A recent White House clarification about who must pay H-1B petition fees has important consequences for hospitals, long-term care facilities, staffing agencies and healthcare systems that recruit international nurses. VisaMadeEZ, an immigration law firm specializing in helping healthcare organizations hire international nurses, breaks down what this clarification means for employer-sponsored visas, recruitment budgets, and compliance for healthcare employers.
Key takeaways (at a glance)
- Employers who sponsor H-1B visas should review who will be responsible for paying new or expanded H-1B fees.
- Healthcare organizations that recruit international nurses need immediate compliance and budget planning steps.
- VisaMadeEZ can help healthcare HR and legal teams navigate fee responsibility, sponsorship strategies, and alternatives (EB-3, TN, and permanent residence routes).
Why the clarification matters for healthcare staffing
The H-1B classification is one common path for internationally educated nurses with qualifying bachelor’s degrees or specialized nursing roles. When federal policy or White House guidance clarifies fee responsibility, that affects:
- Recruitment budgets: fees can be significant and must be accounted for in offer letters and financial planning.
- Contracts and agreements: hospitals and staffing agencies must update vendor and employment contracts to reflect fee-payment responsibility.
- Compliance risk: improper fee collection or misallocation could lead to Department of Labor or USCIS enforcement, fines, or petition denials.
Common scenarios healthcare employers should prepare for
- Hospital directly sponsors an international nurse (employer pays required H-1B filing and statutory fees).
- Staffing agency places a nurse with a hospital (contracts should spell out who pays fees and ensures compliance with wage and benefit obligations).
- International nurse transfers between employers (new petitions and associated fees may apply).
Actionable steps for healthcare employers
1. Audit current sponsorship processes
- Identify which roles use H-1B sponsorship and whether those roles meet specialty occupation requirements.
- Review historical fee payments and how they were handled between employers, staffing agencies, and nurses.
2. Update budgets and offer letters
- Build estimated visa and filing costs into the total cost of hire.
- Explicitly state in offer letters who will cover petition-related fees to avoid misunderstandings.
3. Revise contracts with staffing partners
- Ensure agreements with staffing agencies specify fee responsibility, indemnification, and compliance obligations.
- Include timely communication clauses for petition updates, RFEs, and renewals.
4. Strengthen compliance and documentation
- Maintain detailed records of fee payments, declarations, and employer attestations.
- Train HR and legal teams about the latest fee guidance and reporting requirements.
Alternatives and strategies to reduce risk and cost
- Consider EB-3 permanent employment-based routes for nurses where appropriate often a more stable long-term solution.
- Evaluate TN, H-1B cap-exempt options, or other nonimmigrant classifications depending on the nurse’s nationality and job duties.
- Explore collaboration with academic partners for residency or training-based visa solutions when applicable.
Why work with VisaMadeEZ
VisaMadeEZ specializes in immigration law for healthcare employers and international nurses. Our services include:
- Tailored cost and compliance assessments for H-1B petitions
- Drafting and updating employment and vendor contracts to reflect fee responsibility
- Strategic planning for visa pathways (H-1B, EB-3, TN and others) that align with clinical credentials and workforce needs
- Handling petitions, RFEs, renewals, and audits to reduce legal exposure
Case example (illustrative)
A regional hospital working with a staffing agency faced unexpected expenses after a policy clarification about fee responsibility. VisaMadeEZ conducted a rapid audit, revised the vendor agreement, and restructured the sponsorship process so the hospital could transparently budget for future H-1B petitions eliminating surprise costs and ensuring compliance.
Compliance reminder
Immigration policy and fee guidance can change. Healthcare employers must stay current and consult experienced immigration counsel to avoid costly mistakes. The information in this article is for general guidance and is not a substitute for legal advice tailored to your specific situation.
