Off the Chart: A Business of Medicine Podcast · Medical Economics

When ICE shows up: What medical practices need to know, with Katie Russell, J.D.

·37 min·2 clips

Katie Russell tells staff to verify the warrant, document the badge number, and call counsel before granting access.

1. Off the Chart: A Business of Medicine Podcast centers this episode on immigration enforcement, workplace compliance, and the $100,000 H-1B fee for medical practices. 2. Keith Reynolds, Managing Editor of Physicians Practice, interviews Katie Russell, a partner at Brown Immigration Law in Cleveland, Ohio, because she advises employers on immigration compliance. 3. The episode asks what recent ICE changes mean for medical practices and how leaders should respond if federal officials show up. 4. Russell says the biggest shift is employer-focused enforcement, with less emphasis on dramatic raids and more scrutiny of compliance documentation. 5. She names I-9 form completion, record retention, and visa petition adherence as the main documentation issues employers need to manage. 6. Russell says the I-9 is required for all employees, including U.S. citizens, and that even small technical errors or the wrong form edition can create exposure. 7. She describes panicked calls from businesses that receive notices giving them three days to turn in I-9s and supporting paperwork. 8. Russell recommends quarterly internal I-9 audits, organized binders, and making the process part of standard onboarding. 9. She says practices should train HR or administrative staff and keep close track of employment-based cases even after approval. 10. Russell explains that material changes in job duties or pay beyond a threshold can require a new filing with USCIS. 11. She says healthcare employers often assume they are insulated because they are essential, but they are still subject to the same employer compliance standards as other industries. 12. Russell tells practices to watch visa expiration dates and renewals instead of waiting until an employee’s work authorization has already expired. 13. She discusses the difference between judicial warrants and administrative warrants and says that distinction matters during workplace visits. 14. Russell says staff should verify the warrant, check the issuing authority, note the officer’s name and badge number, and document the time of interaction. 15. She advises staff not to grant unrestricted access until the warrant is verified and to call counsel when there is any uncertainty. 16. On H-1B visas, Russell says the new $100,000 fee caused panic but has not changed most in-U.S. change-of-status cases. 17. She says the fee mainly affects people who are applying through consular processing overseas rather than those already in the United States on F-1, OPT, or related pathways. 18. Russell says the firm has not seen a drop in H-1B filings and expects the program to remain heavily used for physicians and other professionals. 19. The conversation stays practical and consultative, with Keith Reynolds prompting hypotheticals and Russell answering in a training-oriented style. 20. People running medical practices, HR teams, and administrators will get the most value; listeners looking for legal fine points without compliance focus may skip it.

As heard by us

A plain-spoken guide to the compliance steps a federal enforcement visit can force on a healthcare practice.

When a DHS employee shows up at a healthcare practice, the advice stays on the practical question: what staff should do before anyone starts improvising. It walks through the basic compliance moves in plain terms. Ask for the warrant. Check who issued it.

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Need a calm playbook when a surprise DHS or ICE visit hits your practice?

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