Congress is back from its August recess, but only briefly. The House is in session for its final legislative week before the midterms, and the Senate is scheduled to stay through the end of the month. Congress has already passed a stopgap funding bill that keeps the government open through December 11, so there is no shutdown pressure this month. The Senate has spent its limited floor time on unrelated issues such as cryptocurrency and college sports legislation. Government funding and other major priorities, including those affecting our members, will likely be decided in the lame duck session between the election and the start of the new Congress in January. In the meantime, there is plenty of legislative and regulatory activity we are tracking and covering below.

AAPPR Participates in NAMSS Roundtable on Internationally Trained Physicians

On September 10, AAPPR joined the National Association Medical Staff Services (NAMSS) for its 12th annual industry roundtable, focused on building pathways for internationally trained physicians (ITPs). AAPPR was the only physician recruitment organization at a table that included certifying and accrediting bodies, credential verification organizations, hospital and physician associations, and state medical boards. ITPs are physicians who completed their medical education, postgraduate training, and licensure outside the United States, distinct from international medical graduates who enter ACGME-accredited training here. Twenty-seven states and two territories have now enacted alternative licensure pathways for this population, with more legislation pending.

The discussion covered what organizations need in place to onboard these physicians, spanning credential verification, immigration, state licensure, medical staff appointment, and payer enrollment. AAPPR contributed the recruitment and onboarding perspective. The group agreed that NAMSS should develop resources on the topic, and AAPPR will continue to participate as that work moves forward.

AAPPR Endorses CRA Resolution on the Duration of Status Rule

AAPPR has endorsed a Congressional Review Act resolution of disapproval targeting the DHS rule that would end “duration of status” for J-1 physicians and other international students.

The Congressional Review Act gives Congress a formal mechanism to overturn a recently issued federal regulation. The resolution was introduced by Senator Dick Durbin (D-IL) with Senate cosponsors and a House companion led by Representatives Pramila Jayapal (D-WA) and Jamie Raskin (D-MD), and is endorsed by a broad coalition that includes the AAMC, the American Academy of Family Physicians, the American Academy of Pediatrics, the American Osteopathic Association, and more than forty other organizations.

We supported the resolution because the rule would replace open-ended admission for J-1 physicians with fixed periods capped at four years at a time, requiring anyone who needs more time to apply to USCIS and wait. That creates real risk of disruption for residents in longer training programs, physicians moving from residency into fellowship, and programs managing routine situations like medical or parental leave.

Separately, a federal court issued a nationwide injunction on September 14 blocking the rule from taking effect while litigation proceeds. That is a temporary hold rather than a final resolution, and the government is expected to appeal, so we are continuing to engage on both fronts and will keep members updated.

Rural Health Transformation Fund Roundup

Congress created the Rural Health Transformation Program in the 2025 budget reconciliation law. The program provides $50 billion over five years ($10 billion annually from FY2026 through FY2030) to strengthen rural health care. CMS approved all 50 states for funding, with first-year awards averaging about $200 million per state.

States now distribute the money to hospitals, practices, and training programs through their own lead agencies. Recruiting and retaining clinicians in rural communities is one of the program’s approved uses. Members recruiting in rural markets may want to check their state agency’s award lists and upcoming funding rounds. Below are two notable examples from the last month:

• Alabama:On August 24, the state announced 138 grants totaling more than $144 million. The awards include $3.8 million for Cullman Regional Medical Center to launch a family medicine residency with an obstetrics track. They also include $3 million for DCH Health Care Authority to recruit and retain two interventional cardiologists, a heart rhythm specialist, and two advanced practice providers.
• West Virginia: On September 9, CMS announced $2.4 million for a statewide program to recruit and relocate licensed healthcare professionals to rural communities. The program aims to recruit at least 125 professionals in its first year.
• Indiana: On September 3, CMS announced $120 million for Indiana. The funding includes a rural-focused OB residency, along with expanded recruitment, retention strategies, and support for high-need positions in rural communities.

Please reach out if you have any questions on this fund or any other issues.