In this episode, Keith Reynolds, managing editor of Physicians Practice, speaks with Katie Russell, J.D., partner at Brown Immigration Law in Cleveland, Ohio, about what recent shifts in immigration enforcement really mean for medical practices.

Russell explains why enforcement has moved toward employer-focused compliance audits, particularly I-9 documentation and visa adherence. She outlines what practices often misunderstand about their obligations, how to distinguish between judicial and administrative warrants and what staff should do if federal officers arrive unexpectedly.

Register now for Physicians Practice's Practice Academy event: Practice Management Track, on March 19, 2026, from 1:00 PM-5:00 PM EDT: https://registration.physicianspractice.com

Music Credits:
CALM CHILL RELAXED SMOOTH JAZZ (OWE YOU) by Tasty Tunes - stock.adobe.com
A Textbook Example by Skip Peck - stock.adobe.com

Editor's note: Episode timestamps and transcript produced using AI tools.

0:00 — Cold open
Healthcare is not insulated from employer compliance standards.

0:27 — Intro and Practice Academy note

1:56 — Reconnecting since October
What’s changed in immigration enforcement?

2:39 — The biggest shift in ICE enforcement
From dramatic raids to employer compliance audits.

3:33 — I-9 documentation and why it matters
Common gaps practices overlook.

6:11 — Is this really new?
Why compliance scrutiny has always been there.

9:17 — What practices misunderstand
Healthcare is subject to the same employer standards as any industry.

11:18 — Judicial vs. administrative warrants
What staff should know before granting access.

13:42 — What to do if officers show up
Verify, document and call counsel.

16:47 — P2 Management Minute

17:57 — First compliance step this quarter
Audit your I-9 process and training.

20:48 — Is this just paperwork?
The purpose behind employer verification.

22:34 — The new $100,000 H-1B visa fee explained
Who it affects and who pays.

28:31 — Employer responsibility for visa costs

30:12 — Alternatives to H-1B visas
Exploring other pathways.

32:30 — The most practical step for overwhelmed leaders
Preparation, perspective and reducing panic.

35:27 — Final thoughts
Why most compliant practices have little to worry about.

S1 Ep127: ICE updates and visa changes in 2026, with Katie Russell, J.D.

Off the Chart: A Business of Medicine Podcast

S1 Ep127: ICE updates and visa changes in 2026, with Katie Russell, J.D.