Article
What DHS proposed
The proposed rule, filed for public inspection on Aug. 24, would set a fee of $103,265 for H-1B petitions that count against the statutory numerical caps, including petitions eligible for the advanced-degree exemption. Cap-exempt petitions would not pay it. Comments are due Sept. 24.
This is a separate track from the $100,000 payment that a September 2025 presidential proclamation required for new H-1B workers. A federal court blocked that proclamation in July, and the government’s appeal is pending. The proclamation was also written to expire after 12 months unless extended. A fee set through notice-and-comment rulemaking would rest on a different legal footing and could prove more durable.
Who would feel it
Cap exemptions generally cover universities, nonprofits affiliated with them and nonprofit or government research organizations. Many academic medical centers hire through those channels. Independent community hospitals, rural facilities and physician groups often cannot, and they rely on cap-subject H-1B petitions to bring in internists, hospitalists, psychiatrists and other specialists who trained abroad or finished residency on a visa.
For those employers, a fee above $100,000 per hire changes the math on recruiting. It may push them toward other visa routes, longer recruitment timelines or higher locum spending, and it may widen gaps in places that already struggle to fill positions.
What to do before the comment period closes
- Count your exposure. Ask HR and immigration counsel how many current and planned hires depend on cap-subject H-1B petitions, by specialty and site.
- Confirm your exemption status. Review whether any entity in your system qualifies as cap-exempt through a university affiliation or research mission, and whether hiring could be structured through it.
- Model the cost. Add the proposed fee to recruitment budgets for fiscal 2027 and compare it with locum and vacancy costs.
- Comment with data. Specific examples of shortage specialties and communities served carry weight with regulators. Coordinate with your state hospital association and the AHA, which is preparing guidance for members.
- Watch the courts. Track the appeal on the 2025 proclamation, since its outcome could shape how the agency defends the new fee.
Archive entry for Aug 24, 2026, added Nov. 11, 2026.