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Understanding the Proposed H-1B Filing Fee Changes and the Impact on Workforce Planning

Client Alert

On August 25, 2026, the Trump administration published a proposed rule to impose another $103,265 payment clause on any new H-1B visa “cap-subject” petitions. The Department of Homeland Security (DHS) and U.S. Citizenship and Immigration Services (USCIS) have given agencies a 30-day period to comment.

If implemented: Which Employers will be Affected by the $103,265 payment?

  • New H-1B Cap Subject Petitions for Overseas Beneficiaries: Affected.
  • New H-1B Cap Subject Petitions for Beneficiaries within the U.S., i.e. “change of status” petitions including OPT/F-1 to H-1B petitions: Affected.
  • OPT to H-1B New Cap Subject Petition: Affected.
  • All future H-1B lottery petitions: Affected.

Who will Not Be Affected by the $103,265 payment?

  • Current H-1B visa holders with the Same Employer: Not Affected. Cap Exempt valid visas and approved petitions may remain unaffected.
  • H-1B Future Extensions and Renewals with the Same Employer: Not Affected.
  • H-1B Portability/Change of Employer: Not clear guidance. If “cap exempt” Not Affected.
  • “Cap-Exempt H-1B New Petitions” related to Universities, Hospitals or Non-Profits: Not Affected.

You can watch BMD Immigration Member Duriya Dhinojwala's interview with NDTV, which is India’s most watched T.V. channel, on YouTube here. She discusses the impact on the future of the H-1B visas if this fee is not stayed by the federal courts. The interview starts at the 3-minute mark.

Contact Duriya Dhinojwala with additional questions and information on this proposed ruling at ddhinojwala@bmdllc.com or 330.253.5790.


USCIS Policy Change Impacting Work Authorization: Advisory for Employers and Human Resources

USCIS has issued a policy memorandum pausing immigration benefit processing for individuals from 19 high-risk countries and requiring a re-review of certain previously approved cases. This change may affect work authorization, employment verification, and workforce stability. Employers and HR teams should review impacted employees and update compliance procedures.

CMS Releases CY 2026 Medicare Physician Fee Schedule Final Rule with Key Payment and Telehealth Updates

CMS issued the CY 2026 Medicare Physician Fee Schedule Final Rule on October 31, 2025, with changes effective January 1, 2026. The Final Rule includes increases to the conversion factor, a new efficiency adjustment, updates to practice expense methodology, permanent telehealth policy changes, revised payment for skin substitutes, expanded rules for Part B drugs and biologicals, enhanced policies for Rural Health Clinics and Federally Qualified Health Centers, and new care management and behavioral health services.

Ohio Department of Medicaid Updates: Key Changes to Physician Reimbursement Rates in Early Parenthood

The Ohio Department of Medicaid has proposed amending Ohio Administrative Code Rule related to covered Medicaid reimbursements for physicians. Beginning on January 1, 2026, they are proposing an increase to rates for prenatal care, childbirth, and infant care and provider visits.

Name, Image, and Likeness Agreements in Healthcare

For example, some healthcare providers have begun to utilize "Name, Image, and Likeness" agreements to promote the brand they have created through their healthcare practice.  We have seen the most healthcare NIL activity with longevity and wellness providers, as well as orthopedics.

Compounding GLP-1 Drugs - Recent Updates

Recent guidance from the Ohio Board of Pharmacy (“BOP”) indicates that providers should generally use the FDA approved GLP-1 drug, rather than a non-FDA approved compounded version of the medication. Importantly, if a GLP-1 drug is commercially available, it cannot be copied through compounding. Currently, compounded copies of Tirzepatide and Semaglutide are not permitted.