if the alien obtained a waiver of the 2-year foreign resi-
dence requirement upon a request by an interested Federal agency
or an interested State agency.’’.
(c) 
LIMITATION
ON
MEDICAL
PRACTICE
AREAS.—Section
214(l)(1)(D) of the Immigration and Nationality Act (8 U.S.C.
1184(l)(1)(D)) is amended by striking ‘‘agrees to practice medicine’’
and inserting ‘‘agrees to practice primary care or specialty medi-
cine’’.
(d) EXEMPTIONS.—Section 214(l)(1)(D) of the Immigration and
Nationality Act (8 U.S.C. 1184(l)(1)(D)) is further amended—
(1) by striking ‘‘except that,’’ and all that follows and
inserting ‘‘except that—’’; and
(2) by adding at the end the following:
‘‘(i) in the case of a request by the Department of
Veterans Affairs, the alien shall not be required to practice
medicine in a geographic area designated by the Secretary;
‘‘(ii) in the case of a request by an interested State
agency, the head of such State agency determines that
the alien is to practice medicine under such agreement
in a facility that serves patients who reside in one or
more geographic areas so designated by the Secretary of
Health and Human Services (without regard to whether
such facility is located within such a designated geographic
area), and 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
8 USC 1182 note.
Dec. 3, 2004
[S. 2302]
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118 STAT. 2631
PUBLIC LAW 108–441—DEC. 3, 2004
LEGISLATIVE HISTORY—S. 2302:
CONGRESSIONAL RECORD, Vol. 150 (2004):
Oct. 11, considered and passed Senate.
Nov. 17, considered and passed House.
subparagraph (B)) in accordance with the conditions of
this clause to exceed 5; and
‘‘(iii) in the case of a request by an interested Federal
agency or by an interested State agency for a waiver for
an alien who agrees to practice specialty medicine in a
facility located in a geographic area so designated by the
Secretary of Health and Human Services, the request shall
demonstrate, based on criteria established by such agency,
that there is a shortage of health care professionals able
to provide services in the appropriate medical specialty
to the patients who will be served by the alien.’’.
Approved December 3, 2004.
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