The Department of Homeland Security Dec. 23 finalized its proposal to amend the H-1B visa petition and registration process. The final rule implements a weighted selection process for the H-1B lottery — replacing the former random selection — by prioritizing H-1B visas for higher-paid workers. In the final rule, DHS reaffirms the limits on the number of permitted visas to 65,000 annually, with an additional 20,000 for those with a U.S. advanced degree. 

The AHA commented on the proposed rule, saying it would hinder hospitals from using the program to address health care worker shortages and hamper access to care. The AHA recommended that DHS automatically assign the highest weight in the selection process to occupations under the medicine and health categories. 

The rule is effective Feb. 27, 2026, and will be in place for the fiscal year 2027 H-1B cap registration season. 

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