Utah Admin. Code R434-100-5 - Requests
The health care facility or the physician must submit to the Department a written request for the J-1 visa waiver.
(1) The request must include from the health
care facility:
(a) the specialty of physician
that the facility has been unable to recruit;
(b) documentation that it implements a
sliding fee scale, payment schedule, or similar method that demonstrates that
it provides discounts to medically indigent patients; and
(c) an assurance letter that the health care
facility and its principals are not under investigation f o r, under probation
f o r, or under restriction for:
(i)
Children's Health Insurance Program, Medicaid, or Medicare fraud;
(ii) violations of Division of Occupational
and Professional Licensing statute or rules; or
(iii) other violations of law that may
indicate that it may not be in the public interest that a waiver of the
two-year home residency requirement be granted.
(2) The request must include from the
physician:
(a) a completed application that
includes professional experience, education, licenses and certificates,
specialty or specialties, research, honors, professional memberships, and three
professional references;
(b) a copy
of IAP-66 forms "Certificate of Eligibility for Exchange Visitor (J-1) Status"
and INS forms I-94 for the physician and the physician's spouse and children;
and
(c) the case number issued by
the United States Department of State indicating payment of the federal fee
required to apply for the visa waiver.
(3) The request must also include:
(a) a copy of the complete contract between
the J-1 visa waiver physician and the health care facility;
(b) any required processing fees;
and
(c) other information requested
by the Department as may be reasonably necessary to determine whether it is in
the public interest that a waiver of the two-year home residency requirement be
granted.
Notes
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