DOL to Increase Prevailing Wage Levels

On March 27, 2026, the U.S. Department of Labor (DOL) proposed a new rule to increase prevailing wage levels. If finalized, the rule would increase prevailing wage requirements for employers sponsoring foreign nationals under the H‑1B, H‑1B1, E‑3, and PERM (EB‑2 and EB‑3) programs.

Current Prevailing Wage Structure

For more than two decades, DOL has relied on the Occupational Employment and Wage Statistics (OEWS) survey to assign four prevailing wage levels based on percentiles of the wage distribution:

• Level I (Entry Level): 17th percentile
• Level II (Qualified): 34th percentile
• Level III (Experienced): 50th percentile
• Level IV (Fully Competent): 67th percentile

These wage levels are used uniformly for temporary programs, like the H-1B and permanent programs, like EB-2 and EB-3 category Green Cards.

 

Proposed Wage Level Changes

Under the new rule, DOL would substantially raise each wage tier:

 

Wage Level	Current		Proposed
Level I	17th	→	34th
Level II	34th	→	52nd
Level III	50th	→	70th
Level IV	67th	→	88th

 

Notably, entry-level wages would double, moving to the current Level II floor.

 

DOL estimates these changes would increase average required wages by approximately $14,000 annually, depending on occupation and location.

 

When Would the New Wages Take Effect?

DOL will accept comments on the rule from the public until May 26, 2026.

 

If finalized, the new wage methodology would take effect no earlier than 60 days after the final rule is published. Until then, current wage levels remain in effect.

WEBINAR: Immigration & I-9 Compliance

MU will be hosting a FREE webinar on Tuesday, April 21st at 2PM Eastern for our friends and clients. Please join us! 

Join us for this FREE webinar to learn more about:

• What is an I-9 Audit
• I-9 Best Practices
• What to Expect from DHS Site Visits
• H-1B Compliance Best Practices
• H-1B $100K Fee Updates

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Medical Groups Back Legislation that would Exempt Healthcare Workers from $100,000 H-1B Filing Fee

On March 17, 2026, bipartisan legislation was introduced by U.S. Representatives Mike Lawyer (R-NY), Sanford Bishop Jr. (D-GA), Yvette Clarke (D-NY), and Maria Elvira Salazar (R-FL) to exempt physicians and other healthcare workers from the Trump Administration’s $100,000 H-1B filing fee.

The bill, presently called the “H-1Bs for Physicians and the Healthcare Workforce Act,” proposes that the $100,000 H-1B filing fee shall not apply to any H-1B worker who is employed in the healthcare sector. The proposed fee exemption would broadly cover healthcare workers, including doctors, nurses, dentists, certified nurse midwives, psychologists, ambulance workers, and public health professionals as defined by Affordable Care Act.

The American Medical Association (AMA) and the American Hospital Association (AHA)—among other medical organizations—have endorsed this legislation. 

In its recent press release applauding the bill, the AMA wrote that the $100,000 H-1B filing fee raises hiring costs, which in turn worsens physician shortages, increases wait times, and reduces access care. The bill therefore aligns with AMA’s mission to build and maintain a strong healthcare workforce to serve all patient needs.

Similarly, AHA Executive VP Stacey Hughes expressed support for the bill, stating that it would maintain patient access to care by sustaining critical healthcare staffing in shortage areas.

FY 2027 H-1B CAP Lottery

The fiscal year 2027 (March 2026) H-1B cap registration period is currently open and will run through noon eastern on Thursday March 19, 2026.

H-1B CAP registrations are submitted electronically via USCIS’s website. USCIS will update its lottery selections on employers’ my.uscis.gov accounts by March 31, 2026.

H-1B CAP lottery winners are then eligible to submit an H-1B petition between April 1, 2026 – June 30, 2026.

Notable changes to this year’s H-1B cap season are:

• USCIS will require a $100,000 payment for new H-1B visa applicants who are outside the US at the time of their cap case filing.
• USCIS has announced that lottery selection will be weighted, with more entries for selection given to H-1B candidates with high wages. 

For the latest on USCIS’s H-1B changes and to ensure your own H-1B filing strategy, please reach out to your MU attorney.

Congress Implores DHS to Exempt Healthcare Workers from $100,000 H 1B Visa Fee

In February 2026, bipartisan members of Congress renewed calls for relief from the $100,000 H 1B visa filing fee for international healthcare workers. In an American Hospital Association (AHA)-supported letter sent to the U.S. Department of Homeland Security (DHS) on February 11, lawmakers urged the agency to exempt healthcare workers from the fee, warning that the policy threatens already‑strained hospital staffing nationwide.

