A draft Independent Contractor agreement

[Boatswain2PA]

I do almost strictly locums work.  Mostly for a PA locums group, but also on my own for some other hospitals.  I have a contract with the locums group which they developed, and I have a contract with a couple of other hospitals which they also developed.

I'm in negotiations with another hospital and they surprised me by asking ME to come up with a contract.  So, I pieced together what I liked from my other contracts, added a little of my own spice, and came up with this. 

 

Anybody have any suggestions or see any fatal flaws?

 

 

INDEPENDENT CONTRACTOR AGREEMENT

FOR

PHYSICIAN ASSISTANT EMERGENCY MEDICINE SERVICES

 

THIS INDEPENDENT CONTRACTOR AGREEMENT (the “Agreement”) is made and entered into on the __________ Day of _____, 20____, by and between Boatswain2PA, PA-C (“the Provider”) and __________________________________  (“the Company”)

DUTIES OF THE PROVIDER

1.       The Provider shall work and perform the duties as an emergency medicine Physician Assistant in accordance with the laws of the State of *****and of the United States, within the standard of care expected of a Physician Assistant as set forth by the American College of Emergency Physicians (ACEP) and the Society of Emergency Medicine Physician Assistants (SEMPA). 

2.       The Provider agrees to maintain an active Physician Assistant Certification (PA-C) through the National Commission on the Certification of Physician Assistants (NCCPA), and a Physician Assistant license to practice medicine through the ********* State Board of Medicine.

3.       The Provider agrees to maintain professional liability insurance as required by ********** state law.

4.       The Provider agrees to maintain currency Advanced Trauma Life Support (ATLS), Advanced Cardiac Life Support (ACLS), and Pediatric Advanced Life Support (PALS).

5.       The Provider agrees to document activities on a timely basis as necessary to record patient care for historical and continuing care purposes, for billing, risk management or other quality measures, and for purposes reasonably related to the professional practice of medicine.

6.       The Provider agrees to maintain active immunizations against commonly vaccinated infectious pathogens, including annual influenza.

DUTIES OF THE COMPANY

1.       The Company agrees to provide an appropriate supervising physician, including providing for an on call physician competent in the practice of emergency medicine.  The on call physician must be immediately available by telephone for consult by the Provider, and reasonably available to present themselves to the emergency department in person at the Provider’s request.

2.       The Company agrees to document the supervising physician agreement by submitting and maintaining appropriate documentation with the ******* State Board of Medicine.

3.       The Company agrees to ensure the Provider’s supervising physician has Professional Liability insurance coverage of at least $2 Million per Claim/$6 Million aggregate.

4.       The Company agrees to provide a safe and effective work place for the Provider to practice emergency medicine. 

5.       The Company agrees to provide competent nursing and ancillary staff. 

COMPENSATION

1.       Nothing herin shall be construed as creating an Employer/Employee relationship status.  The Provider shall not be considered as an employee of the Company for Federal or State taxation purposes, or for any other purpose.  The Provider agrees to assume all responsibilities for Federal and State withholding taxes, FICA, and any other applicable taxes and shall be responsible for making all required filings relating thereto.

2.       The Provider shall be paid an hourly rate of $75.00 for weekdays and $85.00 for weekends.  Federal holidays (plus Christmas Eve and New Year’s Eve) will be paid at 1.5 times this rate ($112.50/hour for weekdays and $127.50 for weekends).

3.       Last minute or critical fill shifts may be scheduled as needed between the Company and the Provider at a different rate if agreed to by both parties and confirmed via email communication.

SCHEDULING

1.       Scheduling of shifts will be confirmed by email communication between a representative of the Company and the Provider. 

2.       Once a shift is agreed upon, the Provider agrees to make every possible effort to fulfill this obligation.  If an unexpected emergency occurs, such as an extreme illness, injury, or death to the provider or provider’s immediate family, the Provider agrees to immediately inform the Company of the Provider’s inability to cover the shift. 

