The recent announcement of a $100,000 one-time fee on new H-1B petitions has caused significant concern among employers and healthcare professionals. Understandably, healthcare organizations (HCOs) and international healthcare professionals (HCPs) are asking whether this new fee will disrupt recruitment, retention, or travel plans. Fortunately, the answer is clear: hospitals, clinics, and nonprofit healthcare employers should not panic.
The Scope and Intention of the Fee
The $100,000 fee applies only to new H-1B petitions, particularly those filed in future lottery cycles. It is designed to discourage high-volume lottery filings by outsourcing and IT staffing firms that dominate the H-1B system. This policy is not directed at HCOs, which are traditionally recognized as critical shortage employers and often exempt from the H-1B lottery.
Who Is Not Affected
USCIS has clarified that the fee does not apply to current visa holders, pending petitions, or dependents. Specifically:
• Current H-1B holders may continue working and traveling internationally without incurring this fee.
• Pending petitions filed before September 21, 2025 will be adjudicated under existing rules, without the additional cost.
• Approved H-1B petitions are not retroactively subject to the fee.
• H-4 dependents and EADs are not impacted.
This means that international nurses, physicians, and other healthcare professionals already working in the United States, as well as those with petitions filed before September 21, 2025, remain unaffected.
Timing of Implementation
The new fee will first apply in the upcoming H-1B lottery cycle, expected in March 2026. It does not apply to the 2025 lottery winners or to cap-exempt H-1B filings made prior to the next cycle.
Why HCOs Should Not Panic
Healthcare employers are uniquely positioned. Historically, nonprofit hospitals, research institutions, and universities have been recognized as “cap-exempt,” meaning they can file H-1B petitions outside the annual lottery and without the same restrictions imposed on for-profit employers. Given the critical shortage of healthcare workers in the U.S., exemptions or carve-outs for HCOs are widely expected.
Key Takeaway
The $100,000 H-1B fee is targeted at outsourcing and IT staffing practices, not at the healthcare sector. Hospitals and clinics should continue moving forward with their international hiring strategies. The USCIS memo confirms that current visa holders, pending petitions, and dependents are unaffected. While further guidance on healthcare-specific exemptions is forthcoming, the structure of the rule and longstanding precedent indicate that HCOs and international HCPs should not expect disruption.
