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Navigating the Physician National Interest Waiver Journey: Securing State Support from the DOH

March 7th, 2024

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As part of the Physician National Interest Waiver (PNIW) process, the Petitioner will need to obtain a letter of support from Department of Health (DOH). Obtaining a letter of support from the Department of Health (DOH) for a PNIW involves several steps. It’s important to note that the process varies by state. Below is a general guide to the process:

  1. Research State Requirements: Since requirements vary by state, it is important to begin by researching the specific requirements and procedures of the state’s Department of Health where the physician intends to work. Each state may have its own guidelines and criteria for supporting physicians applying for a National Interest Waiver. 
  2. Contact the Department of Health: Reach out to the relevant department within the state’s Department of Health. The DOH’s contact will be your guide to successfully requesting and obtaining a letter of support.
  3. Verify Eligibility: Confirm that your request meets the eligibility criteria set by the state for obtaining a letter of support. For example, the DOH may require evidentiary support of the physician’s commitment to work in underserved areas for a certain period of time and compliance with state-specific regulations.
  4. Submit Request: Submit a request for a letter of support to the appropriate department. The request may require information of the physician including medical education, qualifications, licensure, and their intended practice location.
  5. Provide Supporting Documentation: Include supporting documentation that demonstrates your commitment to serving in a designated shortage area. This will include providing information on the healthcare needs of the community and employment agreement contract(s).
  6. Receive the Letter of Support: If your application is approved, you will receive a letter of support from the Department of Health. This letter is a crucial component of your overall PNIW application and demonstrates that the state endorses your placement in an underserved area.

As mentioned above, the requirements and procedures of the Department of Health vary by state. Specifically, here are the requirements for the NYS DOH when seeking a letter of support for a PNIW petition:

  1. Physician holds NYS Medical License.
  2. Physician provides medical services on a full-time basis in a federally underserved area in NYS.
  3. The physician has been cleared by the Office of Professional Medical Conduct and Office of the Inspector General and has an up-to-date NYS Physician Profile.
  4. The petitioner (employer) requested letter of support from NYS DOH with the following information:
    • Name and specialty of the physician;
    • Address of practice location(s); and
    • Attestation of need for physician for at least a 5-year period.
  5. Updated, signed contract(s) with the following information:
    • Physician specialty;
    • Address(es) of practice location(s);
    • Salary; and
    • Number of hours worked per week.

After receiving the letter of support, it will be included as part of the overall PNIW petition when applying to the U.S. Citizenship and Immigration Services (USCIS). Not only is this letter of support mandatory in the submission of the PNIW petition, but this letter also strengthens the case by showing both state and federal support for your waiver.

Navigating the PNIW process can pose challenges due to the involvement of various agencies. Success hinges on staying well-informed and current on procedures, particularly those related to the state Department of Health. Contact Berardi Immigration Law if you need help.