Nevada law heightens J-1 waiver scrutiny

Nevada has a new law to beef up oversight of its J-1 visa waiver program and help prevent the exploitation of international medical graduates who practice under the program.

A series of investigative reports by the Las Vegas Sun in 2007 revealed that many IMGs in the program were overworked and underpaid by employers. In some cases, employers shifted them from the underserved areas where they had been assigned to more affluent areas. The doctors did not complain because they thought they might lose their jobs and the right to remain in the country, the newspaper noted.

The new law, signed June 2 by the governor, is the latest action taken to address the "crisis," said Lawrence P. Matheis, executive director of the Nevada State Medical Assn.

"We first did everything we could by regulation and by restructuring the state health division's oversight program," he said. A Primary Care Advisory Council also was formed to inspect sites where J-1 visa holders should be working and make sure they are in underserved areas, said Matheis, who serves on the council.

The law, which takes effect July 1, provides additional state authority over the less-restrictive, specialized worker H1-B visas, Matheis said. More physicians are entering the country under H1-B visas, which allow for a stay of up to six years.

The J-1 visa requires physicians to return to their home countries for two years after residency. However, with a waiver, they can stay if they agree to work in an underserved area for at least three years.

Nevada is the second-fastest-growing state in the nation, but has one of the smallest medical schools, Matheis said, making it difficult to attain sufficient numbers of new physicians to meet care demands.

When word of the J-1 waiver abuses made headlines, the state's reputation as a desirable work place among IMGs plunged. "We were unable to get the 30 physicians per year we were allowed under the Conrad 30 program," Matheis said.

But the state's reputation has turned around, he said. "It has gone from being a failing program with a terrible national and international reputation to one of the model programs for recruitment and use of J-1 and H1-B visas."