Hospital-Based Physicians- Independent Contractor or? - Barry H. Frank, Esq.
|
|
- Allan Ford
- 8 years ago
- Views:
Transcription
1 Hospital-Based Physicians- Independent Contractor or? - Barry H. Frank, Esq. The attack by the Internal Revenue Service on the classification of workers who operate as independent contractors has continued unabated over the last nine years, and despite increased congressional concern regarding the Internal Revenue Service s handling of independent contractor audits, every business that utilizes the services of independent contractors should assume that they, in time, will be audited by the Internal Revenue Service. This article will address the problem of how to classify hospital-based physicians (such as emergency room physicians, radiologists, pathologists and anesthesiologists), who contract with hospitals either on a part-time or full-time basis, who are not employees of the hospital or of a group medical practice, and who are not partners in a medical practice. It will not deal with the classification of doctors who contract with hospitals to serve as medical directors or program directors as independent contractors; that topic is beyond the scope of this article. In the mid-1970 s, the IRS aggressively challenged the status of all classes of workers who contracted as independent contractors, focusing its attention on those companies which contracted with the independent contractors. In 1978, Congress enacted legislation intended to grant interim relief to companies which utilized the services of independent contractors. From 1978 through the mid-1980s, the IRS backed off on its challenge to businesses utilizing the services of independent contractors. In 1988, the Internal Revenue Service instituted a program known as ETEP (Employment Tax Enforcement Program), instructing its agents to audit businesses of all types which contract with independent contractors. ETEP has not only continued but has intensified in recent years. Included as one of the targets of the IRS program are hospitals which contract with doctors as independent contractors. If a doctor who contracts with a hospital is an employee of the hospital or a professional corporation, whether it be an individual practice or a group practice, and taxes are withheld from the doctors pay, the physician is an employee and there is no issue for the IRS to challenge. If a doctor is a member of a medical group practicing as a partnership, and one or several members of the group contract or the group itself contracts with a hospital to provide services, there is no issue for the IRS to challenge. What the IRS does challenge is those sole practitioners and partners or shareholders in group practices that contract separately with hospitals. Payments for services are made directly to these doctors, and they are given a Form There is no withholding. Are these doctors employees of the hospital or independent contractors? Historically, almost every state in the United States has a statute prohibiting the corporate practice of medicine by for-profit hospital corporations, a doctrine originally designed to protect patients and to prevent interference in the doctor-patient relationship. All fifty states have laws permitting the employment of physicians by professional corporations and professional associations. Most states have laws allowing HMOs to employ physicians, while others have created special exceptions from the doctrine against the corporate practice of medicine for nonprofit hospitals, medical colleges, and charitable institutions.
2 It is our experience that most doctors, when they contract with a hospital to provide services, enter into a written agreement which is negotiated at arms-length between the hospital and the doctor. Frequently both sides have attorneys representing them in these negotiations. How then can the IRS contend that these same doctors are employees of the hospital - in clear contradiction to the prohibition against the corporate practice of medicine? In so doing, the IRS would place the hospital in a position where it is forced to breach its written contract with the doctors regarding services provided to the hospital by the doctor as an independent contractor. What is the Law? The tax law regarding a physician contracting with a hospital, emergency room, anesthesiology department, pathology department, or radiology department is unclear. Various pronouncements from the IRS, are at best, confusing, inconsistent, and difficult to apply. The question of whether doctors that provide services to hospitals are independent contractors or employees has been considered by the IRS numerous times, in both published Revenue Rulings and Private Letter Rulings. In addition, there are a handful of tax court decisions which have considered whether a doctor was an independent contractor or employee. Most of the court decisions are income tax cases dealing with whether the doctors could properly deduct expenses as a self-employed individual, or whether certain pension payments made either by the doctors or the hospitals on a doctor s behalf are deductible. The classification of emergency room physicians has been considered by the IRS several times in the last eight years, and a careful analysis of the IRS determination and the facts considered might be of some help in determining the proper classification of emergency room physicians as well as other hospital based physicians such as pathologists, anesthesiologists and radiologists. The ideal place to start is the most recent Private Letter Ruling released by the Internal Revenue Service on July 12, 1996, dealing with physicians who contracted with a general partnership that provides emergency room services for various hospitals. The partnership contracted with various doctors, under written agreements to provide services as emergency room doctors at a particular hospital. The agreement provided that the physicians were responsible for the method and manner in which the services were rendered and that the partnership would not exercise any control or discretion over the manner, mode, methods or means used by the doctors in performing these services. The written agreement specifically provided that the doctor was free to provide emergency room services for other groups and hospitals and, in fact, the doctors did perform services for other emergency care facilities in the area. The partnership and the doctors mutually determined the schedule for coverage at the hospital s emergency department on a monthly basis, and the contract between the partnership and the doctor required that the services must be rendered personally by the doctor. Each doctor was paid a percentage of the net receipts collected for their services. The partnership used a billing service to collect fees and net receipts were calculated by reducing gross receipts for services performed by the doctor by the cost of the billing service and by the doctor s malpractice insurance premium. The doctors set their own fees for work preformed and