3.       Once a shift is agreed upon and confirmed by email communication, the Company agrees to pay the Provider for that shift even if the Company finds alternative emergency department coverage.  This subparagraph can be voided if the Provider and the Company agree, in writing or email, on a schedule change. 

SEVERABILITY

1.       If any provision of this Agreement is held to be illegal, invalid, or unenforceable under present or future laws effective during the term hereof, such provision shall be fully severable and this agreement shall be construed and enforced as if such illegal, invalid, or unenforceable provision had never comprised a part hereof, and the remaining provisions hereof shall remain in full force and effect and shall not to be affected by the illegal, invalid or unenforceable provision. 

IN WITNESS WHEREOF, the Parties have executed this Agreement as of the date first stated above.

Provider                                                                                           the Company

 

[jer_sd]

Few quick topics to add

 

Payment is it 30 days after invoicing or when ever they get get around to it. I had one facility try to reimburse 6 months after services were provided.

 

Duration of contract, does it automatically review? Method to cancel ect..

 

Company needs to provide access to nessisary systems to preform requested or customary duties (emr, security doors pacs system ect)

 

Provider may want to include DEA registration in your list with acls ect

[Boatswain2PA]

Awesome, thanks. Especially the payment part!

[ventana]

2.       The Provider shall be paid an hourly rate of $75.00 for weekdays and $85.00 for weekends.  

 

 

wow 1099 at those rates

 

you are giving yourself away!  WAY under what you should be at

 

also, BTW,  you are not a 1099 employee - and the IRS or the state will come down on the employer if they audit....

[Boatswain2PA]

Vent - $75/hr is a very high rate for these areas.  There are PA/NP jobs here that pay $45/hr (with marginal benefits).  I also live in an area with a cost of living score of 0.87, so that money goes a LOT further than in the Berkshire's with a COL score of 108.  Using these COL rates, my $150K a year income is equal to a $186K a year income in the Berkshires.

 

Oh, and most of the places I work have 24-72 hour shifts, so I get paid $75 an hour to sleep.  I work about 210 hours in October, and 226 hours in November, and I still get a full 10 day block off in October and a full 10 days off around Thanksgiving.  I think I have worked one Saturday and one Friday night all year so far.  Don't think I've worked a Sunday yet this year. Life is good.  

 

I've heard the stories about how locums can't legally be 1099 contractors, but I have never heard of the IRS making a big deal about it.  And, like you said, the rumors are that the IRS or state would come down on the employeR if they audit, so I'm okay with it.  

[GetMeOuttaThisMess]

Sounds like standard nationwide EmCare offer. If you do not control your days/hours of employment you don't qualify as 1099. Liability does fall upon the contracting employer for back employment taxes but they (IRS) may be curious and audit your self-employment deductions. For offers like these why not get the opinion of an attorney? I had a similar offer last year with a new UC facility and their contract didn't pass my sniff test. They're now closed. Your rates would be competitive locally for me.

 

 

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[Boatswain2PA]

I have absolute control over what days/hours I work.  I work when I want to, and don't work when I don't.  

I'm working insane hours now because I cut way back over last summer, and intend to cut back even more next summer (we like to play at the lake).  We also already have three vacations scheduled for next year.  

 

Isn't it ridiculous that we practice medicine, yet we have no real clue about what the federal government's rules are regarding our job!  Just another reason we need the flat tax.

[bananapeppers]

I just signed a contract as a w-2 employer (part time) as a hospitalist for $85/hr, covering mileage and hotel. What rate do you charge for "last minute we need you" shifts? How do you typically negotiate that? Do they ever say "No" to you when you negotiate last minute pick up shifts? 

[Boatswain2PA]

What area do you live in....or what's your cost of living index?

 

As for last minute pricing - I don't call them, they call me. If I'm not doing c anything anyway, I throw out a number (85/hr maybe). If I have plans, but could change them, then maybe $100/hr....whatever rate that would make me go "Damn....that's a lot of money, I'll do it". If that's too much for them then they call someone else.