The letter, led by Representatives Yvette D. Clarke (D‑NY) and Michael Lawler (R‑NY), was signed by 100 members of Congress and emphasized that hospitals and health systems rely heavily on international professionals to maintain access to care, particularly in rural and underserved communities.

 

Hospitals Warn of Worsening Workforce Shortages

 

Lawmakers cautioned that imposing a $100,000 fee on new H‑1B visa petitions would further exacerbate existing staffing shortages and push financially vulnerable hospitals closer to the brink. According to the letter, if healthcare employers are unable to petition for H‑1B workers without absorbing the additional cost, critical clinical positions may remain unfilled, reducing patient access to essential services.

 

AHA Continues Advocacy for a Healthcare Exemption

 

The AHA’s support for the congressional letter aligns with broader, ongoing advocacy efforts by hospitals, academic medical centers, and healthcare associations seeking an exemption from the $100,000 H‑1B fee. These organizations argue that restricting access to H‑1B visas will worsen workforce shortages across multiple healthcare professions and undermine the financial viability of care providers serving high‑need populations.

 

As DHS continues to evaluate implementation of the fee, healthcare stakeholders remain focused on securing targeted relief that recognizes the essential role international professionals play in sustaining the U.S. healthcare system.

2026 H-1B Cap Webinar

MU will be hosting a FREE webinar on Thursday, February 19th at 2PM Eastern for our friends and clients. Please join us! 

Join us for this FREE webinar to learn more about:

• $100K Fee latest updates
• H-1B Cap Registration Process/Timeline
• Weighted Lottery Rule
• What is a Specialty Occupation?
• Cap-gap for F-1s as well as CPT/OPT Maintenance

Please join us!

US Healthcare Industry Continues to Push for Exemptions to $100,000 H-1B Fee

In September 2025, President Trump instituted a prohibitive $100,000 fee on new H-1B visas. While lawsuits against the fee have been ongoing, the fee currently remains in effect. Hospitals, medical schools, and other healthcare companies have continued their calls for an exemption from the fee for international healthcare professionals who are essential to the US healthcare system.

In a recent article, the American Association of Medical Colleges (AAMC) raised concerns about how the fee is already affecting major staffing decisions for US hospitals approaching national Match Day with graduating medical students on March 20, 2026.

AAMC reports that in a fall survey by the Greater New York Hospital Association (representing 260 hospitals across NY, NJ, CT, and RI), 25% of hospitals said they had paused, deferred, or limited recruitment of physicians requiring H‑1B visas. Those hospitals currently employ 1,100 H‑1B medical residents and 800 H‑1B attending physicians, highlighting the scale of potential disruption.

Importantly, AAMC emphasizes that visa‑holding physicians do not displace U.S. graduates; in fact, 97.8% of U.S. MD seniors matched into residency positions in 2025.

International medical graduates make up about 25% of all practicing U.S. physicians. In fiscal year 2024 alone, approximately 11,000 new H‑1B visas were approved for physicians, who disproportionately practice in rural and high‑poverty counties and are more likely to work in primary care.

AAMC has cosigned multiple letters, joining medical organizations, institutions of higher education, and health professions education groups, in requesting that the U.S. Department of Homeland Security (DHS) exempt these groups from the fee. AAMC also sent a letter to DHS Secretary Kristi Noem in December 2025, warning that the proclamation will worsen the nation’s existing workforce shortage, further strain the health care workforce, and ultimately jeopardize patient access to care.

WEBINAR: H-1B Visa Updates

MU will be hosting a FREE webinar on Tuesday, January 13th at 2PM Eastern for our friends and clients.  Please join us! 

Join us for this FREE webinar to learn more about:

• H-1B $100k Payment Litigation Updates
• H-1B Cap Weighted Lottery

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DHS Issues Final Rule for Weighted Selection of the Highest Wages in H-1B Cap

On December 29, 2025, DHS published a Final Rule in the Federal Register, amending the way in which USCIS will select candidates in the H-1B Cap Lottery.  

Instead of the existing random lottery system, USCIS will implement a weighted selection process that prioritizes allocating H-1B visas to higher-skilled and higher-paid workers according to their Occupational Employment and Wage Statistics (OEWS) wage levels.