3 the doctors were paid by the partnership each month, no later than the last day of the following month in which the services were rendered. The doctors received no fringe benefits from the partnership nor were they reimbursed for any business expenses. The doctors were required It is our experience that most doctors when they contract with a hospital to provide services, enter into a written agreement which is negotiated at arms-length between the hospital and the doctor. Frequently both sides have attorneys representing them in these negotiations. How then can the IRS contend that these same doctors are employees of the hospital in clear contradiction to the prohibition against the corporate practice of medicine? to pay their own professional license, liability insurance, and their own continuing medical education expenses. The Internal Revenue Service concluded that the doctors were independent contractors, basing its conclusion on the following: (1) the partnership did not exercise any control or discretion over the doctors or their work methods; (2) the doctors were free to provide similar services to others; (3) the parties mutually determined the scheduling; (4) the doctors were paid a percentage of the receipts generated by their services; and (5) the physicians set their own fee for their work. Recently, another Private Letter Ruling concluded that emergency room physicians were independent contractors and in doing so reversed a prior IRS Private Letter Ruling which had initially concluded that the ER physicians were employees. In this situation, the hospital, operated by the Catholic Church, contracted with various doctors to operate its emergency room. Each written agreement with the doctors was for a term of two years and could be renewed for an additional two-year terms. The agreement provided that the doctors were responsible for the method and manner in which services were rendered and that the hospital did not have nor exercise any control or direction over the doctors. The hospital indicated that the doctors were not required to adhere to the hospital s rules and regulations for employees, but only to the medical staff by-laws - which were applicable to all doctors with hospital privileges - and to directives relating to the emergency department. Because the hospital is a Catholic institution, the doctors were also required to agree to perform services in accordance with the ethical and religious directives for Catholic health facilities. Each doctor was also required to participate in the hospital s medical staff quality assurance and peer-review committees with respect to services performed. The hospital did not determine the hours of work or when services were to be performed, as long as the emergency department was covered twenty-four hours a day, seven days a week. The written agreement between the hospital and the doctors did state that, in the event that the doctors were unable to agree on a schedule, they would be bound by the decision of the hospital s medical director. The doctors had the right to hire assistants as they deemed necessary to carry out their duties, as long as the presence and duties of the assistants was approved by the hospital and was in compliance with the hospital s rules and regulations. The cost of assistants
4 was borne solely by the doctors. The doctors were free to engage in private practice, as long as that practice did not interfere with the performance of their duties for the hospital. Under the written agreement, a fee schedule was agreed upon between the hospital and the doctors. Each doctor assigned to the hospital all professional fees attributable to their services and the hospital had the responsibility for billing and collecting such fees. The doctors were to receive 60% of billed professional fees for Medicare and Medicaid patients and 70% of billed professional fees for all other patients. In concluding that these doctors were independent contractors, the IRS specifically pointed to the fact that the hospital did not retain the right to exercise the overall control over the doctors services necessary to establish an employer-employee relationship, noting specifically that the doctors could hire assistants for which they had the responsibility to pay. The doctors were not subject to hospital rules regarding employees in general, and no income guarantee was made. In conclusion, the IRS noted that it did not appear that the doctors, in the performance of their professional services were subject to the direction and control of the hospital. Other private letter rulings, as well as several published revenue rulings, discuss those common-law factors generally considered as evidence in determining whether physicians are independent contractors or employees. Unfortunately, an analysis of the various factors considered in these rulings does not allow one to come to a consistent conclusion. In 1993, the IRS published a Proposed Coordinated Issue Paper on the Employee Status of Hospital-Based Physicians ( Paper ), discussing whether hospital-based physicians are employees or independent contractors for employment tax purposes. The Paper lists 20 factors, 16 of which evidence control, and four of which indicate independence - all of which should be considered in determining the status of hospital-based physicians. The Paper emphasizes that in determining a physicians status, control over the physician s business operations should be given greater weight than control over the physician s professional decisions. Where the physician controls his own business activities, this tends to indicate he is acting as an independent contractor. The IRS acknowledges that the business structure and intent of the parties in establishing a work relationship can be relevant, and may effect the status of the physician. This is especially true in the case of a physician who often practices medicine through complex business forms, such as partnerships, corporations, joint ventures, and who frequently uses the facilities or equipment owned by hospitals. Determining whether a physician who provides services to patients in a hospital setting is an independent contractor or employee is difficult, because the twenty-factor tests are harder to apply as the degree of independent judgment of the physician performing the services increases. Further, the application of the twenty-factor test to physicians is more complicated because the setting in which the physician performs the services for the patients often involves additional parties. The IRS also believes that the factors should be weighed differently for physicians than for other workers who are unskilled, because of the degree of independent skill and judgment that must be exercised by a physician in providing medical services to patients. Thus, the factors in the twenty-factor test that focus on independence of judgment and the physician s skill in