[bananapeppers]

The COL index is 82 here in Ohio. I work prn in an ED outside of my full time job. I've asked them to add me onto the schedule as I enjoy working there, but the scheduler doesn't add me. Usually if they ask me in a month advance, I give them my normal rate $75/hr. But if they call me last minute, they usually offer me $100/hr. They called me to pick up 2 shifts next week, they wanted me to cancel my plans and pick up for my regular rate, and i was like ughhh. I ended up doing 100/hr one day and then 75/hr the next day. Whats the highest rate they've given you for last minute?

[Boatswain2PA]

That's great Banana!

 

I think the highest last minute rate Ive had was about 90/hr, but it was at a very low census place. I've had to turn down $115/hr cause I was already scheduled elsewhere.

[ventana]

$$$$

 

goes back to my original post of $$

 

Also, if you are a 1099 do you carry workers comp (to protect YOU if you get hurt on job) - think needle stick - Hep C - $100,000 treatment; or get hurt and have to miss your primary job?  Also what about Med Mal - do you cover yourself for ER exposure?  These are all costs the employer is saving (and are fairly sizable savings - and if you don't have them you are exposing yourself to a HUGE risk

 

Also, and this is general advice, you need to think of yourself not as a PA - but instead a provider that is allowing them to remain open.  We classically have a huge influence on our perceived value - if we think we are worth only $75/hour that is what we get paid, but if we are worth $100/hour that is what we get paid.  I have seen this again and again in my own career...

 

 

Not lecturing here at all because if you like it and it works that is the important thing, but just pointing out items....

[Boatswain2PA]

Lecture away my friend, I put this out there to get (and give) information.

 

I am retired military, so I have Tricare.  I carry my own Med Mal which covers me for anything other than cosmetic surgery, and in my state it's pretty cheap ($2M/$6M for about $2500/year).  And I buy my own disability insurance ($177/mo for $5600/mo coverage X 10 years if needed).  

The guys who work this hospital daily get $50/hr + reasonable benefits.  

[GetMeOuttaThisMess]

For those who may be interested in the IC IRS "sniff test":  https://www.irs.gov/pub/irs-pdf/p1779.pdf

 

With all these COL indexing discussions, it would be nice if there were a standard that everyone uses because I've found them to be all over the board for my area.  Not bad on the disability.  I pay $261/mo. for an unlimited policy ($4540/mo., and looks like I could go higher now if I were to so choose) that is old-school and pays out for any disability that limits my ability to work in my specialty area (medicine).  For those who may be unaware, self-payment of premium allows for payout of up to 70% of income and is NOT considered taxable income.  Payment by employer only allows for 60% (or so was the case when I last updated my policy) and IS taxable.  It would still pay if I were able to work in another setting away from healthcare.  These types of policies have gone by the wayside over the years.

[cinntsp]

It may be worth the cost of an attorney specializing in medical contracts to review this and get an air-tight document that you can continue to use with future employers.

 

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[ventana]

Lecture away my friend, I put this out there to get (and give) information.

 

I am retired military, so I have Tricare.  I carry my own Med Mal which covers me for anything other than cosmetic surgery, and in my state it's pretty cheap ($2M/$6M for about $2500/year).  And I buy my own disability insurance ($177/mo for $5600/mo coverage X 10 years if needed).  

 

The guys who work this hospital daily get $50/hr + reasonable benefits.  

 

 

what about workers comp?

[Boatswain2PA]

No workers comp.  I guess that's what my savings is for.

 

Mess:  Try Zander insurance, they may be cheaper for you.  Mine is Own Occupation, but will only pay for 10 years.  Yours may be until age 65.

 

As to the taxable/not taxable issue:  I have been told that IF you pay your premiums out of a business account (ie: pretax), then any disability payments are taxable.  However if it's after tax money, then it's not.  

 

Cinn:  No such thing as an air-tight contract.  Lawyer's don't create such things because it's bad for business.  I hate lawyers....I really do, even my own lawyer.