Physician Assistant Contract Attorney: Contract Review for Physician Assistants (PA)

Chelle Law provides PA Contract Review for those entertaining a new job or renegotiating an existing physician assistant employment contract. You have worked hard to develop your skills and deserve to advance in your professional career with fair market value contracts. So, when you are about to enter into a PA contract, getting contract review services before signing is vitally important. The terms of the physician assistant contract will impact your practice and your day-to-day life. Attorney Robert Chelle can review your physician assistant contract, identify the areas that could be improved and assist you in negotiating the best physician assistant contract possible. PAs that request Mr. Chelle’s expert assistance receives:

• Available in any state
• Flat Fee Structure, with no hidden costs
• Review of your proposed agreement
• Phone consultation reviewing the physician assistant agreement term by term
• Follow up with a review of the needed clarifications and negotiations

Reviews for Agreements by a Contract Attorney

PA contracts are a pervasive and obligatory part of every job search. Well-drafted contracts for a PA helps to enumerate the responsibilities of the involved parties, divide liabilities, protect legal rights, and insure future relationship statuses. These touchstones are even more crucial when applying their roles to the case of a physician assistant employed by a hospital, medical group, or other medical provider. While contracts for PA drafting and negotiation can be a long and arduous process, a search for quality legal representation is a must in order to ensure that your rights are being protected before you start your new job and sign a new contract for PAs.  The present day conclusion is simple: A PA should not sign an agreement without having the agreement reviewed by legal counsel.  For instance, concerns include: supervising physician, AAPA compatibility, hospital network locations, team responsibility, etc.

Physician Assistant Contract Checklist

Every PA employment contract is unique.  However, nearly every employment contract for PAs should contain several essential terms.  If these essential terms are not spelled out in the employment agreement, disputes can arise when there is a disagreement between the employer and employee as to the details of the specific term.  For instance, if the PA is expecting to work at the practice Monday through Thursday and the employer is expecting the provider to work Monday through Friday, but the specific workdays are absent from the Agreement; who prevails?  Spelling out the details of your job is crucial to avoid conflicts during the term of your employment.  Below is a checklist of essential terms that employment contracts should contain (and a brief explanation of each term):

1. Services Offered: What are the pa’s clinical patient care duties? Are you given time for administrative tasks?
2. Patient Care Schedule: What days and hours per week are you expected to provide patient care and have patient contact?
3. Locations: Which facilities will you be scheduled to provide care at (outpatient clinic, surgical sites, in-patient services, etc.)?
4. Outside Activities: Are you permitted to pursue moonlighting or locum tenens opportunities? Do you need permission from the employer before you accept those medicine related positions? Committee leadership meeting and memberships?
5. Supervision:  Who is the supervising physician? Who reviews the delegation agreement? Who are the physicians that will supervise you? Will the physicians duties be split?
6. Call Schedule: How often are you on call (after hours office call, hospital call (if applicable)?
7. Electronic Medical Records (EMR): What EMR system is used? Will you receive training prior to providing care?
8. Base Compensation: What is the annual base salary? What is the pay period frequency?  Does the base compensation increase over the term of the Agreement?
9. Productivity Compensation: If there is productivity compensation; how is it calculated (wRVU, net collections, patient encounters, etc.)?
10. Benefits Summary: Are standard benefits offered: healthcare, vision, dental, life, disability, medical, retirement, etc.?
11. Paid Time Off: How much time off is offered? What is the split between vacation, sick days, CME attendance and holidays?
12. Continuing Medical Education (CME): What is the annual allowance for CME expenses and how much time off is offered?  Is there academic support?
13. Dues and Fees: Which business expenses are covered (licensing, DEA registration, privileging, PSPA, AAPA or AMA national conference participation and AAPA dues)?  Fellowship, internship or residency costs. Board fees?
14. Relocation Assistance: Is relocation assistance offered? What are the repayment obligations if the Agreement is terminated prior to the expiration of the initial term?
15. Signing Bonus: Is a signing bonus offered? When is it paid?
16. Professional Liability Insurance: What type of professional liability insurance is offered: claims made, occurrence, self-insurance?
17. Tail Insurance: If tail insurance is necessary, who is responsible to pay for it when the Agreement is terminated?
18. Term: What is the length of the initial term? Does the Agreement automatically renew after the initial term?
19. For Cause Termination: What are the grounds for immediate termination for cause? Covid furloughs?
20. Without Cause Termination: How much notice is required for either party to terminate the Agreement without cause?
21. Post Termination Payment Obligations: Will you receive production bonuses after the Agreement is terminated?
22. Non-Compete: How long does the non-compete last and what is the prohibited geographic scope?
23. Non-Solicitation: How long does it last and does it cover employees, patients, and business associates?
24. Notice: How is notice given? Contact via email, US mail, etc.?
25. Assignment: Can the Agreement be assigned by the employer?
26. Outside Activities: Expert witness participation?
27. Alternative Dispute Resolution: If there is a conflict, will mediation or arbitration process be utilized?