Each worker’s OEWS wage level, which ranges from Levels I to IV, will determine how many registration entries that candidate will receive. Higher wage levels receive more entries—four for Level IV, three for Level III, two for Level II, and one for Level I—resulting in higher-paid positions having greater odds of selection while still allowing all wage levels to participate.

Although DHS received nearly 17,000 public comments on its Notice of Proposed Rulemaking (NPR), issued back in September 2025, DHS published this Final Rule without any modifications. DHS notes that some commenters suggested that DHS should consider an exemption for healthcare occupations, especially in rural or shortage areas. However, DHS declined to carve out exemptions for certain industries or give additional weight for registrations in “critical sectors.”

The Final Rule is effective February 27, 2026, and will be in place for the H-1B Cap Registration Season for the 2027 Fiscal Year.

Department of State Will Review H-1B and H-4 Visa Applicants’ Social Media

The Department of State (DOS) has announced that effective December 15, 2025, it will review the online presence of all H-1B visa applicants and their dependents, H-4 visa applicants.

As this measure is being enacted by the DOS, it will apply to visa applicants applying for visas at embassies abroad and does not explicitly apply to H-1B or H-4 petitions filed within the US, such as amendments, extensions, transfers, and changes of status.

 

In June 2025, DOS announced it would begin to review social media of students applying for F, M and J visas. This December 2025 announcement expands that online vetting process to include H-1B and H-4 visa applicants.

 

If social media profile(s) exist for H-1B and H-4 visa applicants, DOS will instruct them to adjust the privacy settings to “public”.  

 

DOS’s stated purpose for social media review of applicants is national security and public safety.

 

DOS also notes that its social media review will include whether an applicant’s online information shows an intention “to engage in activities consistent with the terms for their admission”.

American Hospital Association Urges Trump to Exempt Health Care Personnel from $100,000 H 1B Fee

Recently, the American Hospital Association (“AHA”) voiced its support for an exemption from the $100,000 H-1B fee for health care workers.

 

In its letter, AHA urges the federal government to exempt health care personnel from the $100,000 H‑1B visa fee established by President Trump’s September 2025 proclamation, “Restriction on Entry of Certain Nonimmigrant Workers,” (MU’s blog on the fee is available here) arguing that the fee threatens hospitals’ ability to recruit and retain qualified foreign‑trained professionals.

 

Health care systems across the United States continue to grapple with profound clinician and nurse shortages that are projected to deepen significantly in the years ahead. 

 

The H-1B visa is essential to meeting shortages in health care occupations in the US. In fiscal year 2024 alone, of nearly 400,000 H‑1B petitions approved, 16,937 (4.2 %) were for medical and health occupations, including physicians, surgeons, and registered nurses.

 

AHA also articulated its strong support for the bipartisan Healthcare Workforce Resilience Act (discussed by MU here). These combined measures represent a coherent strategy to preserve and expand the U.S. health care workforce. Ensuring exemption from the fee is not only a regulatory measure—it is a critical component of maintaining continuous and equitable access to health services across communities nationwide.

WEBINAR: H-1B $100,000 Proclamation Updates

MU will be hosting a FREE webinar on Tuesday, October 28th at 2PM Eastern for our friends and clients.  Please join us! 

Join us for this FREE webinar to learn more about:

• Who is Subject to the $100,000 Payment
•  Exception Criteria
• Litigation Updates

Please join us!

WEBINAR: Business Immigration Hot Topics

MU will be hosting a FREE webinar on Tuesday, October 7th at 2PM Eastern for our friends and clients.  Please join us! 

Join us for this FREE webinar to learn more about:

• H-1B $100k Visa Fee
• H-1B Cap Employees October 1 Start Considerations
• USCIS H-1B Site Visit Trends   
• Visa Bulletin Fiscal Year 2026 Projections
• Healthcare Workforce Resilience Act

Please join us!

H-1B PROCLAMATION COULD ADD $100,000 FEE TO PETITIONS

Late Friday, September 19, 2025, President Trump issued the Presidential Proclamation, Restriction on Entry of Certain Nonimmigrant Workers.  The Proclamation creates a $100,000 fee due on each H-1B petition at the time the case is filed, although some exemptions exist.  There was – and continues to be -- widespread confusion about the applicability of the Proclamation to various types of H-1B cases.

