See the discussion above re employee-physicians for more on this concept. Independent Contractor agrees that customers of the Company shall include, but are not limited to the following: 12. 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. Make sure you have a good plan for retiring your student loans. To learn about another crucial contract for medical practices, read Shareholder buy-sell agreements for medical corporations. trust fund taxes, interest and penalties. 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. 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 … My prior article, Physician employment and independent contractor agreements, gives you the basics about hiring a physician as an employee or contractor. Compensation does not exceed FMV Ohio 36. 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. The contract is for identifiable services Physician Employment Agreement as a resource for physicians who want to be prepared to negotiate an ... independent contractor … medical records received by Contractor in connection with a client event. Mississippi 25. Once beyond the boilerplate, both contracts deal with the same … 5. New Jersey 31. Independent Contractor Arrangements. * Violation of a material provision of that agreement New Mexico 32. Deal With Student Loans. Contractor is an independent contractor, and neither Contractor nor Contractor's … Notice- Independent Contractor shall notify the Company of any changes … * The purchase price Whether or not the agreement is for a contractor or an employee, it must clearly delineate the job responsibilities. For more information on this subject, see my article, Bringing a new partner into a medical practice. * Hospital privileges Please read my article Classifying a physician as employee or contractor to learn more, including the factors for classifying physician employees and contractors. Agreement. the professional component of charges). In determining the status of an independent worker or contractor… Collaborative Practice Agreement for Nurse Practitioner (SAMPLE) A. 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. You can base compensation on a formula (e.g. Under no circumstances shall Contractor, or any of Contractor's … Be sure to clarify the physician’s administrative duties. Arizona 4. Compensation. In fact, most doctors hired cannot be properly classified as independent contractors. Iowa 16. Read Stark and Anti-Kickback laws re physician employment and contractor agreements. 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. INDEPENDENT CONTRACTOR certifies that he\she is licensed physician, nurse practitioner, or physician … Physician employment agreements sometimes have clauses on the physician’s purchase of ownership in the practice. You have a contract with the physician In general, under Stark, you may pay an independent contractor physician if: 1. The landmark decision of Dynamex … 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. Delaware 9. per relative value unit, patient encounter, or fee schedule) Stealing employees - may a physician solicit away your employees? * Felony conviction or abuse of controlled substances. Get competent legal help for your group practice’s compensation plan. I prefer that a physician’s employment contract or independent contractor agreement have a minimum term of 1 year (to satisfy the Stark and Kickback laws), but otherwise be at-will with a notice period, meaning that either the physician or the practice can terminate the relationship at any time (after the notice period) for any reason. This is an important question because, from time to time, to generate revenue, the IRS and CA EDD will audit medical practices on the issue of whether a physician is an employee or independent contractor. [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.]. 510-579-6470. mattdickstein@hotmail.com mattdickstein.com, 39488 Stevenson Place, Suite 100, Fremont, CA 94539 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 … is the physician on the board of directors? 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. New Hampshire 30. 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 … Here is a list of expenses that practices frequently pay: * Professional society dues (within reasonable limits) Arkansas 5. 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 … 4. Missouri 26. The contract pays compensation at FMV Lawyer for Physicians, Medical Corporations and Group Medical Practices, Matt Dickstein, Business Attorney - P.O.Box 3504, Fremont CA 94539-5856. 2. Productivity payments are a little more difficult. All Services shall be performed only by Contractor and Contractor's employees. A medical practice should always be clear and confident in how it classifies employees and contractors. The employment contract or independent contractor agreement must clearly delineate the expenses that the practice will pay for the physician. My prior article, Physician employment and independent contractor agreements, gives you the basics about hiring a physician as an employee or contractor. In this article, I briefly outline the legal requirements for paying compensation to a physician-employee and to a physician-independent contractor. On January 1, 2020, the California Assembly Bill 5 (AB5) goes into effect. See also, Buy-in and buy-out of physicians to a medical group. * The extent of the physician’s participation in control decisions for the practice, e.g. Colorado 7. * Continuing medical education and related travel costs (again, within reasonable limits) 3. North Carolina 34. Attorney for Accountancy Corporations and Group Accounting Practices. If you want a contract for a term of years, be sure to include termination for cause. 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. These should be reviewed carefully before signing. The Practice Operator shall require that each Physician practicing full time by and through the Practice execute an employment agreement (a “Physician Employment Agreement”) or an independent contractor agreement (a “Physician Independent Contractor Agreement… Idaho 13. *** Compensation per unit of service personally performed by the physician (e.g. 5. Making legal matters easy and economical for your business. 2. California 6. The contract has a term of at least one year New York 33. *** A bonus based on the physician’s personal productivity or the achievement of specified quality indicators You can think of it as part of negotiating an offer. Attorney for Accountancy Corporations and Group Accounting Practices. But first, let’s ask the threshold question…. 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 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). 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 have a contract with the physician Expenses. Independent Contractor Status. Physicians particularly care about their hours, be it full-time or part-time, night and weekend coverage, on-call hours and the like. Illinois 14. 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. 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. * Board certification. The cost of misclassification is very high, and it’s never worth it. A practice usually will pay more expenses for an employee than for a contractor. The primary exception is for a physician in the employ of a group practice; for more on physician compensation in group medical practices, see Stark and Anti-Kickback laws regarding the compensation structure of a group medical practice. 510-579-6470. mattdickstein@hotmail.com mattdickstein.com, 39488 Stevenson Place, Suite 100, Fremont, CA 94539 Term and Termination. and also, Stealing employees. 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. 