Breaking an Agreement with a Non Compete with Physician Assistants

Non compete clauses were originally considered as restraints of trade, and thus were invalid on the grounds of public policy at common law; however, many restraints of trade incident to employment contracts were upheld based on the rule of reason.  Thus, restrictive covenants between PA’s not to compete after termination of employment are generally enforceable as long as it is reasonable.  However, there are a few states which prohibit medical provider non compete clauses.  Please check your state laws for a PA non compete contract to see what the specific rules for your state are.  The general test for reasonableness of a non-competition contract holds that on termination of employment, a covenant  which restrains an employee from competing with his former employer is termed reasonable if:

• The restraint is not more than required for protecting the employer,
• It does not inflict any untold of hardships to the employer, and
• The restraint is not injurious to the public.

Review of Non Compete With a Practice

For instance, in Ohio, a non-competition clause was unreasonable when it was noted that a provider’s sub-specialty was uncommon, and that it would be harsh if the restrictive covenant was enforced as the hospital where he was precluded from practicing was only one of the few institutions in the area where he could practice his specialty. Thus, in Ohio, covenants restraining providers from competing with his employer on termination of employment is considered unreasonable if it inflicts untold of hardship on the provider, is injurious to the public, if the demand for the PA’s medical expertise is important for the community people and if the PA’s services are important for the health, medical care and treatment of public.  However, non-competition clauses for employment concerns, in general, are enforceable as long as they protect some of the employer’s legitimate interests.

Should a Physician Assistant take a position as an independent contractor?

If a PA is offered a position which would be as an independent contractor, should they agree to take it? There are pros and cons to any situation, so knowing details allows the PA to make a good decision. A PA might see employers offering as much as $40 an hour more to work as a 1099 independent contractor, but is it as beneficial as it looks?

How Taxes Work as an Independent Contractor

Taxes are handled differently with regular employees vs independent contractors. When a PA is a W-2 employee, they must state and federal taxes, social security taxes, etc. come out of their paycheck. This doesn’t happen with a 1099 position. No taxes are deducted from the pay. Come tax time, the PA (not the practice) is responsible for paying income tax, social security tax, Medicare tax as well as a self-employment tax. Social security and Medicare taxes will be twice as much, since the PA doesn’t have the practice paying half. Although it looks as if the nurse practitioner is being paid a lot of money per pay period, they can’t forget that they will still owe taxes at tax time.

Demanding More Pay as PAs

When working as an independent contractor, the PA can demand more money. The employer doesn’t have to shoulder the tax burden, so should be able to pay the NP quite a lot more. Since the NP also won’t receive any benefits as a 1099 contractor, the pay should make up for that. The PA can figure that they can ask for ten to twenty percent more than standard pay for a W-2 employee.

Are You Self-Employed?

Some people get confused as to whether an independent contractor is considered self-employed. In fact, they are the same thing. In fact, independent contractors often go by other names, such as freelancers, contract workers, small business owners, and more.

When being offered a job as an independent contractor and receiving a contract to sign, it is wise to have the contract reviewed by an attorney who is trained to handle these types of things. This way they can be sure that the contract is a binding legal document that will benefit the PA in important ways.

PA Employment Negotiations

Physician assistants face much risk when they take a contract for physician assistants into their own hands. PA agreement terms are highly negotiable and have a great impact not only on professional life but also on lifestyle, family and the future.  There are many important contract terms and clauses which can present new complex and diverse issues for any PA, including:

• Unfavorable call schedules
• Small Production Bonuses
• Lack of Benefits
• Not enough paid-time-off
• Not enough vacation time
• Unfair Non-Compete
• Inadequate professional liability coverage

Medical Contract Experts

When your PA agreement is reviewed by a contract review attorney, you will find financial benefits which end up outweighing the cost of the review. Leave it to the experts.  If you are in need of assistance with an employment agreement or contract review schedule a Physician Assistant Contract Lawyer with Chelle Law today!