At a glance
On January 26, 2016, the Department of Health and Human Services (HHS)/Centers for Disease Control and Prevention (CDC) posted a Final Rule to the Federal Register that revises the medical screening process for the medical examination for people immigrating to the United States (e.g., immigrants, refugees, asylees, and parolees). HHS/CDC has authority to establish requirements for the medical examination of aliens before they may be admitted into the United States.
Revisions
This final rule updates 42 CFR part 34 to better protect U.S. public health.
Specifically, this final rule revised the definition of "communicable disease of public health significance" by removing chancroid, granuloma inguinale, and lymphogranuloma venereum as health conditions that prevent entry into the United States; updated the notification of the health-related grounds of inadmissibility to include proof of vaccinations to align with existing requirements established by the Immigration and Nationality Act; revised the definitions and evaluation criteria for mental disorders, drug abuse and drug addiction; clarified and revised the evaluation requirements for tuberculosis; clarified and revised the process for the HHS/CDC-appointed medical review board that convenes to reexamine any appeal; and updated the titles and designations of federal agencies within the text of the regulation.
You can learn more about this final rule through the links below:
You may also view the final rule as a PDF file [PDF – 16 pages].
Frequently Asked Questions about the Final Rule for the Medical Examination of Aliens
Why did CDC revise the Regulations for Medical Examination of Aliens?
Through this final rule, HHS/CDC updated 42 CFR part 34 to reflect modern terminology and plain language used in medicine by public health practitioners. Over time, CDC and other agencies involved in medical exams of immigrants and refugees have issued guidance and rules to supplement these regulations. Today’s changes consolidate and formalize these practices. These updates also ensure regulations for the medical screening of immigrants and refugees are based upon current medical practices and scientific principles.
What are the key changes to the Regulations for the Medical Examination of Aliens?
Today's final rule:
- removes three sexually transmitted infections, chancroid, lymphogranuloma venerum, granuloma inguinale, from the list of disease within the definition of a "communicable disease of public health significance;"
- updates the "notification of the health-related grounds of inadmissibility" to require proof of vaccinations to align with existing requirements in the Immigration and Nationality Act ;
- revises the definitions and evaluation criteria for mental disorders, drug abuse, and drug addiction;
- clarifies and revises the evaluation requirements for tuberculosis screening;
- clarifies the appeal process for the HHS/CDC-appointed medical review board that convenes to reexamine a medical condition to include a subject matter expert; and
- updates the titles and designations of federal agencies within the text of the regulation.
Why did CDC remove these three diseases?
Through this final rule, HHS/CDC removed three uncommon health conditions (chancroid, lymphogranuloma venerum, granuloma inguinale) from the list of communicable diseases of public health significance in 42 CFR part 34. Current medical knowledge and practice does not support these three diseases as conditions that would prevent someone from entering the United States. These diseases are not very common, there is little risk of importation, they cannot be transmitted through casual contact, and they can easily be treated. To modernize and streamline the regulations to truly address diseases of public health significance, CDC has removed these sexually transmitted infections.
Will the rule change increase the risk that Americans will contract these infections?
Allowing non-U.S. citizens with these infections into the United States will not pose a risk to the public's health through casual contact. Chancroid, lymphogranuloma venerum, and granuloma inguinale are not very common, are all preventable, and are not spread through casual contact or day-to-day activities. These infections are spread through sexual contact and can be easily treated.
It is important to remember that any risk posed by people with these infections is not a result of their nationality. The risk of spreading sexually transmitted infections increases only when a person engages in specific behaviors, such as having unprotected sex.
When are these changes effective?
These changes are effective March 28, 2016.
Where can I view comments made to the NPRM?
Comments may be viewed at www.regulations.gov, docket number CDC-2015-0045.