Lawyer for Physicians, Medical Corporations and Group Medical Practices, Matt Dickstein, Business Attorney - P.O.Box 3504, Fremont CA 94539-5856. Please get competent legal counsel before you hire a physician. An independent contractor usually agrees to complete a specific job and is responsible for its satisfactory completion, or is legally obligated to make good for failure to complete it. If the physician (or their family member) is paid as an independent contractor instead of as an employee, then the agreement must satisfy either the Stark … medical records received by Contractor in connection with a client event. This article explains how you pay compensation to a physician employee or contractor in compliance with the referral laws for California … Oklahoma 37. and also, Stealing employees. INDEPENDENT PHYSICIAN AGREEMENT This Independent Physician Agreement (“Agreement”) is made as of April 12, 2006 (the “Effective Date”), by and between VIRTUAL RADIOLOGIC PROFESSIONALS, … See also, Buy-in and buy-out of physicians to a medical group. As always, the contract may not take into account the volume or value of any referrals or any other business generated between the parties. In this article, I briefly outline the legal requirements for paying compensation to a physician-employee and to a physician-independent contractor. Under no circumstances shall Contractor, or any of Contractor's … Arkansas 5. Purpose. The contract sets compensation in sufficient detail so that it can be verified (“set in advance”) The key concept is that you may pay an employee-physician in a manner that directly correlates to the professional services that the physician personally performs (e.g. In determining the status of an independent worker or contractor… May a physician compete against his or her former practice? You can base compensation on a formula (e.g. For more on the termination of a physician employment contract or a physician contractor agreement, see my article, Termination clauses in physician employment and contractor agreements. Georgia 11. Get competent legal help for your group practice’s compensation plan. *** A bonus based on the physician’s personal productivity or the achievement of specified quality indicators Should you incorporate your medical practice? A practice usually will pay more expenses for an employee than for a contractor. Michigan 23. The cost of misclassification is very high, and it’s never worth it. Providing business legal services in Northern and Southern California, including San Francisco, Physician employment and independent contractor agreements, Stark and Anti-Kickback laws regarding the compensation structure of a group medical practice. The contract is for identifiable services If you are … Connecticut 8. We’ve suffered enough. Contractor is an independent contractor, and neither Contractor nor Contractor's … Arizona 4. Ohio 36. North Carolina 34. Here is a list of expenses that practices frequently pay: * Professional society dues (within reasonable limits) Contractor enters into this Agreement as, and shall continue to be, an independent contractor. In some cases – such as running your own busi… New Jersey 31. * Board certification. the professional component of charges). INDEPENDENT CONTRACTOR certifies that he\she is licensed physician, nurse practitioner, or physician … Before you sign that contract and make an employment commitment, hire a … For more information on this subject, see my article, Bringing a new partner into a medical practice. Attorney for Accountancy Corporations and Group Accounting Practices. 6. The purpose of this document is to describe the scope of practice for the nurse practitioner (NP) who signs this agreement, as well as, provide written authorization by the supervising physician for the NP to initiate and provide psychiatric and medical … Using this key concept, you may pay a physician employee as follows: *** A percentage of collections for services personally performed by the physician There is a lot more to this topic than introduced here. * Hospital privileges a percentage of collections) so long as the formula is set in advance in the contract. 510-796-9144. mattdickstein@hotmail.com mattdickstein.com, In this article, I look at the essential terms of a physician employment contract and a physician independent contractor agreement. 3. My prior article, Physician employment and independent contractor agreements, gives you the basics about hiring a physician as an employee or contractor. In general, under Stark, compensation to an employee-physician is OK if: 1. Term and Termination. Kentucky 18. These should be reviewed carefully before signing. Be sure to clarify the physician’s administrative duties. The California independent contractor agreement is used to define a client’s expectations when employing the services of an individual working independently to fulfill a duty. To learn about non-competition clauses for physicians, read May a physician compete against his or her former practice? Independent Contractor Arrangements. Productivity payments are a little more difficult. Legal compliance checklist for a medical corporation, Corporate structure - Levels of legal control over a group medical practice, Legal structure for a group medical practice, How to structure a new group medical practice, Legal structure for a medical practice with 50/50 shareholders, Shareholder buy sell agreements for medical corporations, How to bring a new partner into a group medical practice, Buy-in and buy-out of physicians to a medical group, Installment buy-in of a physician to a medical practice, Removing a doctor / shareholder from a practice, Using buyout to resolve a shareholder deadlock, Management agreements for surgery centers, Classifying a physician as employee or contractor, Physician employment and contractor agreements, Termination clauses in physician employment and contractor agreements, Notices to patients when a physician leaves a group practice, Professional service agreements