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S. 4637Senate119th Congress (2025-2027)In Committee

Conrad 30 Physician Workforce Optimization Act

Sponsored by Kevin CramerSen. Kevin Cramer (R-ND)
Introduced May 21, 2026

AI-Generated Summary

Updated June 9, 2026 at 5:41 AM UTC

The Conrad 30 Physician Workforce Optimization Act expands the number of J‑1 physician “flex waivers” each state can grant from 10 to 15, giving more foreign‑trained doctors the chance to stay in the U.S. after training. It also creates a new online portal that lets physicians who weren’t selected for a waiver, or who couldn’t apply because a state’s cap was full, be matched with other states that still have unused waivers. The goal is to help fill primary‑care and specialty‑care shortages in underserved areas.

Key Provisions

  • Increases each state’s flex‑waiver limit for J‑1 physicians from 10 to 15 slots.
  • Establishes a secondary match portal for alien physicians who missed a waiver or couldn’t apply due to state caps.
  • Allows states or employers with open waivers to view physician credentials in the portal and interview candidates during a 60‑day secondary match period before March 1 of the fiscal year.
  • Requires participating employers to certify that the job is in a health‑professional shortage or medically underserved area and that the position was unsuccessfully advertised.
  • Mandates the USCIS director, after consulting state health officials, to publish best‑practice guidelines for the secondary match process.

Legislative Activity

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1 earlier action
SenateIntro Referral Latest Action

Read twice and referred to the Committee on the Judiciary.

Judiciary Committee

May 21, 2026

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SenateIntro Referral

Introduced in Senate

May 21, 2026

SenateIntro Referral

Read twice and referred to the Committee on the Judiciary.

Judiciary Committee

May 21, 2026

Bill Text

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Introduced in SenateIssued May 21, 2026

II

119th CONGRESS

2d Session

S. 4637

IN THE SENATE OF THE UNITED STATES

May 21, 2026

Mr. Cramer (for himself and Ms. Klobuchar) introduced the following bill; which was read twice and referred to the Committee on the Judiciary

A BILL

To increase by 5 the number of flex waivers available in each State for J–1 nonimmigrants and to establish a secondary physician match portal to assist alien physicians who are unable to find employment in their preferred State of residence to find employment in another State.

1.

Short title

This Act may be cited as the Conrad 30 Physician Workforce Optimization Act.

2.

Increasing the maximum number of flex waiver allowance slots in each State

Section 214(l)(1)(D)(ii) of the Immigration and Nationality Act (8 U.S.C. 1184(l)(1)(D)(ii)) is amended by striking 10 and inserting 15.

3.

Secondary physician match portal

Section 214(l) of the Immigration and Nationality Act (8 U.S.C. 1184(l)) is amended by adding at the end the following:

(4)
(A)

The Director of U.S. Citizenship and Immigration Services, after consultation with the heads of a representative sample of State Departments of Public Health, shall establish a portal for alien physicians who—

(i)

have been granted the status of a nonimmigrant described in section 101(a)(15)(J)(i);

(ii)
(I)

have applied for a waiver of the 2-year foreign residence requirement under section 212(e), but were not selected by the State to which they submitted their application; or

(II)

have sought to apply for a waiver of the 2-year foreign residence requirement under section 212(e), but were unable to submit an application because the State’s numerical cap had been reached, or applications were otherwise not accepted at the time of the attempted submission; and

(iii)

request to be included in such portal.

(B)

Any State, or any employer located in such State, that has not filled all of its allotted waivers under paragraph (1)(B) for the current fiscal year may use the portal established pursuant to subparagraph (A) to access information about the credentials of potential alien physicians who may be interested in obtaining full-time employment as a primary care or specialty care provider in such State.

(C)

Information about international medical graduates who request to be included in the portal established pursuant to subparagraph (A) shall be included on an attestation form that is sent to an organizing body to facilitate the dissemination of such information to States with available waivers.

(D)

The Director shall establish a secondary match period, not to exceed 60 days, during which employers in States with available waivers for the current fiscal year can review and interview alien physicians included in the portal before March 1st of such fiscal year.

(E)
(i)

The portal shall contain essential information contained in the alien physicians initial application to streamline the secondary application process for potential employers.

(ii)

Employers participating in the secondary application process shall certify that—

(I)
(aa)

their facilities are located in a health professional shortage area or in a medically underserved area; or

(bb)

they are seeking an applicable flex waiver under section 214(l)(1)(D)(ii); and

(II)

they have unsuccessfully advertised the position for which the alien physician will be hired.

(iii)

State departments of public health and prospective employers shall be provided access to the portal in order to identify potential alien physicians.

(F)

The Director, after consultation with a representative sample of State departments of health or related agencies, shall publish a set of best practices and core application requirements that—

(i)

assist States in determining the sufficiency of waiver applications submitted for the secondary match; and

(ii)

include the essential elements necessary to establish sufficiency and ensure a streamlined process for the secondary match applications.

.