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