for hospital-based physicians, Stark and Anti-Kickback laws re physician employment and contractor agreements, Outline of a compensation / expense structure for a group medical practice, Compensation structures for a group medical practice, Stark and Anti-Kickback laws regarding the compensation structure of a group medical. Make sure you have a good plan for retiring your student loans. Compensation. Idaho 13. The hiring entity and the physician should be mindful, however, that establishing an independent contractor relationship is not automatic from legal standpoint, their desire and their written agreement notwithstanding. Common examples of cause are: * Loss of medical license or federal DEA registration TTG LOCUM TENENS INDEPENDENT CONTRACTOR AGREEMENT Independent Contractor shall provide medical services in a competent and lawful manner and at all times as requested by Client Companies (Medical Facilities). Requesting adjustments to the contract is completely acceptable. The contract specifies and encompasses all of the services that the physician will provide, and the aggregate services are reasonable and necessary for legitimate business purposes In general, under Stark, you may pay an independent contractor physician if: 1. Making legal matters easy and economical for your business. New Hampshire 30. You have a contract with the physician Just as for employee-physicians, you may pay to a contractor a percentage of collections or productivity bonus, but only for services performed personally by the physician, not for services provided by someone else. You may not, however, pay an employee-physician for services performed by others or a share in the overall profits of the group, or a facility or department. Making legal matters easy and economical for your business. Iowa 16. * Termination or suspension of hospital privileges For example, the physician might receive an incentive of X% of the gross revenue he or she generates in excess of $Y (Y being the expenses associated with the income including an allocation of general overhead, that is, the break-even point in income). The contract doesn’t take into account the volume or value of referrals, and is commercially reasonable even if no referrals are ever made. The bill codifies a ruling from the California Supreme Court that included a new test for determining whether a worker is an employee or an independent contractor. A medical practice should always be clear and confident in how it classifies employees and contractors. The essential terms are about the same as between a physician employment contract and a physician independent contractor agreement. * Malpractice insurance https://watkinsfirm.com/independent-contractor-agreements-for-physicians Note that this article is focused on contracts that are provided to you (the physician) by a company that is hiring you to do some work for them. * Felony conviction or abuse of controlled substances. The law places limitations on a company’s ability to classify workers as independent contractors and requires them to use a three-part test to prove these workers are independent contractors. I frequently see physicians receive a fixed base salary + an incentive based on the income that the physician personally generates. Illinois 14. 2. On January 1, 2020, the California Assembly Bill 5 (AB5) goes into effect. These governmental agencies hope that the practice has misclassified the physician as a contractor (not an employee) so that they can collect on the plethora of taxes and premiums for employees, e.g. * The period over which the physician will pay the purchase price In fact, most doctors hired cannot be properly classified as independent contractors. Legal compliance checklist for a medical corporation, Corporate structure - Levels of legal control over a group medical practice, Legal structure for a group medical practice, How to structure a new group medical practice, Legal structure for a medical practice with 50/50 shareholders, Shareholder buy sell agreements for medical corporations, How to bring a new partner into a group medical practice, Buy-in and buy-out of physicians to a medical group, Installment buy-in of a physician to a medical practice, Removing a doctor / shareholder from a practice, Using buyout to resolve a shareholder deadlock, Management agreements for surgery centers, Classifying a physician as employee or contractor, Physician employment and contractor agreements, Termination clauses in physician employment and contractor agreements, Notices to patients when a physician leaves a group practice, Professional service agreements for hospital-based physicians, Stark and Anti-Kickback laws re physician employment and contractor agreements, Outline of a compensation / expense structure for a group medical practice, Compensation structures for a group medical practice, Stark and Anti-Kickback laws regarding the compensation structure of a group medical. If the physician’s buy-in is a material part of the deal, however, specify these deal terms: * The ownership percentage that the physician will obtain 3. The contract pays compensation at FMV trust fund taxes, interest and penalties. Once beyond the boilerplate, both contracts deal with the same … 5. To learn about another crucial contract for medical practices, read Shareholder buy-sell agreements for medical corporations. One significant difference is that employment agreements sometimes have clauses that address the physician’s purchase of ownership in the practice, whereas independent contractor agreements rarely have such terms. It makes sense that an employer would require such a non-compete covenant by an employee physician before introducing the physician … California Medical Association. Alaska 3. Physician Buy-In. Massachusetts 22. Stealing employees - may a physician solicit away your employees? Compensation does not exceed FMV North Dakota 35. Expenses. Delaware 9. Indiana 15. [Note that to fit within its safe-harbor, the Anti-Kickback law requires that the contract state the total, aggregate compensation payable to the physician, hence you may not use a formula under the Kickback safe harbor.]