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HHS Exchange Visitor Program

Contact the Florida Department of Health

  •  850-245-4009

    Mailing Location

    4052 Bald Cypress Way 

    Bin A-05 

    Tallahassee, FL 32304

HHS Exchange Visitor Program


The HHS Exchange Visitor Program is administered by the U.S. Department of Health and Human Services. Physicians applying for this waiver must submit a letter of support from their state health department. In Florida, the Primary Care Office provides support letters on behalf of the Florida Health Department. The program is designed to improve access to the shortage of qualified primary care doctors within federally designated Health Professional Shortage Areas to address health disparities across the country.


Physician Eligibility

  1. The physician must practice primary care medicine in the fields of family practice, general pediatrics, obstetrics/gynecology, general internal medicine, or general psychiatry.
  2. The physician must practice primary care medicine full time - no less than 40 hours per week – for at least three (3) years
  3. The physician must practice primary care medicine in a designated primary care or mental health geographic or population HPSA (A facility HPSA score will not suffice in the absence of a geographic or population HPSA score), for the required three (3) year obligation period). The HPSA must have a score of seven (7) or greater.
  4. Applicants must have a current Florida medical license.

Employer Eligibility

  1. The sponsoring facility/employer and all practice site locations must accept Florida Medicaid clients and be actively billing Florida Medicaid, whether through Fee-for-Service or as a Medicaid Managed Care plan provider.
  2. All physicians at the practice site location must accept Medicaid. The applicant physician cannot be the only physician in the practice accepting Medicaid.
  3. All employers, facilities, and practice locations must be physically located in Florida.

Employment Contract Eligibility

For an employment contract to be considered eligible, it must:

  1. Be signed by the head of the medical facility and the physician
  2. Dated
  3. Notarized
  4. Be a minimum three-year term of full-time employment, including the specific start and end dates
  5. Obligate the physician to begin work within the first three months (90 days) of receiving the waiver approval,
  6. Obligate the physician to work at least 40 hours per week providing primary care (family practice, general internal medicine, general pediatrics, or obstetrics/gynecology) or general psychiatric services,
  7. Specify the site in which the physician will work (if more than one, all sites must be located in designated health professional shortage areas (HPSAs) with a score of 7 or higher, and HPSA identifier numbers and name must be provided),
  8. Include a clause that the contract can only be terminated for cause until completion of the three-year commitment, and
  9. Not contain a non-compete provision or restrictive covenant.

Submission Timeframes

Support letters may be requested year-round.

Process to Apply

Application packets can be emailed to or mailed to:

The Florida Department of Health
Division of Public Health Statistics and Performance Management
State Primary Care Office
4052 Bald Cypress Way Bin #A05
Tallahassee, Florida 32399-1720.

Documentation Required

  1. HHS Application for Letter of Support
  2. A Cover Letter from the employer, signed and dated by the medical facility director on the facility's letterhead. The letter should include:
    1. Name of the facility/employer
    2. The telephone number of the practice locations/facilities
    3. An email address of a contact at the facility
    4. the HPSA identifier number and HPSA name for all employment sites.
    5. accepts Medicare, Medicaid, and SCHIP (Florida Kid Care) assignment,
    6. uses a sliding fee scale, and
    7. may charge no more than the usual and customary rate prevailing in the geographic area in which the services are provided.
  3. Employment Contract
  4. Evidence that the facility is located in a designated shortage area with a score of at least 7 (copy of the HRSA query result) (A facility HPSA score will not suffice in the absence of a geographic or population HPSA score),
  5. Copy of the physician’s valid Florida medical license
  6. Curriculum Vitae of the physician
  7. Personal Statement from physician regarding his or her reasons for not wishing to fulfill the two-year home country residence requirement to which the applicant agreed at the time of acceptance of exchange visitor status
  8. Readable copies of J-1's IAP-66 and/or DS 2019 forms for each year in J-1 status
  9. Form G-28 (Notice of Entry of Appearance as Attorney or Accredited Representative) or letterhead from law office, if an attorney represents the applicant

After Application

After reviewing submitted documents, if all of the requirements have been made, the Letter of Support will be drafted and emailed to the physician and their lawyer to include with their application filing with HHS.

Contract Changes

Contract changes that result in a change of practice location or employer that require a support letter from the state health department must be presented in writing to the Department at least ten business days prior to the change.

Change in practice location – Notification of contract changes that result in the relocation of the physician from the employer’s current approved site(s) to a new site(s) must include:

  • the name and address of the new location(s),
  • the reason for the change, and
  • verification that the new site(s) are located within a designated shortage area.

Change in Employers – A transfer request must be made when a physician transfers from:

  • one Florida provider to another Florida provider
  • an out-of-state provider to a Florida provider, or
  • a Florida provider to an out-of-state provider.

Transfer requests must include:

  • A cover letter from the physician indicating the intent to transfer, reasons for the transfer, proof of the extenuating circumstance(s), and intended date of transfer
  • A letter from the current employer indicating the release of the physician and reasons for termination of employment. If the physician is unable to obtain a letter from the current employer due to the extenuating circumstance(s), the physician shall clearly state this in their letter and provide a detailed explanation as to why the letter cannot be obtained.
  • A letter from the new employer stating their desire to hire the physician.
  • Employment Contract from the new employer that incorporates all eligibility requirements [see Employment Contract Eligibility section above].
  • Evidence of Shortage Designation Status: A copy of the HRSA “Find Shortage Areas by Address” query result for each practice site location, and
  • Florida Medical License, if the physician is relocating into Florida.


In the event of a termination of employment, the employer and/or the employee must notify the Department in writing within five business days of the termination.


Violation of any of the employer eligibility criteria in Rule 64W-1.003 may result in denial of future requests for visa waivers.