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Laws and Regulations

Legal Authorities for Medical Examination of Aliens

The Department of Health and Human Services has regulatory authority to promulgate regulations that establish requirements for the medical examination of aliens (immigrants, refugees, asylees, and parolees) before they may be admitted into the United States. Under this authority, the Division of Global Migration and Quarantine administers the regulations which include the health-related conditions that make aliens ineligible for entry into the United States.

The legal foundation for this authority is found in Title 8 and 42 of the U.S. Code and relevant supporting regulations.

United States Federal Laws and Regulations for Medical Examination of Aliens

United States Code

Nurse handing patient materials.

Nurse handing patient materials.

The United States Code is a consolidation and codification by subject matter of the general and permanent laws of the United States. Section 252 of the following portion of the code applies: Title 42 – The Public Health and Welfare, Chapter 6A – Public Health Service, Subchapter II – General Powers and Duties, Part C – Hospitals, Medical Examination, and Medical Care. Also, Sections 1182 and 1222 of the following portion of the code apply: Title 8- Aliens and Nationality, Chapter 12 – Immigration and Nationality, Subchapter II – Immigration, Part II – Admission Qualifications for Aliens; Travel Control of Citizens and Aliens and Part IV – Inspection, Apprehension, Examination, Exclusion, and Removal. Links are provided by the Government Printing Office.

Code of Federal Regulations

The Code of Federal Regulations (CFR) is the codification of the general and permanent rules published in the Federal Register by the executive departments and agencies of the Federal Government. It is divided into 50 titles that represent broad areas subject to Federal regulation. Part 34 of the following portion of the CFR apply: Title 42 – Public Health, Chapter 1 – Public Health Service, Department of Health and Human Services. Links from the Office of the Federal Register, National Archives and Records Administration on the United States Government Printing Office web site.

42 CFR, Part 34: Medical Examination of Aliens

Changes and Proposed Changes to Laws and Regulations

Final Rule 42 CFR Part 34 (Medical Examination of Aliens)

On January 26, 2016, HHS/CDC posted a Final Rule to the Federal Register to revise the medical screening process for the medical examination for aliens. Read more >

See also previous federal register notice: Notice of Proposed Rulemaking 42 CFR Part 34: Medical Examination of Aliens – Revisions to Medical Screening Process (issued June 23, 2015).

Removal of HIV Entry Ban
Revision of 42 CFR Part 34 (Medical Examination of Aliens): Removal of Human Immunodeficiency Virus (HIV) from Definition of “Communicable Disease of Public Health Significance”

Final Rule Removing HIV Infection from U.S. Immigration Screening (November 2, 2009)

On November 2, 2009, the Department of Health and Human Services (HHS) and Centers for Disease Control and Prevention (CDC) published a final rule that removes HIV (Human Immunodeficiency Virus) infection from the list of communicable diseases of public health significance. As a result, HIV infection will not prevent non-U.S. citizens from entering the United States. Further, HIV testing will no longer be required for U.S. immigration medical screening.

See also previous federal register notice: Revision of 42 CFR Part 34 (Medical Examination of Aliens) Removal of Human Immunodeficiency Virus (HIV) from Definition of “Communicable Disease of Public Health Significance” – Notice of Proposed Rule Making (NPRM) (issued July 2, 2009).

Revision of 42 CFR Part 34 (Medical Examination of Aliens)

Updated Screening for Communicable Disease of Public Health Significance – Interim Final Rule (IFR)

Key revisions include:
  • 1. The definition of a “communicable disease of public health significance” remains as those diseases previously listed in the former regulation plus the addition of
    • Any quarantinable, communicable disease specified by current or future Presidential Executive Orders – current diseases:
      • pandemic flu
      • severe acute respiratory syndromes
      • viral hemorrhagic fevers
      • cholera
      • diphtheria
      • infectious tuberculosis
      • plague
      • smallpox
      • yellow fever
    • Any communicable disease that is a public health emergency of international concern reported to the World Health Organization (under revised International Health Regulations of 2005), such as smallpox, poliomyelitis due to wild-type poliovirus, cholera, or viral hemorrhagic fevers (Ebola).
  • 2. Addition of a risk-based approach for medical screening and testing based on medical and epidemiologic factors to determine where and for how long additional screening and testing should be conducted.
  • 3. Updated screening and testing for tuberculosis using current medical knowledge and practice to screen for tuberculosis.

Read more >

Revised Vaccination Criteria for U.S. Immigration

Notice of Revised Vaccination Criteria for U.S. Immigration (November 13, 2009)

On November 13, 2009, the Department of Health and Human Services (HHS) Centers for Disease Control and Prevention (CDC) posted a Federal Register Notice revising the vaccination criteria for U.S. immigration. CDC will use this criteria for vaccines recommended by the Advisory Committee on Immunization Practices (ACIP) to decide which vaccines will be required for U.S. immigration. The criteria will be used at regular periods, as needed, by CDC.

See also Notice of Proposed Vaccination Criteria for U.S. Immigration (issued April 8, 2009).

Additional United States Federal Law Resources

8 USC 1522. Authorization for programs for domestic resettlement of and assistance to refugees

The United States Code is a consolidation and codification by subject matter of the general and permanent laws of the United States. Section 412 of the following portion of the code applies: Title 8- Aliens and Nationality, Chapter 12 – Immigration and Nationality, Subchapter IV – Refugee Assistance. Links are provided by the Government Printing Office.

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