15 Miss. Code. R. 9-96-1.2.2

Current through December 10, 2024
Rule 15-9-96-1.2.2

All requests must at a minimum, include the following:

1. Information describing the public benefit of approval of the placement.
2. Attestation that site provides health care services to Medicare and Medicaid-eligible patients, indigent patients, and uninsured patients. And, the percentage of Medicaid, Medicare, indigent, and uninsured patients served by site.
3. Proof that practice site is located in a HPSA or the documentation required to prove the practice is serving patients from a nearby HPSA.
4. Evidence that other avenues, regionally and nationally, to secure a physician not bound by the 2-year home residence requirement have been undertaken over a period of at least three (3) months. The recruitment effort must have occurred prior to sub Mission of the Mississippi Conrad State 30 J-1 Visa Waiver Application.
5. Information about the home government "No Objection" requirement.
6. A copy of notarized, dated, executed tentative employment contract indicating three (3) year full-time (40 hours per week) employment with the sponsoring medical facility.
7. Information about the applying physician.
8. Attestation that the physician will start employment within 90 days of receiving the waiver.
9. Attestation to submit the MSDH Annual J-1 Visa Waiver Physician Employment Verification Form.
10. The required documentation for specialist applicants.
11. An indication of whether the applying physician is a party to any existing or possible future (one that may occur within the obligation period) petition that would result in the applying physician not having to complete the service obligation.

15 Miss. Code. R. 9-96-1.2.2

Miss Code Ann, § 41-3-17
Amended 11/19/2014
Amended 2/17/2020
Amended 10/19/2020
Amended 2/14/2022