5 providing patient care are less important than the factors that focus on the independence of the physician s business operations and those business operations of the hospital. The business relationships between multi-parties in the medical care delivery system are important in applying the twenty-factor test to the provider of medical services, depending on whether a two-party setting or a multi-party setting exists. A physician who practices medicine as an unincorporated, sole proprietor offering services to the public is generally a self-employed, independent contractor. The test for determining whether a physician is an independent contractor is whether someone other than the physician has the right to direct or control those components of the physician s medical practice that are not necessarily linked to the physician s independent medical judgment. Thus, the presumption that a physician is generally an independent contractor is grounded on the basis that the typical physician s business operations, costs, and risks are not subject to the patient s (or any other third party s) control. Employee status of physicians is most difficult to determine where medical services are provided through multi-business entities, where a physician is the sole shareholder, director and officer of a professional corporation or association, or where the physician is a shareholder or partner in a group practice. In determining whether a hospital is the employer of the physician, the more obvious characteristics of such an arrangement include the following: The physician is a designated faculty member of the institution, with a specified academic title. The physician works exclusively in the hospital or hospitals owned by or affiliated with the institution. The physician s salary is fixed without reference to fees collected by the institution for services rendered to patients. The physician is included as an employee for purposes of the institution s employee benefits program. In addition, the following are the major factors typically present in cases where the physician is an employee of the institution: The institution reserves the right to specify the hours during which the physician must be present to perform medical services. The institution is entitled to fees collected for medical services rendered to patients. The institution bears the risk and expenses associated with the delivery of medical care (e.g., the cost of professional liability insurance, the provision of office space
6 and supplies, the furnishing of business support staff such as secretaries and transcriptionists). For a hospital-based physician to qualify as a self-employed individual, it must be clear that the physician has bona fide control over the business aspects of the delivery of his or her medical services, despite the need for performances of such services in a hospital setting. Thus, if the written agreement between the hospital and the doctor provides that the physician, not the hospital, determines when and how frequently these services are to be performed, and that the physician, not the hospital, is entitled to all fees for medical services rendered, and that the physician is responsible for maintaining professional liability insurance and all other expenses of the medical practice, it would indicate that the physician is an independent contractor and not an employee. Assume further that the physician offers similar services under similar conditions to other hospitals and/or has a private practice of medicine, this strongly suggests that the physician is an independent contractor. The IRS also acknowledges that there are some factors common to virtually all hospital/physician relationships, regardless of whether the physician is an independent contractor or the hospital s employee, and that these factors should not be given much weight in determining the status of their relationship. These common factors are as follows: A requirement that medical procedures be performed in accordance with hospital protocol. The necessity of the physician to comply with internal hospital accreditation requirements before hospital privileges are granted. The use of hospital facilities (e.g., operating rooms, patient examination rooms, equipment). The reservation of rights of the hospital to terminate the physician s privileges for cause (such as loss of license to practice medicine). Conclusion There is no clear-cut litmus test; the facts of each specific relationship must be examined thoroughly. Clearly, the professional nature of the relationship indicates that the mere lack of control over the method and means by which a physician renders his services is not alone sufficient to create an independent contractor relationship, but that the other relevant factors must be considered. Barry H. Frank, Esquire, is a senior tax partner in the law firm of Mesirov Gelman Jaffe Cramer & Jamieson in Philadelphia. He is nationally recognized for his expertise, and has submitted testimony to Congress on the topic of independent contracting and employee status v1
BSM Connection elearning Course
BSM Connection elearning Course Basics of Medical Practice Finance: Part 1 2009, BSM Consulting All rights reserved. Table of Contents OVERVIEW... 1 FORMS OF DOING BUSINESS... 1 BUSINESS FORMATS AT A GLANCE...
More informationPRESENT LAW AND BACKGROUND RELATING TO WORKER CLASSIFICATION FOR FEDERAL TAX PURPOSES
PRESENT LAW AND BACKGROUND RELATING TO WORKER CLASSIFICATION FOR FEDERAL TAX PURPOSES Scheduled for a Public Hearing before the SUBCOMMITTEE ON SELECT REVENUE MEASURES and the SUBCOMMITTEE ON INCOME SECURITY
More informationBROKER SALESPERSON INDEPENDENT CONTRACTOR AGREEMENT. THIS AGREEMENT is entered into this day of, 20, between ( Broker ) and ( Salesperson ).
BROKER SALESPERSON INDEPENDENT CONTRACTOR AGREEMENT THIS AGREEMENT is entered into this day of, 20, between ( Broker ) and ( Salesperson ). RECITALS: Broker is engaged in business as a duly licensed real
More informationIndependent Contracting
Independent Contracting USED BY PERMISSION From AAPA: 950 North Washington Street, Alexandria, VA 22314 www.aapa.org Deciding to practice as an independent contractor requires consideration of many factors.
More informationEMPLOYMENT ISSUES 2012-2013 BROKER-IN-CHARGE ANNUAL REVIEW INTRODUCTION
2012-2013 BROKER-IN-CHARGE ANNUAL REVIEW EMPLOYMENT ISSUES Outline: Introduction Business Entity Forms Employee versus Independent Contractor? Internal Revenue Service Criteria Unemployment Tax Purposes
More information4. EMPLOYMENT LAW. LET S GO LEGAL: The Right Road to Compliance & Protection KNOW KNOW MORE. 1. Minimum Wage & Overtime
4. EMPLOYMENT LAW KNOW There are five key areas of Employment Law for nonprofit to be aware of: 1. Minimum Wage & Overtime: Federal, State, and in some cases Local law regulates employers pay practices
More informationDiscussion. Incorporated Worksite Employer
Tax Memo Our PEO Company ( BCC ) has developed a professional employer organization ( PEO ) program to provide lower cost health insurance, and other benefits, to small businesses and self-employed individuals.
More informationWHAT ARE THE CONSEQUENCES OF INCORRECTLY CHARACTERIZING AN INDIVIDUAL AS A CONTRACTOR AND NOT AN EMPLOYEE?
EMPLOYEE/INDEPENDENT CONTRACTOR PAYROLL POLICY Purpose StFX has developed a policy to provide guidance on the appropriate methods of payment for services provided to StFX University and whether or not
More informationSB 1241. Introduced by Senator Barto AN ACT
REFERENCE TITLE: AHCCCS; contractors; providers State of Arizona Senate Fifty-second Legislature First Regular Session SB Introduced by Senator Barto AN ACT AMENDING SECTION -, ARIZONA REVISED STATUTES;
More informationGuide to Nondiscrimination Testing for Code Section 403(b) Plans. For Employers
Guide to Nondiscrimination Testing for Code Section 403(b) Plans For Employers Table of contents PREFACE... III Question and Answers about Nondiscrimination Testing for Section 403(b) Tax-Sheltered Annuity
More information6.5.2 Individual Consultants
6.5.2 Individual Consultants There are legal distinctions and ramifications between retaining a consultant and hiring an employee. For example, the State incurs liabilities for withholding and/or the payment
More informationCHRISTUS PHYSICIAN GROUP STANDARD TERMS AND CONDITIONS APPLICABLE TO ALL EMPLOYMENT AGREEMENTS
CHRISTUS PHYSICIAN GROUP STANDARD TERMS AND CONDITIONS APPLICABLE TO ALL EMPLOYMENT AGREEMENTS The following Standard Terms and Conditions ( STC s ), as posted on the following site (the STC Site ): http://christusphysiciancareers.org
More informationBusiness Organization\Tax Structure
Business Organization\Tax Structure One of the first decisions a new business owner faces is choosing a structure for the business. Businesses range in size and complexity, from someone who is self-employed
More informationFinance Guideline. Guidelines
Finance Guideline Objective Context FG002 Contractor s Questionnaire To provide guidance as to the independence or otherwise of a UCT contractor and to ensure tax is deducted accordingly. UCT is obliged
More informationHow To Get A Health Insurance Tax Credit
Small Business Health Care Tax Credit: Frequently Asked Questions The new health reform law gives a tax credit to certain small employers that provide health care coverage to their employees, effective
More informationSmall Business Health Care Tax Credit: Frequently Asked Questions
Small Business Health Care Tax Credit: Frequently Asked Questions The new health reform law gives a tax credit to certain small employers that provide health care coverage to their employees, effective
More informationBusiness Organization\Tax Structure
Business Organization\Tax Structure Kansas Secretary of State s Office Business Services Division First Floor, Memorial Hall 120 S.W. 10th Avenue Topeka, KS 66612-1594 Phone: (785) 296-4564 Fax: (785)
More informationGUIDELINES FOR DETERMINING EMPLOYEE OR INDEPENDENT CONTRACTOR RELATIONSHIPS
GUIDELINES FOR DETERMINING EMPLOYEE OR INDEPENDENT CONTRACTOR RELATIONSHIPS Under University policy, contracts will generally only be entered into with independent contractors (IC). Independent contractors
More informationWashington Scene. Safe Harbor Rules issued for Medicare/Medicaid antikickback law
Washington Scene KATHLEEN A. MICHELS, RN, JD Director of Federal Government Affairs AANA Federal Government Affairs Office Washington, DC Safe Harbor Rules issued for Medicare/Medicaid antikickback law
More informationNews Release Date: 6/25/12
News Release Date: 6/25/12 Hire Spouse to Work in a Family Business Tax Issue A sole proprietor can deduct health care costs that are paid for an employee as a business expense. By deducting the expenses
More informationTEXAS ASSOCIATION OF REALTORS INDEPENDENT CONTRACTOR AGREEMENT FOR SALES ASSOCIATE. Robyn Jones Homes, LLC
1 TEXAS ASSOCIATION OF REALTORS INDEPENDENT CONTRACTOR AGREEMENT FOR SALES ASSOCIATE USE OF THIS FORM BY PERSONS WHO ARE NOT MEMBERS OF THE TEXAS ASSOCIATION OF REALTORS IS NOT AUTHORIZED Texas Association
More informationDisability Retirement Benefits
Contact Us Disability Retirement Benefits PO Box 268 Jefferson City, MO 65102-0268 3210 W. Truman Blvd. Jefferson City, MO 65109 (573) 634-5290 or toll free (800) 392-6848 Email: psrspeers@psrspeers.org
More informationAgreement for Professional Emergency Services. professional emergency and related services provided at (hospital name) Hospital be
Agreement for Professional Emergency Services This Agreement, made and effective on (effective date) by and between (name of hospital) Hospital, Inc., located at (address of hospital), (city, state and
More informationW I T N E S S E T H: NOW, THEREFORE, in consideration of the mutual covenants as contained herein, the parties agree as follows:
ST. VINCENT HOSPITAL AND HEALTH CARE CENTER, INC. RESIDENCY PROGRAM AGREEMENT This RESIDENCY PROGRAM AGREEMENT ( "Agreement") is entered into by and between St. Vincent Hospital and Health Care Center,
More informationServices Agreement Instruction Sheet
Delta-T Group POB 884 Bryn Mawr, PA 19010 Phone: 800-251-8501 FAX: 610-527-9547 www.delta-tgroup.com Services Agreement Instruction Sheet We thank you for your interest in Delta-T Group. Below please find
More informationINDEPENDENT CONTRACTOR vs. EMPLOYEE:
INDEPENDENT CONTRACTOR vs. EMPLOYEE: IMPROPERLY TREATING A D.C. OR LMT AS AN INDEPENDENT CONTRACTOR INSTEAD OF AN EMPLOYEE CAN LEAD TO AN IRS AUDIT, FINES, PENALTIES AND PAYMENT OF UNCOLLECTED TAXES By,
More informationSmall Employers Eligible for Health Care Tax Credit
Brought to you by Clark-Mortenson Insurance Small Employers Eligible for Health Care Tax Credit The Affordable Care Act (ACA) created a health care tax credit for eligible small employers that provide
More informationSmall Employer Health Care Tax Credit: Questions & Answers (Q&A)
Brought to you by Seubert & Associates Small Employer Health Care Tax Credit: Questions & Answers (Q&A) The Patient Protection and Affordable Care Act (ACA) provides a tax credit to certain small employers
More informationINDEPENDENT HEALTHCARE PROVIDER SERVICES AGREEMENT
INDEPENDENT HEALTHCARE PROVIDER SERVICES AGREEMENT This Independent Healthcare Provider Services Agreement (the Agreement ) by and between ("Provider") a licensed physician or licensed nurse/healthcare
More informationPsyBar, LLC 6600 France Avenue South, Suite 640 Edina, MN 55435 Telephone: (952) 285-9000 Facsimile: (952) 848-1798
PsyBar, LLC 6600 France Avenue South, Suite 640 Edina, MN 55435 Telephone: (952) 285-9000 Facsimile: (952) 848-1798 Updated 12/8/15 PSYBAR, L. L. C. INDEPENDENT CONTRACTOR AGREEMENT PsyBar attempts to
More informationSummary of Small Business Health Insurance Tax Credit Under PPACA (P.L. 111-148)
Summary of Small Business Health Insurance Tax Credit Under PPACA (P.L. 111-148) Chris L. Peterson Hinda Chaikind April 20, 2010 Congressional Research Service CRS Report for Congress Prepared for Members
More informationRESIDENT PHYSICIAN CONTRACT
RESIDENT PHYSICIAN CONTRACT THIS RESIDENT PHYSICIAN CONTRACT (the Agreement ) is made by and between «First» «Middle» «Last» ( RESIDENT ), of «Address», «City», «State_» «Zip» and Indiana University Health
More informationHealth Care Compliance Association 888-580-8373 www.hcca-info.org
Volume Twelve Number Five Published Monthly Meet Miaja Cassidy Director of Healthcare Compliance at Target page 14 Feature Focus: Managing security risks in business associate relationships page 32 Earn
More information2015 -- S 0168 S T A T E O F R H O D E I S L A N D
LC000 01 -- S 01 S T A T E O F R H O D E I S L A N D IN GENERAL ASSEMBLY JANUARY SESSION, A.D. 01 A N A C T RELATING TO INSURANCE - HEALTH MAINTENANCE ORGANIZATIONS Introduced By: Senator James E. Doyle
More informationCOMPENSATION GUIDELINES 2015. NEW YORK CONFERENCE UNITED CHURCH OF CHRIST 5575 Thompson Road DeWitt, NY 13214-1639
COMPENSATION GUIDELINES 2015 NEW YORK CONFERENCE UNITED CHURCH OF CHRIST 5575 Thompson Road DeWitt, NY 13214-1639 1 TABLE OF CONTENTS Introduction Section I - The Pastor Cash Salary 3 Rental or Housing
More informationN. HOSPITAL FINANCING ISSUES (Adopted From a Speech by E. D. Coleman to the National Health Lawyers Association - Toronto, Canada, November 1984)
N. HOSPITAL FINANCING ISSUES (Adopted From a Speech by E. D. Coleman to the National Health Lawyers Association - Toronto, Canada, November 1984) 1. Introduction The National Office continues to see large
More informationSummary of Small Business Health Insurance Tax Credit Under PPACA (P.L. 111-148)
Summary of Small Business Health Insurance Tax Credit Under PPACA (P.L. 111-148) Chris L. Peterson Hinda Chaikind April 5, 2010 Congressional Research Service CRS Report for Congress Prepared for Members
More informationDEERFIELD COMMUNITY CODE: 671.3 SCHOOL DISTRICT DATE OF ADOPTION: 06-16-97
DEERFIELD COMMUNITY CODE: 671.3 SCHOOL DISTRICT DATE OF ADOPTION: 06-16-97 TAX SHELTERED ANNUITY PROGRAM Attached is the district s policy and supporting materials regarding Tax Sheltered Annuities. ADMINISTRATIVE
More informationPHYSICIAN CONTRACT CHECKLIST: RECRUITMENT, EMPLOYMENT, AND INDEPENDENT CONTRACTORS
PHYSICIAN CONTRACT CHECKLIST: RECRUITMENT, EMPLOYMENT, AND INDEPENDENT CONTRACTORS Name of Physician Specialty Subject Matter of Contract TO Term of Contract Under the Contract, will Physician be an: Employee
More informationCOBRA Common Questions: Definitions
Brought to you by Taylor Insurance Services COBRA Common Questions: Definitions What is COBRA? COBRA stands for the Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA). COBRA is a federal statute
More informationCOBRA AND OTHER HEALTH CARE ISSUES
COBRA AND OTHER HEALTH CARE ISSUES By Debbie Dees Phelps Dunbar LLP 111 East Capitol Street, Suite 600 Post Office Box 23066 Jackson, Mississippi 39225-3066 Telephone: (601) 360-9334 Facsimile: (601) 360-9777
More informationS T A T E O F T E N N E S S E E OFFICE OF THE ATTORNEY GENERAL PO BOX 20207 NASHVILLE, TENNESSEE 37202. August 8, 2007. Opinion No.
S T A T E O F T E N N E S S E E OFFICE OF THE ATTORNEY GENERAL PO BOX 20207 NASHVILLE, TENNESSEE 37202 August 8, 2007 Opinion No. 07-116 Provision of Medical Services By a Certified Nurse Practitioner,
More informationSmall Business Health Care Tax Credit: Presented by Maureen O Gara-Adford, CPA & David Fox, Senior Accountant
Small Business Health Care Tax Credit: Presented by Maureen O Gara-Adford, CPA & David Fox, Senior Accountant Today s Speakers Maureen O Gara-Adford, CPA Practicing CPA since 1989 Managing partner since
More informationTitle 19, Part 3, Chapter 14: Managed Care Plan Network Adequacy. Requirements for Health Carriers and Participating Providers
Title 19, Part 3, Chapter 14: Managed Care Plan Network Adequacy Table of Contents Rule 14.01. Rule 14.02. Rule 14.03. Rule 14.04. Rule 14.05. Rule 14.06. Rule 14.07. Rule 14.08. Rule 14.09. Rule 14.10.
More informationSECURING AND PAYING FOR CONSULTANTS AND INDEPENDENT CONTRACTORS
SECURING AND PAYING FOR CONSULTANTS AND INDEPENDENT CONTRACTORS PURPOSE The primary purpose of this policy and procedure statement is to guide the Seminary in three areas: (1) To properly classify employees,
More informationOrder or Sequence Independent contractors must determine which patient to see next and what nursing orders are written.
Employee versus Independent Contractor There are two basic types of work arrangements an emergency physician may undertake an employee hired by a hospital/group or an independent contractor secured by
More informationSociety For Human Resource Management of Greater Tucson, Inc. BY-LAWS
Society For Human Resource Management of Greater Tucson, Inc. BY-LAWS Section 2 ARTICLE I NAME The name of the corporation is the Society for Human Resource Management of Greater Tucson, Inc. (SHRM-GT),
More informationPersonal Service Companies and IR35
Personal Service Companies and IR35 Introduction The IR35 rules are intended to prevent the avoidance of tax and National Insurance Contributions (NICs) through the use of personal service companies and
More informationPhysician Employment Agreements
The University of Texas School of Law Presented: 21 st Annual Health Law Conference April 15-17, 2009 Houston, Texas Physician Employment Agreements Sheryl T. Dacso Patrick Owens Sheryl T. Dacso Brown
More informationPROPOSAL FOR DRUG/ALCOHOL TESTING SERVICE Stearns County Human Services
PROPOSAL FOR DRUG/ALCOHOL TESTING SERVICE Stearns County Human Services INSTRUCTIONS: Please provide information as detailed below. Please write directly on this document, attaching additional pages as
More informationNEVADA DEPARTMENT OF JUSTICE Office of the Attorney General A GUIDE TO NON-PROFITS. Catherine Cortez Masto, Attorney General
NEVADA DEPARTMENT OF JUSTICE Office of the Attorney General A GUIDE TO NON-PROFITS Catherine Cortez Masto, Attorney General INTRODUCTION Directors of Nevada nonprofit corporations are responsible for management
More informationStark Law Exceptions and Anti-Kickback Safe Harbors
Law Exceptions and Safe Harbors Physician Services exception to the referral prohibition related to both [No comparable safe harbor ownership/investment and compensation arrangements for certain physician
More informationKATHLEEN L. DEBRUHL & ASSOCIATES, L.L.C. 614 TCHOUPITOULAS STREET NEW ORLEANS, LOUISIANA 70130 504.522.4054 (OFFICE) 504.522.9049 (FAX) WWW.MD-LAW.
CMS RELEASES PROPOSED ACCOUNTABLE CARE ORGANIZATION REGULATIONS By: Kathleen L. DeBruhl, Esq. and Lindsey E. Surratt, Esq. On March 31, 2011, the Centers for Medicare and Medicaid Services ( CMS ) issued
More informationBenefits through the stages of your life. DISABILITY BENEFITS
Benefits through the stages of your life. DISABILITY BENEFITS Table of Contents 1. Disability Benefits Death and Disability Plan...1 Overview.... 1 Eligibility and Enrollment... 3 Disability Benefits....
More informationMedical Malpractice, the Affordable Care Act and State Provider Shield Laws: More Myth than Necessity?
Boston College Law School Digital Commons @ Boston College Law School Boston College Law School Faculty Papers 5-14-2013 Medical Malpractice, the Affordable Care Act and State Provider Shield Laws: More
More informationThe following ECFA guide discusses some important aspects of the law and penalties that will be in effect on or before 06/30/2105.
Dear reader, Since we are aware that many of our clients are non-profits, charitable organizations, mission agencies and similar groups operating both in the USA and overseas, we feel the need to make
More informationPHYSICIAN CONTRACT CHECKLIST: RECRUITMENT, EMPLOYMENT, AND INDEPENDENT CONTRACTORS
PHYSICIAN CONTRACT CHECKLIST: RECRUITMENT, EMPLOYMENT, AND INDEPENDENT CONTRACTORS EXHIBIT "D" Name of Physician Specialty Subject Matter of Contract to Term of Contract Under the Contract, will Physician
More informationREFERENCE TITLE: accountancy board; certified public accountants HB 2218. Introduced by Representative Thorpe AN ACT
REFERENCE TITLE: accountancy board; certified public accountants State of Arizona House of Representatives Fifty-second Legislature First Regular Session HB Introduced by Representative Thorpe AN ACT AMENDING
More information2015 Tax Implications. of Long Term Care Insurance (LTCi) for Individuals and Businesses. Tax Solutions Guide for Individuals and Businesses
Tax Solutions Guide for Individuals and Businesses 2015 Tax Implications of Long Term Care Insurance (LTCi) for Individuals and Businesses Insurance Strategies LTC1419 What are the Tax Implications of
More information58 JOURNAL OF COURT REPORTING / APRIL 2001
?? 58 JOURNAL OF COURT REPORTING / APRIL 2001 B Y P E T E R W A C H T Independent contractor status remains a hot issue for freelance reporters. If you don t know and follow the requirements, an unpleasant
More informationSHOULD MY BUSINESS BE AN S CORPORATION OR A LIMITED LIABILITY COMPANY?