Please join our webinar on Tuesday, September 23, 2025 at 2PM.  We will spend much of the webinar addressing the new Proclamation.  We have been involved with some non-public conversations with Washington DC.  We will share what we are allowed to share during that webinar.

REGISTER FOR THE WEBINAR

Here’s what we currently know. We will share updates as soon as they are announced:

• The Proclamation is effective Sunday, September 21, 2025 at 12:01AM Eastern Time and is valid for a period of 12 months.
• A fee of $100,000 per H-1B petition will be charged.  Note some reporting said the $100,000 would be assessed annually (totaling $300,000 for a three-year H-1B); that reporting is incorrect, the fee is a one-time $100,000 per H-1B petition. 
• Who the Fee Applies To – New H-1B petitions (both cap-subject and cap-exempt) that are filed with the USCIS after September 20, 2025.  The plain language of the Proclamation indicates the fee applies to all H-1B entries after September 20, 2025, but the Administration issued subsequent guidance on Saturday clarifying the fee will be applied to new H-1B petition filings submitted to the USCIS after September 20, 2025.
• Who is Exempt from the Fee – The fees does not apply to H-1Bs filed before September 20, 2025, including:
• Current H-1B holders who are traveling abroad and re-entering the US;
• Foreign nationals with a current H-1B approval and/or H-1B visa stamp who are entering the US for the first time; and
• H-4 dependents.
• Waiver of the $100,000 fee (National Interest Exemptions) – The USCIS may waive the $100,000 fee if:
• The H-1B employee’s work is in the national interest, and
• Their admission would not pose a threat to U.S. security or welfare.

No specific guidance has been issued yet on how to apply for a national interest exemption, or which industries or companies might qualify. Given the ongoing nursing shortage, RNs and other healthcare workers may have a strong case for this exemption.  IT professionals probably will not have a strong case for the exemption. We expect more details soon. 

• Legal Challenges Expected:
• Lawsuits challenging the Proclamation are likely and may request an emergency block of the Proclamation and the implementation of the fee.

MU will update our clients with additional information as this Proclamation is implemented and challenged in court.  Again, please join us on Tuesday’s webinar for the latest information.

FY 2026 H-1B Cap is Reached: USCIS Will Not Conduct Second Round of Lottery

USCIS announced in a News Alert that the FY 2026 H-1B cap has been reached as of July 2025. Because the cap has been reached, USCIS will not conduct a second round of H-1B cap lottery selections in 2025.

The FY 2026 H-1B cap has been reached because USCIS received enough H-1B petitions between April 1, 2025 and June 30, 2025 to meet the 65,000 H-1B visa regular cap and 20,000 H-1B visa master’s cap. 

The case status for registrations that were not selected in the FY 2026 cap will be updated from “Submitted” to “Not Selected” in their https://my.uscis.gov/ account.

Webinar: Immigration Updates for the Healthcare Industry

MU will be hosting a FREE webinar on Thursday, July 10 at 3PM Eastern for our friends and clients.  Please join us! 

IMMIGRATION UPDATES AND THE STATE OF THE HEALTHCARE INDUSTRY

Join us for an information-packed webinar designed for HR leaders, immigration professionals, and staffing companies navigating today’s complex immigration landscape.

In just half an hour, we’ll deliver critical updates and actionable strategies on:

• 🚦 Green Card Processing Timelines & Prevailing Wage Determinations – how to stay ahead and avoid any delays in filing
• 📈 RFE Rates & Trends under the Trump Administration – and how to minimize your risk
• 💸 "Ability to Pay" Challenges – especially for staffing firms during retrogression, with proven solutions
• 👩‍⚕️ H-1B Options for Registered Nurses – what you need to know now
• 📰 Policy Shifts & Breaking News from Washington – decoded and explained
• 🏛️ Legislative Outlook – what’s coming and how it could impact your workforce strategy

Reserve your spot today!

USCIS Releases FY 2026 H-1B Cap Registration Numbers

USCIS recently posted its FY 2026 H-1B cap lottery update, announcing it received 358,737 total registrations in the FY 2026 (March 2025) H-1B cap lottery. The total number of registrations submitted in FY 2026 decreased 25% from FY 2025, when 479,953 total registrations were submitted. 

The H-1B CAP lottery was open to employees filling positions requiring bachelor’s degrees, which may include healthcare occupations such as Medical Technologists, Occupational Therapists, Physical Therapists, and even Registered Nurses.

