Current through Register Vol. 24-18, September 15, 2024
(1) Applicants and
physicians must meet all federal criteria for international medical graduates
seeking a visa waiver including the criteria established in
8 U.S.C. Sec.
1182(e),
8 U.S.C Sec.
1184(1), and
22 C.F.R. Sec.
41.63(e).
(2) Except for state psychiatric or
correctional facilities, the applicant must:
(a) Currently serve:
(i) Medicare clients;
(ii) Medicaid clients;
(iii) Low-income clients; and
(iv) Uninsured clients.
(b) Accept all patients regardless of the
ability to pay.
(c) Demonstrate
that during the 12 months prior to submitting the application, the practice
location(s) where the physician will work provided a minimum of 15 percent of
total patient visits to medicaid and other low-income clients. Clients dually
enrolled for medicare and medicaid may be included in this total.
(d) Implement and maintain a sliding fee
discount schedule for each practice location(s) in which the J-1 visa waiver
physician will work. The schedule must be:
(i)
Available in any language spoken by more than 10 percent of the population in
the practice location's service area;
(ii) Posted or prominently displayed within
public areas of the practice location(s);
(iii) Distributed in hard copy upon patient
request; and
(iv) Updated annually
to reflect the most recent federal poverty guidelines.
(3) If the applicant does not
charge patients, then subsection (2)(d) of this section does not
apply.
(4) Applicants must
demonstrate that they engaged in active recruitment, specific to the location
and physician specialty, a total or aggregate of at least six months in the
12-month period immediately prior to signing an employment contract with the
J-1 visa waiver physician.
(5)
Applicants must have a signed employment contract with the physician that meets
state and federal requirements throughout the period of obligation, regardless
of physician's visa status. The employment contract must:
(a) Identify the physician's name.
(b) Identify the name and address of the
proposed practice loca-tion(s).
(c)
Identify the nature of services to be provided by the physician.
(d) Describe duties to be provided by the
physician.
(e) Specify the wages,
working conditions, and benefits.
(f) Include a statement of the federal HPSA
to be served.
(g) Specify a minimum
three-year period of full-time employment.
(h) State that the physician agrees to begin
employment within 90 days of visa waiver approval.
(i) Not prevent the physician from providing
medical services in the designated HPSA after the term of employment including,
but not limited to, noncompetition clauses.
(j) State that the physician:
(i) Will provide care to medicaid, medicare,
and other low-income patients;
(ii)
Must see all patients regardless of ability to pay based on sliding fee scale;
and
(iii) Meets all requirements
set forth in 8 C.F.R. Sec.
214.1 of the Immigration Nationality
Act.
(6)
Applicants must pay the physician at least the required wage rate as referenced
by the federal Department of Labor at
20 C.F.R. Sec.
655.731(a) for the specialty
in the area or as set by negotiated union contract.
(7) If the applicant has previously requested
sponsorship of a physician, WAC
246-562-020 (5)
will apply.
(8) Applicants must
cooperate in providing the department with clarifying information, verifying
information already provided, or in any investigation of the applicant's
financial status.
(9) Applications
for a specialist physician must include a letter from the applicant. The letter
must:
(a) Be on the organization's
letterhead;
(b) Identify the
physician by name;
(c) Demonstrate
a need for the nonprimary care specialty by using available data to show how
the physician specialty is needed to address a major health problem in the
practice location service area, address a population to provider ratio
imbalance, or meet government requirements such as trauma designation
regulations;
(d) Describe how this
specialty will link patients to primary care physicians;
(e) Describe how the demand for the specialty
has been handled in the past;
(f)
Be signed and dated by the head of the organization; and
(g) Describe the practice location's referral
system that includes:
(i) On-call sharing;
and
(ii) How patients from other
health care entities in the service area, specifically publicly funded
employers, will be able to access the sponsored physician's services.
(10) Applicants
applying for a specialist physician must provide written notice to the
department and all publicly funded employers in the applicant's HPSA within 30
days of the sponsored physician's start-date of employment. The notice must
include:
(a) The employer and physician's
name, employment start date, and practice location;
(b) Specialty and services to be provided;
and
(c) Identification of accepted
patients, such as medicaid, medicare, and the availability of a sliding fee
schedule.
Statutory Authority: Chapter 70.185 RCW and
Public Law
108-441. 06-07-035, § 246-562-060, filed
3/8/06, effective 4/8/06. Statutory Authority: Chapter 70.185 RCW. 03-19-054,
§ 246-562-060, filed 9/11/03, effective 10/12/03; 00-15-082, §
246-562-060, filed 7/19/00, effective 8/19/00; 98-20-067, § 246-562-060,
filed 10/2/98, effective 11/2/98.