. If you want a contract for a term of years, be sure to include termination for cause. * The purchase price I prefer a free relationship, as opposed to contractually locking the two sides into a relationship that isn’t working – this only leads to unhappy endings and litigation. Maryland 21. Stealing employees - may a physician solicit away your employees? Montana 27. Job Description. Notice- Independent Contractor shall notify the Company of any changes … 2. * The extent of the physician’s participation in control decisions for the practice, e.g. 4.8 Employment and Independent Contractor Agreements. The referral laws are voluminous, complex, subtle and idiotic. * Continuing medical education and related travel costs (again, within reasonable limits) All Services shall be performed only by Contractor and Contractor's employees. Collaborative Practice Agreement for Nurse Practitioner (SAMPLE) A. This article explains how you pay compensation to a physician employee or contractor in compliance with the referral laws for California and the fed (Stark and Anti-Kickback). If an independent contractor is performing non-clinical, administrative services, you may need to execute a separate HIPAA business associate agreement (“BAA”); however, no BAA is required to the extent the physician is acting as either a member of your workforce (i.e., you have the right to control them), or as a member of an organized health care arrangement … This is an independent contract agreement between a health care worker and a provider of health care services such as vaccinations, screenings and health education, and who uses the services of qualified independent healthcare professionals, including but not limited to registered nurses, licensed practical nurses, nurse assistants, medical … Deal With Student Loans. Once beyond the boilerplate, both contracts deal with the same basic issues, such as the description of services, compensation, reimbursement of expenses, and term and termination (all discussed below). Mississippi 25. 510-579-6470. mattdickstein@hotmail.com mattdickstein.com, 39488 Stevenson Place, Suite 100, Fremont, CA 94539 Matt Dickstein, P.O.Box 3504, Fremont, CA 94539-5856 Physician Independent Contractor Agreement California California courts generally think that a worker is a worker, unless the alleged employer proves that the worker is an independent contractor. Kansas 17. Being labeled an independent contractor, being required to sign an agreement stating that one is an independent contractor, or being paid as an independent contractor (that is, without payroll … 510-796-9144. mattdickstein@hotmail.com mattdickstein.com. Nevada 29. Should you incorporate your medical practice? Hawaii 12. See the discussion above re employee-physicians for more on this concept. Oregon 38. Minnesota 24. Attorney for Accountancy Corporations and Group Accounting Practices. California 6. May a physician compete against his or her former practice? You have a contract with the physician Essential Terms of a Physician Employment Contract and an Independent Contractor Agreement The essential terms are about the same as between a physician employment contract and a physician independent contractor agreement. per relative value unit, patient encounter, or fee schedule) My prior article, Physician employment and independent contractor agreements, gives you the basics about hiring a physician as an employee or contractor. You probably don’t need a lawyer to explain physician compensation, so I’ll keep it short. 510-579-6470. mattdickstein@hotmail.com mattdickstein.com, 39488 Stevenson Place, Suite 100, Fremont, CA 94539 This article only gives a short roadmap of physician employment contracts and independent contractor agreements. Providing business legal services in Northern and Southern California, including San Francisco, Classifying a physician as employee or contractor, Stark and Anti-Kickback laws re physician employment and contractor agreements, Termination clauses in physician employment and contractor agreements, Bringing a new partner into a medical practice, Buy-in and buy-out of physicians to a medical group, Shareholder buy-sell agreements for medical corporations. 5. Louisiana 19. A practical reinforcement to the independent contractor status is to include provisions in the ICA that commit the corporate contractor to comply with all compensation, payroll, benefits, and other … Alabama 2. A medical practice rarely has Stark issues when it pays its physician employees straight salary or compensation based on an hourly rate. What is California … Independent Contractor Status. Whether or not the agreement is for a contractor or an employee, it must clearly delineate the job responsibilities. Term sheets for the buying or selling of a medical practice, Preparing to sell your solo medical practice, Avoid successor liability when buying a medical practice, including provider numbers and taxes, When large medical groups buy up small physician practices - legal and economic structure, Professional service agreements for hospital based physicians, Multi-discipline, integrated health care practices, How a non-licensed person works with a medical practice; administrative / management service companies, How to structure a management company’s relationship with a medical practice, Regulatory compliance for medical practices, Stark and Anti-Kickback laws regarding the compensation structure of a group medical practice, Leaving a medical practice / closing a medical practice, Action items for the estate when a solo physician dies, Franchising for medical, dental, veterinary businesses, Attorney for Medical Corporations and Group Medical Practices, Attorney for Dental Corporations and Group Dental Practices, Attorney for Veterinary Corporations and Group Veterinary Practices. 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