Among the federal programs available under the IGA waiver are Veterans Administration, the Appalachian Regional Commission, the Department of Health and Human Services, and the Delta Regional Authority. All these federal programs, except the Veterans Administration, require the foreign physician to work full-time in primary medical care in a Health Professional Shortage Area or Medically Underserved Area. All of the federal programs require proof of recruitment to demonstrate that no U.S. physicians are available. A physician who receives an IGA waiver must remain at their medical facility in H-1B status for three years.
Each federal program has specific geographic application and/or work requirements:
Veterans Administration Waiver: Foreign physicians are required to hold at least a five-eighths staff appointment at a VA hospital.
Appalachian Regional Commission: Includes all of West Virginia and parts of 12 other states: Alabama, Georgia, Kentucky, Maryland, Mississippi, New York, North Carolina, Ohio, Pennsylvania, South Carolina, Tennessee, and Virginia. Physicians work in shortage areas in rural counties within these states.
Delta Regional Authority: Physicians work in underserved areas found within 252 counties and parishes in eight states: Alabama, Arkansas, Illinois, Kentucky, Louisiana, Mississippi, Missouri, and Tennessee.
Department of Health and Human Services: A clinical program where foreign physicians are limited to practicing primary care in the most severe shortage areas.