What Shortage Area and Recruitment Evidence Does a Physician IGA Waiver Need?
For the standard physician IGA route based on medical service, DOS requires shortage-area evidence, facility information, and evidence that efforts to recruit a U.S. citizen physician were unsuccessful.
DOS requires shortage-area evidence
For standard IGA physician service cases, DOS calls for evidence that the clinic or facility is located in an HHS-designated Health Professional Shortage Area or Medically Underserved Area.
The facility must provide a detailed statement
DOS requires a statement from the facility head addressing the shortage-area location and confirming care for Medicaid and Medicare eligible patients and indigent uninsured patients.
The facility statement must identify the geographic area
DOS asks for the applicable county and census information or the nine-digit ZIP code used to identify the facility's designated area.
Recruitment efforts must be addressed
DOS also requires evidence that the facility unsuccessfully attempted to recruit a U.S. citizen physician, with examples including medical-journal advertising, labor certification, or an explanation of unsuccessful recruitment efforts.
Frequently Asked Questions
Does a physician IGA case usually require HPSA or MUA evidence?
Yes for the standard medical-service route, subject to statutory and DOS exceptions such as certain VA or federal research and training cases.
Does the facility need to treat indigent patients?
Current DOS instructions ask the facility to confirm that it provides care to Medicaid and Medicare eligible patients and indigent uninsured patients.
Must recruitment of U.S. physicians be documented?
DOS requires evidence of unsuccessful efforts to recruit a U.S. citizen physician.
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