The table below provides the total number of H-1B registrations from FY 2021 - 2026:

Fiscal Year	H-1B registrations
2026	358,737
2025	479,953
2024	780,884
2023	483,927
2022	308,613
2021	274,237

 

As indicated by the table, the number of H-1B cap registrations has steadily declined since FY 2024. USCIS credits its final rule Improving the H-1B Registration Selection Process and Program Integrity, which was implemented in 2024 and introduced a beneficiary-centric registration system designed to prevent employers from submitting duplicate registrations for the same individual. 

H-1B registrations once again far outnumbered the 85,000 cap, and a total of 120,141 registrations were selected for FY 2026. Those selected in the lottery have been notified and must file their full H-1B petitions with USCIS by June 30, 2025.

If less than 85,000 CAP petitions are filed by June 30, 2025, USCIS may issue additional selections in a subsequent round of the lottery. Individuals whose registrations are listed in the Registrant’s online account as “Submitted” are not yet rejected in the CAP but are eligible to be chosen in a later round of the lottery.

USCIS Should Update H-1B Policy for Nurses

The USCIS should consider issuing a new policy memo to modernize and liberalize the approvability of H-1B visas for registered nurses. The current guidance—based on a 2015 memo from the Obama administration—is outdated and no longer reflects the realities of the U.S. healthcare workforce.

The U.S. Faces a Critical Nursing Shortage

Nursing remains one of the most understaffed professions in the United States. This shortage is driven by several key factors:

• An aging population that is increasing demand for healthcare services.
• A large number of nurses retiring from an aging workforce.
• Bottlenecks in nursing education due to faculty shortages and limited training capacity.

To address this crisis, allowing more foreign-trained nurses into the U.S. through H-1B visas could provide much-needed relief.

Why H-1B Approval for Nurses Makes Sense Now

Historically, USCIS has been reluctant to approve H-1B petitions for registered nurses because bedside nursing roles did not universally require a Bachelor of Science in Nursing (BSN). However, that landscape has changed significantly.

According to a recent study by the American Association of Colleges of Nursing (AACN), 72% of registered nurses in the U.S. now hold at least a BSN. (Source)

Given this shift, the USCIS should revise its policy to instruct officers to generally approve H-1B petitions for RN positions requiring a BSN.

No Risk of Job Offshoring

Some critics of the H-1B program argue that it can lead to offshoring of American jobs—especially in the IT sector. That concern does not apply to nursing. RN positions are inherently in-person and cannot be outsourced. A nurse must be physically present to care for patients. The real choice facing U.S. patients is not between a U.S. nurse and an international one—it is between having a nurse or going without care.

Fiscal Year 2026 H-1B CAP Lottery Completed

USCIS announced it has received enough electronic registrations for unique beneficiaries during the H-1B CAP registration lottery to reach the fiscal year (FY) 2026 H-1B CAP of 85,000 beneficiaries.

The H-1B CAP lottery was open to employees filling positions requiring Bachelor’s degrees, which may include healthcare occupations such as Medical Technologists, Occupational Therapists, Physical Therapists, and even Registered Nurses.

Musillo Unkenholt has begun notifying clients who are H-1B lottery winners that they are eligible to file an H-1B cap-subject petition.

Selected registrations may be filed from April 1, 2025 – June 30, 2025.

If less than 85,000 CAP petitions are filed during the 90-day filing window, USCIS may issue additional selections in a subsequent round of the lottery. Individuals whose registrations are listed in the Registrant’s online account as “Submitted” are not yet rejected in the CAP but are eligible to be chosen in a later round of the lottery.

“Winning” the lottery does not guarantee an H-1B approval. Petitioners filing for selected beneficiaries based on their valid registration must still submit evidence or otherwise establish eligibility for petition approval.

FY 2026 H-1B CAP Lottery

The fiscal year 2026 (March 2025) H-1B cap registration period will open this week, at noon eastern on March 7, 2025 and run through noon eastern on March 24, 2025.

H-1B CAP registrations are submitted electronically via USCIS’s website. H-1B CAP lottery winners are then eligible to submit an H-1B petition between April 1, 2025 – June 30, 2025.

The H-1B CAP lottery is open to employees filling positions requiring Bachelor’s degrees, which may include healthcare occupations such as Medical Technologists, Occupational Therapists, Physical Therapists, and even Registered Nurses.

This year, USCIS has increased its CAP registration fee from $10 to $215 per registration.

Further information on this year’s CAP lottery can be found on USCIS's H-1B Electronic Registration Process website.