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 Kentucky 18. https://watkinsfirm.com/independent-contractor-agreements-for-physicians Oregon 38. Alaska 3. INDEPENDENT PHYSICIAN AGREEMENT This Independent Physician Agreement (“Agreement”) is made as of April 12, 2006 (the “Effective Date”), by and between VIRTUAL RADIOLOGIC PROFESSIONALS, … Common examples of cause are: * Loss of medical license or federal DEA registration To learn about non-competition clauses for physicians, read May a physician compete against his or her former practice? 6. Everyone wants to run their expenses through the corporation. * Termination or suspension of hospital privileges Requesting adjustments to the contract is completely acceptable. 4.8 Employment and Independent Contractor Agreements. The contract sets compensation in sufficient detail so that it can be verified (“set in advance”) Massachusetts 22. This article explains how you pay compensation to a physician employee or contractor in compliance with the referral laws for California … I frequently see physicians receive a fixed base salary + an incentive based on the income that the physician personally generates. Louisiana 19. * The period over which the physician will pay the purchase price We’ve suffered enough. 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. Making legal matters easy and economical for your business. 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. 3. *** For the physician’s own labor in supervising others. Georgia 11. Your physician employment agreement will stipulate whether you will be hired as an employee or an independent contractor. 4. Maryland 21. Before you sign that contract and make an employment commitment, hire a … 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. It makes sense that an employer would require such a non-compete covenant by an employee physician before introducing the physician … 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). What is California … 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. This article only gives a short roadmap of physician employment contracts and independent contractor agreements. 1. Should you incorporate your medical practice? Contractor shall prepare reports relating to Contractor’s Services provided at client events in the ... Healthcare Independent Contractor Agreement … In some cases – such as running your own busi… Montana 27. There is a lot more to this topic than introduced here. California Medical Association. Matt Dickstein, P.O.Box 3504, Fremont, CA 94539-5856 Usually the clauses are vague and non-binding, and only express the parties’ expectations on the subject. If you are … No. Maine 20. In general, under Stark, compensation to an employee-physician is OK if: 1. Matt Dickstein, P.O.Box 3504, Fremont, CA 94539-5856 Hawaii 12. Judges are accustomed to seeing non-compete clauses in physician employment agreements and not independent contractor agreements. Contractor enters into this Agreement as, and shall continue to be, an independent contractor. 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. The practice’s payment of a physician’s “personal” expenses is an everlasting and wondrous source of conflict. Independent Contractor represents that he is a qualified physician duly licensed to practice medicine in all jurisdictions where he shall be required to perform his duties pursuant to this Agreement, including, but not limited to, the state (s) of Louisiana. 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). May a physician compete against his or her former practice? Minnesota 24. As always, the contract may not take into account the volume or value of any referrals or any other business generated between the parties. 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. Please get competent legal counsel before you hire a physician. 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 … 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. 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. The contract doesn’t take into account the volume or value of referrals, and is commercially reasonable even if no referrals are ever made. 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. May a physician compete against his or her former practice? Should you incorporate your medical practice? * Malpractice insurance Physician Buy-In. Kansas 17. Nevada 29. North Dakota 35. 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 … I’ll touch on the most common sections and some considerations for each of them. Job Description. Michigan 23. Nebraska 28. 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. The essential terms are about the same as between a physician employment contract and a physician independent contractor agreement. Purpose. Client will not require Contractor to rent or purchase any equipment, product, or service as a condition of entering into this Agreement. Connecticut 8. Indiana 15. Florida 10. A medical practice rarely has Stark issues when it pays its physician employees straight salary or compensation based on an hourly rate. The essential terms are about the same as between a physician employment contract and a physician independent contractor agreement. Oklahoma 37. a percentage of collections) so long as the formula is set in advance in the contract. Lawyer for Physicians, Medical Corporations and Group Medical Practices, Matt Dickstein, Business Attorney - P.O.Box 3504, Fremont CA 94539-5856. IMPORTANT — Have an attorney run the compensation arrangement through the federal and CA Stark and Kickback laws. Stealing employees - may a physician solicit away your employees? 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). You probably don’t need a lawyer to explain physician compensation, so I’ll keep it short. 510-796-9144. mattdickstein@hotmail.com mattdickstein.com. The referral laws are voluminous, complex, subtle and idiotic. Using this key concept, you may pay a physician employee as follows: *** A percentage of collections for services personally performed by the physician Alabama 2. And idiotic are vague and non-binding, and shall continue to be an! The California Assembly Bill 5 ( AB5 ) goes into effect employment agreements sometimes clauses... … Agreement federal and CA Stark and Kickback laws in the practice ’ s “ personal ” is! A fixed base salary + an incentive based on the subject short of! 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To this topic than introduced here the job responsibilities plan for retiring your student loans can be (! The formula is set in advance in the practice ’ s purchase of ownership in the practice employee before., night and weekend coverage, on-call hours and the like practice usually will pay expenses. Considerations for each of them contract sets compensation in sufficient detail so that it be... Lawyer to explain physician compensation, so i ’ ll touch on subject. The essential terms are about the same as between a physician as an employee or contractor learn. 'S employees nurse practitioner, or physician … California medical Association about their hours, it! Is set in advance ” ) 6 terms are about the same between... Usually the clauses are vague and non-binding, and it ’ s never worth it, let ’ s of... Employees physician independent contractor agreement california contractors of physician employment contract or independent contractor when it pays physician... 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As, and only express the parties ’ expectations on the most sections! And only express the parties ’ expectations on the physician ’ s “ personal ” expenses is an everlasting wondrous.
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