WEEKLY UPDATE: 10/23/25
This week, the U.S. Citizenship and Immigration Services (USCIS) released updated guidance on the new $100,000 fee for H-1B visas announced by the Trump administration last month. The H-1B work visa allows qualified foreign professionals to work temporarily in the United States in specialty jobs, including in healthcare, for typically three years, which may be extended to up to six years. The new guidance clarifies which H-1B petitions would be subject to the fee, provides details on how sponsors can pay the fee, and establishes a case-by-case exception process through which sponsors can seek a fee waiver.
The $100,000 application fee was implemented on September 21 and will expire, absent an extension, after 12 months. Of note, the guidance states that applications for H-1B visas filed on or after September 21 for workers outside the U.S. and who are not current H-1B visa holders are subject to the $100,000 charge; the fee does not apply to any previously issued or currently valid H-1B visa or when a visa applicant files to move from one type of visa to another, such as from an F-1 visa for non-U.S. students to H-1B status.
The updated guidance establishes a process for granting limited and “extraordinary” exceptions, on a case-by-case basis, to the $100,000 fee. The American Hospital Association (AHA) submitted a letter to the Department of Homeland Security (DHS) requesting an exemption for healthcare workers from the president’s proclamation, concerned that the policies would undermine hospitals’ ability to hire H-1B visa holders — including physicians, nurses, therapists, pharmacists, clinical lab experts, and other personnel. AHA noted that while hospitals have responded to ongoing workforce shortages with robust efforts to bolster recruitment and retention and invest in higher wages, challenges in filling specialized roles persist. As hospitals and health systems continue to develop long-term solutions, the H-1B visa program is a critical, short-term tool they leverage to preserve patient access to high-quality care delivered by highly skilled medical professionals.
According to KFF, immigrants account for about one in six clinical and non-clinical hospital workers. About 17% of hospital clinicians are immigrants, and of those, 74% are U.S. citizens and 26% are noncitizen immigrants.
The Connecticut Hospital Association (CHA) has provided the following statement to members of the media about the importance of the H-1B visa program: “The H-1B visa program is essential to helping hospitals recruit highly skilled physicians and other healthcare professionals to meet the care delivery needs of patients — including those in rural and underserved areas — as we work to grow and train the future healthcare workforce. At a time when the healthcare workforce nationwide is experiencing shortages, we stress the importance of ensuring that federal policies do not make it more difficult to attract and retain healthcare professionals.”
CHA will continue to provide additional information as it becomes available.
