Viewing entries tagged
payer contracts

Physician's Guide to the New DOL Overtime Pay Law

Physician's Guide to the New DOL Overtime Pay Law

On May 23, 2016, the Department of Labor passed long-awaited overtime pay rules, modifying the Fair Labor Standards Act (FLSA) for the first time in 12 years. The overtime rules apply to all industries across the country, but will like have a major impact on the healthcare industry, especially independent physician and other clinician employers. The rule significantly increases the amount of money an employee must be paid for that employee to qualify as exempt from the overtime pay rules. This means a much larger pool of employees that now qualify for overtime pay (an additional 4.2 million Americans), and likely significant cost increases for employers. Some healthcare employers will be hit harder than others.

Payer Contract Negotiation Nuts and Bolts

Payer Contract Negotiation Nuts and Bolts

Contracts are long and complicated, often missing or obscuring key information a provider needs to make an informed decision about whether to agree to the contract’s terms. In addition, insurance companies are incredibly resistant to modifying their contracts. Contract negotiation employees often say “no” to even minor changes, expecting that the provider will back down. It takes a significant amount of pushing back to gain access to the staff with the power to make changes. Many providers, we know, simply negotiate the fee schedule, and sign the payer contract without a full understanding of its content. We think that is a mistake—these contracts can have legal and financial impacts unrelated to the fee schedule rates, which outlive the contract itself. But, it's not always clear what parts of these gargantuan documents medical practices should be looking for to reduce their risk. In this post, we describe specific types of provisions to read carefully and consider, how easy it will be to change them, and why you may be agreeing to more than the language inside the contract: