For information concerning those regulatory requirements, see our Client Alert, Stark Requirement for Physician Contracts. While not a panacea to all ED coverage issues, development of physician on-call contracts may serve as an incentive to provide call coverage and is preferable to imposing onerous call requirements through bylaws that create the potential to discipline nonconforming physicians. If you intend to bill patients and payers for the physician’s services and retain collections, the contract should reassign to you the right to do so. Many contracts require the provider/employer to provide adequate space, equipment, supplies, or personnel for the physician. Looking for reliable information regarding your options? contract must include the correct spelling of both the CP and the DP names. Once an appropriate contract is signed, it is important that the parties comply with its terms to ensure regulatory compliance. Again, you may want to reserve the right to establish a reasonable schedule to provide flexibility. Nature of Relationship. Both the contracts and the physician’s performance should be reviewed periodically to ensure the physician is rendering the services for which he or she is being paid consistent with contract requirements. Within independent contractor arrangements, it is typically a good idea to provide for automatic renewal to avoid the unintentional lapse of a written agreement and corresponding Stark and/or AKS liability. Among other things, the definition requires that physicians in the group may not receive compensation based on the volume or value of his or her referrals for DHS.12 Physician group members may be paid productivity bonuses based on services they personally perform or “incident to” services.13 They may also be paid a share of overall profits subject to certain conditions.14 Groups should carefully review the “group practice” compensation requirements to ensure that their compensation structures satisfy the conditions if they intend to rely on the “physician services” or “in-office ancillary services” safe harbors. This news update is not intended to create an attorney-client relationship between you and Holland & Hart LLP. It doesn’t matter if you work as an employee of a hospital group or as a locum tenens physician in an urgent care center — contracts are to be expected. You may want to identify any additional benefits you intend to provide the physician, e.g., paid time off, CME allowances, insurance, retirement, or equipment; etc. Exempt Status. Benefits. Confirm that the physician is an exempt employee for purposes of the Fair Labor Standards Act and state wage and hour laws. Billing Policies Auditing and monitoring Physician contracts Medical staff bylaws C2.1 Billing Policies C2.2 Site-of-Service Audit C2.3 Physician Contracts Should be included w/Checklist A Standard Met Provider should know the consideration element in physician patient contract with small or a practitioner. If the contract is with the physician’s corporate entity, you should identify the person(s) who will perform the services and/or reserve your right to approve such persons, and confirm that such persons are obligated to comply with relevant terms of the agreement. Contract Specifics: 2017 Review of Physician Recruiting Incentives – 24th consecutive year – 3,287 real world physician contracts – Starting salaries, not total compensation Services. For example, you may want to provide tail insurance if you terminate without cause, but require the physician to acquire tail insurance if the physician terminates the contract within a certain period of time. Stark also applies to referrals for DHS within a group. In general, hospitals and health system employers offer a better range of benefits and … The first draft of many standard physician employment agreements is silent on patient contact hour requirements. Independent Contractor Arrangements. Failure to report and repay within 60 days may result in additional civil penalties of $15,000 per claim as well as False Claims Act liability.4 Repayments can easily run into the hundreds of thousands if not millions of dollars. Kim C. Stanger You can always waive it if you want, but having it in the agreement may help avoid a situation in which you invest in the physician only to have the physician set up a competing practice across the street. The agreement may not be modified within its first year. This document is provided as a resource when establishing contracts between HMOs and providers. Given the potential liability, it is critical that physician arrangements be structured to fit within the regulatory safe harbors. Physician health is a special area of medical practice that raises critical ethical questions for practitioners and organizations. If this contract is replacing a prior contract, ensure that the two agreements are coordinated so that any obligations under the prior agreement that are intended to continue do so (e.g., repayment obligations). These may include completing health records and billing statements. Noncompetition. This does not prohibit payment of remuneration in the form of a productivity bonus based on services performed personally by the physician. Contracts usually contain provisions establishing the requirements for providing notice under the agreement, e.g., notice of breaches or notice of termination. By navigating this Site and not disabling cookies via your browser or other means, you are consenting to the use of cookies. Physicians can expect independent contractor agreements to include complicated language regarding insurance coverage. v. Greber, 760 F.2d 68, 69 (3rd Cir. 1342 CFR 411.352(i)(1) and (3). 