As used in these rules, the terms below shall have the
application - submittal, by certified mail, of all forms and information
outlined by the Department in the policies and procedures for the State Conrad
J-1 Visa Waiver Program to the Nashville, Tennessee office of the State Conrad
J-1 Visa Waiver Program.
Waiver - see State Conrad J-1 Visa Waiver Program.
(3) Critical Access Hospital (CAH) - a
federally designated hospital that is very small with staffing flexibility
under Medicare rules for providing emergency, outpatient, and short-stay
- Tennessee Department of Health.
(5) Health Professional Shortage Area (HPSA)
- a geographical area designated by the Secretary of the U.S. Department of
Health and Human Services as having a shortage of health manpower (formerly
Health Manpower Shortage Area).
Health Resource Shortage Area (HRSA) - an area designated annually by the
Commissioner of the Department as having inadequate resources in place to
ensure access to primary, pediatric, obstetric or TennCare Services. It
includes State designated Health Resource Shortage Areas for Primary,
Pediatric, Obstetrical Care and TennCare.
(7) Indigent patients - patients who are at
or below two-hundred percent (200%) of the federal poverty level with no
comprehensive third-party coverage.
(8) Managed Care Organization (MCO) - an
entity rendering or arranging necessary medical services to persons who are
eligible for Medicaid or TennCare Standard and who are enrolled in the TennCare
managed care program. MCO's are paid by the State of Tennessee authorized and
consistent with a Section 1115 waiver of the Social Security Act granted by the
Health Care Financing Administration (renamed in 2001 as the "Centers for
Medicare and Medicaid Services or "CMS"), U.S. Department of Health and Human
(9) Medicare Dependent
Hospital - a federally designated hospital that is a small rural hospital for
which Medicare patients comprise a significant percentage of their patients and
Underserved Area (MUA) - a geographical area which is designated by the
Secretary of the U.S. Department of Health and Human Services as having a
shortage of health care services using several factors, in addition to the
availability of health care providers, including infant mortality rate, poverty
rate, and percentage of population aged sixty five (65) or over.
(11) Primary care physician - a physician who
has completed a residency in Family Practice, General Pediatrics, Obstetrics,
or General Internal Medicine and who is also supported by a sponsoring
(12) Primary health care
- services which emphasize first contact patient care. The provider assumes
overall and ongoing responsibility for the patient in both health maintenance
and treatment of illness, emphasizing continuity of care over the entire
spectrum of health care services.
(13) Physician specialist - a physician who
has completed a residency in Family Practice Adolescent Medicine or Geriatric
Medicine; or Internal Medicine Adolescent Medicine, Cardiovascular Disease,
Critical Care Medicine, Endocrinology, Diabetes, & Metabolism, Emergency
Medicine, Gastroenterology, Geriatric Medicine, Hematology, Hospitalists,
Infectious Disease, Interventional Cardiology, Oncology, Nephrology, Neurology,
Pulmonary Disease, Rheumatology; or Obstetrics & Gynecology Critical Care
Medicine or Gynecologic Oncology; or Pediatric Adolescent Medicine,
Developmental-Behavioral Pediatrics, Pediatric Cardiology, Pediatric
Endocrinology, Pediatric Gastroenterology, Pediatric Hematology-Oncology,
Pediatric Infectious Disease, Pediatric Nephrology, Pediatric Pulmonology, or
Pediatric Critical Care Medicine; or Addiction Psychiatry, Child &
Adolescent Psychiatry, or Geriatric Psychiatry; or General Orthopedic Surgery
or General Surgery. If all slots permitted by federal law are not filled by
June 30th of each year, at the Commissioner's
discretion, a "specialist" may also include a physician who has completed a
residency in a medical specialty or subspecialty other than one listed above,
if the specialty or subspecialty is among those recognized by the American
Board of Medical Specialties at the time the physician applies for placement
through the J-1 visa waiver program.
(14) Rural areas - all counties in Tennessee,
excluding Shelby, Davidson, Knox and Hamilton.
(15) Rural Hospital - a federally designated
hospital meeting the requirements for placement of primary care physicians.
Rural Hospitals which are located in counties containing federally designated
health professional shortage areas (HPSAs) and/or medically underserved areas
(MUAs), either of which must also be located within the top thirty (30) state
designated health resource shortage areas (HRSAs) for TennCare, primary care,
obstetrics or pediatrics.
Rural Referral Center (RRC) - a federally designated hospital that is
authorized under the Tax Equity and Fiscal Responsibility Act of 1982. These
are rural hospitals with generally high volume whose costs more closely
resemble those of urban hospitals because they treat regionally or nationally
referred complex cases.
Community Hospital (SCH) - a federally designated hospital that is the only
provider of hospital care in its market area either because it is
geographically isolated or because severe weather or travel conditions prevent
travel to another hospital offering similar services.
(18) Sponsoring employer - a health care
facility or physician practice located in qualifying communities which provides
primary health care to underserved residents. Examples of these facilities are
hospitals, primary care clinics, community health clinics, local health
departments, or private physician offices which routinely accept TennCare and
Conrad J-1 Visa Waiver Program - the enactment of the Immigration and
Nationality Technical Corrections Act of 1994 (
) has provided an additional basis upon
which a foreign medical graduate may seek a waiver of the two-year home
residence requirement. Section 220(a) of that Act added a provision that
authorizes a State Department of Public Health or its equivalent to request the
Director of the United States Information Agency to recommend that Immigration
and Naturalization Service grant the waiver.