Compensation: It’s important to consider all forms of compensation, and physicians and others working in healthcare should closely examine their compensation arrangement for potential legal problems. Two major concerns in a compensation arrangement are violations of the Stark law (i.e., physician self-referral) and the Anti-Kickback Statute. Broadly speaking, these laws protect Medicare and Medicaid from being billed as part of an inappropriate compensation arrangement. These arrangements can be complex and often seem innocent to the untrained eye. This is where legal counsel experienced in healthcare comes in. Unfortunately, a compensation structure that violates these laws cannot be negotiated. If an arrangement is improper, it must be restructured before anything is signed.
Professional liability insurance: Medical professionals should all have professional liability insurance to cover malpractice claims. In addition to knowing what plan your new employer is offering you, it is also important to know what sort of coverage you had in your previous position.
Determine if you have occurrence-based or claims-based coverage. Occurrence-based coverage plans are tied to alleged instances of malpractice. Claims-based coverage plans are tied to when the claim of malpractice is made. If you have occurrence-based coverage, you will be covered for any alleged instances of malpractice that occurred while you were under that plan. If you have claims-based coverage, you may need a tail coverage plan as well. Unless you stay with the same insurance company when you switch practices, your claims-based coverage will not cover any claims that originated during your time at the previous practice. Tail coverage can bridge that gap.
Before accepting your new job, make sure you know what coverage you will need to prevent headaches down the road. A point of negotiation may be whether you or your employer will pay for the tail coverage. After all, your new employer certainly would rather have you working than distracted by a costly malpractice claim.
Outside work: It’s important to know how much control your employer has over your work for organizations other than the employer. Contracts may have a provision that prevents you from providing medical services for anyone but your employer. This could prevent moonlighting, speaking or even volunteering. Employers may have a legitimate reason to prevent you from doing these things. However, if it’s important that you be able to engage in your profession outside this employment contract, it may be time to head to the negotiation table.