9See 42 CFR 411.357(d) and (l). To be enforceable, however, a liquidated damages clause must represent a fair estimate of actual damages, not an unreasonable penalty. The parties to a contract may sometimes become lax or their performance may change. Require the physician to complete records, in a timely manner, that are consistent with your policies. Employment Arrangements. I generally do not include such provisions because that requirement is usually assumed; including express terms may give the physician a basis for arguing breach of contract if support is not provided per the physician’s demands. 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 “personal services”6 or “fair market value”7 safe harbor. The arrangement must be in writing, signed by the parties, and cover only identifiable items or services, all of which are specified in the agreement. some important contract provisions, if not understood, can lead to problems in the future. Q. I was contacted by a company that runs a chain of clinics, and one is about to open in my region. Term. However, you can be sure th… Be sure to address the costs of such process. The essential terms are about the same as between a physician employment contract and a physician independent contractor agreement. Governing Law and Venue. Covered entities with contracts that qualify are permitted to continue to operate under those contracts with their business associates until April 14, 2004, or until the contract is renewed or modified, whichever is sooner, regardless of whether the contract meets the Rule’s applicable contract requirements at 45 CFR 164.502(e) and 164.504(e). In this subpart, the following definitions apply: . NPs must meet once every six months (every month for the first six months of the agreement) NPs can prescribe schedule II, III, IV, and V medications. If your state recognizes the corporate practice of medicine doctrine, you may need to structure your arrangement to fulfill any unique requirements applicable to your state. If you pay a bonus, consider requiring the physician to remain employed through the end of the bonus period to be eligible for the bonus. 1442 CFR 411.352(i)(2). Many physicians enter into employment contracts without seeking legal advice. Stark requirements for physician contracts Blog Health Law Blog. The writing must specify the compensation that will be provided under the arrangement. 1142 CFR 411.355(b). Provider should know the consideration element in physician patient contract with small or a practitioner. Although most providers do not realize it, Stark allows you to condition compensation under employment or contractor agreements on referrals to your organization so long as the referrals relate to the services provided under the agreement. If you are paying relocation expenses, a signing bonus, student loan payments, or other similar items, consider requiring some form of repayment if the physician leaves within a certain period of time. Things included (and negotiated) in a physician employment contract are compensation, benefits, schedule (such as on-call obligations), terms of termination, and restrictive covenants. The contract should generally describe whether the services are full-time, part-time, or as-needed. Role of Contract Management Due to stringent federal and state regulations surrounding healthcare, an effective compliance program that includes organization and oversight of a healthcare facility’s contracts, agreements and critical documentation is a must! Assignment. You may generally pay the physician based on services the physician personally performs (e.g., per wRVU or similar methodology). Confirm that nothing in the contract confers any rights on third parties. With all of a physician assistant's responsibilities, it is expected for physician assistants to negotiate certain terms in their employment contracts. Appropriate termination provisions are your safety valve; they will allow you to get out of a bad contract. You should retain the right to assign your rights or duties to your successors, provided that such assignment does not abrogate the physician’s rights. Prohibit the physician or contractor from assigning their rights or duties without your approval. This Site uses cookies as outlined in our Online Privacy Statement. Physician contracts are often lengthy and complicated. Liability Insurance for Team Physician The physician(s) should provide proof … As a doctor, you have to work under a contract provided by your employer. To fit within the Stark safe harbor applicable to employment contracts,5 the employment agreement with the physician (or their family member) must satisfy all of the following: Unlike independent contractor arrangements, employment contracts are not required to be written; the compensation need not be set in advance; and the compensation may be amended at any time. Holland & Hart LLP MEMBER FIRM OF . In this case, the amount of notice is usually A physician or provider may make the request for information by any reasonable and verifiable means. 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