SHOULD MY BUSINESS BE AN S CORPORATION OR A LIMITED LIABILITY COMPANY? 2015 Keith J. Kanouse One Boca Place, Suite 324 Atrium 2255 Glades Road Boca Raton, Florida 33431 Telephone: (561) 451-8090 Fax: (561)
More information10 Facts About the Affordable Care Act and Worker Classification
Latham & Watkins Tax Controversy Practice Number 1611 November 18, 2013 10 Facts About the Affordable Care Act and Worker Classification Businesses subject to the Affordable Care Act s shared responsibility
More informationThursday, October 10, 2013 POTENTIAL BARRIERS TO HOSPITAL SUBSIDIES FOR HEALTH INSURANCE FOR THOSE IN NEED
Thursday, October 10, 2013 POTENTIAL BARRIERS TO HOSPITAL SUBSIDIES FOR HEALTH INSURANCE FOR THOSE IN NEED AT A GLANCE The Issue: A number of hospitals and health systems have inquired about whether it
More informationSmall Business Health Care Tax Credit
Small Business Health Care Tax Credit Frequently Asked Questions Small Business Health Care Tax Credit This information is only intended as a high-level guide and is not to be relied upon as actuarial,
More informationINTRODUCTION. Penalties waived until 6/30/15? Description of Payment/Reimbursement Arrangement: Employer with 50 or more FTEs
The purpose of this publication is to present highly focused information on the healthcare reimbursement aspects of the Affordable Care Act (ACA) based on the information available as of the date of this
More informationDo good, but do it right: Wyoming s Medical Volunteer Immunity Law Law s specific exceptions require Doctors to jump through some hoops
Do good, but do it right: Wyoming s Medical Volunteer Immunity Law Law s specific exceptions require Doctors to jump through some hoops By Nick Healey Dray, Dyekman, Reed & Healey, P.C. Wyoming physicians
More information2015 Relief for Reimbursing Employees for Health Insurance Information is current as of May 29, 2015
1 Q: I understand there is an exception for one employee/participant. If I'm the employee, can a 105 be used to reimburse for my spouse or dependents as well? A: Yes. Pursuant to 105, a plan can reimburse
More informationNSS Billing Contract Between. Innovative Healthcare Solutions
INNOVATIVE HEALTHCARE SOLUTIONS, LLC 213 EAST BROADWAY LOUISVILLE KY 40202 502-561-0963 888-856-9570 -efax NSS Billing Contract Between & Innovative Healthcare Solutions This Billing Services Agreement
More informationAMENDED BYLAWS SAN MARCOS UNIVERSITY CORPORATION. A California Nonprofit Public Benefit Corporation. ARTICLE I Objectives
Adopted by the Board of Directors 08/09/01 Revised 12/7/04; 10/10/07; 06/30/11 AMENDED BYLAWS OF SAN MARCOS UNIVERSITY CORPORATION A California Nonprofit Public Benefit Corporation ARTICLE I Objectives
More informationIndependent Contractor or Employee? Worker Classification Rules under IRS Guidelines
Independent Contractor or Employee? Worker Classification Rules under IRS Guidelines Christine F. Miller (512) 495-6039 (512) 505-6339 FAX Email: cmiller@mcginnislaw.com 1 Introduction What do AT&T, JPMorgan
More informationplan, hereinafter referred to as the Plan, means the statutory, COMMISSIONER OF INSURANCE 82-33
COMMISSIONER OF INSURANCE 82-33 Ins 3.35 Wisconsin health care liability insurance plan. (1) FINDINGS. (a) Legislation has been enacted authorizing the commissioner of insurance to promulgate a plan to
More informationIndependent Contractor vs. Employer; Identifying the correct classification
Independent Contractor vs. Employer; Identifying the correct classification Version 3A February 15, 2013 Disclaimer: This guide is solely intended to be a free advisory source. All the information contained
More informationRecitals. NOW, THEREFORE, the parties hereto agree as follows: Agreement
THIS INDEPENDENT CONTRACTOR SERVICES AGREEMENT (this Agreement ) is made this day of, 20 (the Effective Date ), regardless of the date of execution, by and between Sierra Field Services, Inc., a Nevada
More informationContractor s questionnaire for a Private Company/Close Corporation/Trust or other legal entity
Contractor s questionnaire for a Private Company/Close Corporation/Trust or other legal entity 1. Your name: 2. Which of the following do you provide to the University of Cape Town (UCT)? 1.1. Persons
More informationStaker Parson. Short Term Disability Income Protection Plan
Staker Parson Short Term Disability Income Protection Plan Effective Date: 01/01/2006 Contact Information Plan Administrator: Address and Telephone #: Claims Administrator: Address and Telephone #: Staker
More informationSmall Business Health Care Tax Credit Frequently Asked Questions
Caring For Those Who Serve Since 1908 1901 Chestnut Avenue Glenview, Illinois 60025-1604 1-800-851-2201 www.gbophb.org March 28, 2013 Small Business Health Care Tax Credit Frequently Asked Questions The
More informationThings Small Businesses Need To Know About Health Care Reform
7 Things Small Businesses Need To Know About Health Care Reform Make sure your business meets the requirements of the Affordable Care Act on schedule 7 Things Small Businesses Need To Know About Health
More informationINSURANCE AGENCY AGREEMENT
INSURANCE AGENCY AGREEMENT BritAmerica Management Group, Inc., hereinafter referred to as the Company, hereby appoints: Agent Agency Address City State Zip Tax ID hereinafter referred to as the Agent.
More informationCommercially Reasonable - Whose Responsibility is it?
OCTOBER 2012 healthcare financial management FEATURE STORY Jen Johnson Commercially Reasonable - Whose Responsibility is it? AT A GLANCE Key factors that a hospital finance leader should focus on when
More informationThe Patient Protection and Affordable Care Act ( ACA ) and Your Facility
The Patient Protection and Affordable Care Act ( ACA ) and Your Facility By Christine Garrity: Chief Administrative Officer & General Counsel for The Professional Golfers' Association of America President
More informationInsurance Audit Form HELP
Top of the form has important information so we know who the insurance company is and exactly what policy year is being audited. If you save the form you will only need to do this once for every insurance
More informationWarwick Public Schools 34 Warwick Lake Ave Warwick, RI 02889 INDEPENDENT CONTRACTOR AGREEMENT
Warwick Public Schools 34 Warwick Lake Ave Warwick, RI 02889 INDEPENDENT CONTRACTOR AGREEMENT This agreement is between Warwick Public Schools and the Independent Contractor (IC) as herein named: IC s
More informationPATIENT TRANSFER AGREEMENT
Appendix 2 SAMPLE PATIENT TRANSFER AGREEMENT THIS AGREEMENT is made effective as of by and between ( Children s Hospital) a nonprofit corporation, and ( Hospital ), a corporation. WHEREAS, operates a tertiary
More informationBenefits through the stages of your life. Understanding Effective Salary
Benefits through the stages of your life. Understanding Effective Salary Table of Contents The Community of Faith and the Benefits Plan...1 Effective Salary and the Benefits Plan... 3 Plan Definition...
More information1. Is there a difference between an employee and a subcontractor?
? Subcontractors Frequently Asked Questions Text Publications & Forms Internal Revenue Code & Treasury Regulations Revenue Procedures & Revenue Rulings 1. Is there a difference between an employee and
More informationCMS PROPOSED STARK REGULATIONS MATERIALLY IMPACT HOSPITAL-PHYSICIAN JOINT VENTURES AND VARIOUS OTHER PHYSICIAN ARRANGEMENTS
CMS PROPOSED STARK REGULATIONS MATERIALLY IMPACT HOSPITAL-PHYSICIAN JOINT VENTURES AND VARIOUS OTHER PHYSICIAN ARRANGEMENTS Health care providers beware: Many commonplace hospital and physician arrangements
More informationSAMPLE LETTER OF EMPLOYMENT
SAMPLE LETTER OF EMPLOYMENT Dear : On behalf of the Medical Center I am pleased to welcome you as a Physician Assistant for our Medical Clinic. This letter contains details about your starting salary and
More informationFair Play Act Targets Commercial Trucking Industry Robert C. Whitaker Jr., New York Law Journal
Fair Play Act Targets Commercial Trucking Industry Robert C. Whitaker Jr., New York Law Journal July 14, 2014 The misclassification of employees as independent contractors has been a focal point for the
More informationHighmark Blue Shield Provider Information Management P.O. Box 898842 Camp Hill, PA 17089-8842
Dear Health Care Professional: The enclosed forms are provided to process your request for an Assignment Account number with Highmark Blue Shield. An Assignment Account is Highmark Blue Shield s term for
More informationState of Rhode Island and Providence Plantations DEPARTMENT OF BUSINESS REGULATION Division of Insurance 1511 Pontiac Avenue Cranston, RI 02920
Table of Contents State of Rhode Island and Providence Plantations DEPARTMENT OF BUSINESS REGULATION Division of Insurance 1511 Pontiac Avenue Cranston, RI 02920 INSURANCE REGULATION 21 MEDICAL MALPRACTICE
More informationA Service Contractor s Planning Guide. to the Affordable Care Act
A Service Contractor s Planning Guide to the Affordable Care Act Planning for compliance and the impact of health care reform Starts with understanding the basics: The McNamara-O Hara Service Contract
More informationHealth Care Mergers and Acquisitions
AMGA Annual Meeting March 24, 2015 Health Care Mergers and Acquisitions The Legal Perspective Presented by Joseph N. Wolfe, Esq. Hall, Render, Killian, Heath & Lyman, P.C. 1 Today s Agenda Introductory
More informationQualified Tuition Reduction Plans: Fact & Fiction Regarding Using Pre-Tax Dollars for Your Child s Education. Judah I. Kupfer, Esq.
Introduction Qualified Tuition Reduction Plans: Fact & Fiction Regarding Using Pre-Tax Dollars for Your Child s Education Judah I. Kupfer, Esq. As an Orthodox Jewish parent with children attending a yeshiva
More informationThe Teachers Life Insurance (Government Contributory) Act
TEACHERS LIFE INSURANCE 1 The Teachers Life Insurance (Government Contributory) Act being Chapter T-8 of The Revised Statutes of Saskatchewan, 1978 (effective February 26, 1979) as amended by The Revised
More informationScott & White Healthcare Short Term Disability Plan. Summary Plan Description
Scott & White Healthcare Short Term Disability Plan Summary Plan Description Effective January 1, 2015 Short Term Disability Summary Plan Description Table of Contents SECTION PAGE NUMBER INTRODUCTION
More informationThe Hospital Authority of Valdosta and Lowndes County dba South Georgia Medical Center
LIFE INSURANCE COMPANY OF NORTH AMERICA 1601 CHESTNUT STREET GROUP POLICY PHILADELPHIA, PA 19192-2235 (800) 732-1603 TDD (800) 552-5744 A STOCK INSURANCE COMPANY POLICYHOLDER: POLICY NUMBER: The Hospital
More informationTax Implications of Health Care Reform
Tax Implications of Health Care Reform Presented by: Art Sparks, CPA Partner Certified Public Accountants Summary Summary The Patient Protection and Affordable Care Act (PPACA) and the companion Health
More informationSUPPLEMENTAL NOTE ON SUBSTITUTE FOR SENATE BILL NO. 11
Corrected SESSION OF 2007 SUPPLEMENTAL NOTE ON SUBSTITUTE FOR SENATE BILL NO. 11 As Amended by House Committee of the W hole Brief* Sub. for SB 11, as amended by the House Committee of the Whole, would
More informationCHAPTER 26.1-36.3 SMALL EMPLOYER EMPLOYEE HEALTH INSURANCE
CHAPTER 26.1-36.3 SMALL EMPLOYER EMPLOYEE HEALTH INSURANCE 26.1-36.3-01. Definitions. As used in this chapter and section 26.1-36-37.2, unless the context otherwise requires: 1. "Actuarial certification"
More informationNEBRASKA PROPERTY AND LIABILITY INSURANCE GUARANTY ASSOCIATION ACT
NEBRASKA PROPERTY AND LIABILITY INSURANCE GUARANTY ASSOCIATION ACT Section. 44-2401. Purpose of sections. 44-2402. Kinds of insurance covered. 44-2403. Terms, defined. 44-2404. Nebraska Property and Liability
More information