Why Labor Investigations Target Independent Contractors

Why Labor Investigations Target Independent Contractors

Today I want to touch on a type of investigation that affects healthcare providers of all types: U.S. Department of Labor investigations, and specifically those that classify workers as independent contractors versus employees.

Why does it matter?

Because now the topic is coming under scrutiny.

The Department of Labor, which has seen an increase in its ability to bring enforcement actions in recent years, has flagged the healthcare industry as a prime target for investigation.

According to the Department of Labor, in the 2022 fiscal year, the agency’s Wage and Hour Division recovered more than $32.5 million in back wages, specifically for workers in healthcare. That’s more than its recovery for workers in agriculture, retail, food services, or business services, and only just barely less than the recovery in the construction industry.

Why has the Department of Labor targeted healthcare facilities for investigations into employee misclassification, sometimes claiming millions of dollars in unpaid overtime?

The issue is that independent contractors are effectively considered self-employed, so they aren’t subject to federal minimum wage and overtime requirements. During COVID-19, we all know there was a huge demand for healthcare workers, and a lot of facilities turned to contract nursing and other contracted positions to provide necessary healthcare during the pandemic. Now, as we are transitioning out of the public health emergency (PHE), healthcare employers should pay close attention to how their workers are classified.

Now, there’s no black-and-white answer as to whether an individual should be classified as an employee or an independent contractor, but here are six things to consider:

  1. How much control the person has over how the work is performed;
  2. The person’s opportunity for profit or loss, depending upon his or her managerial skill – for example, whether they earn a set salary, or they control how much money they can make;
  3. The relative degree of investment in equipment or materials that are required for their tasks;
  4. Whether the services provided by the person require special skill;
  5. The degree of permanency and duration of the working relationship; and
  6. The extent to which the services are an integral part of the healthcare facility’s business.

All of these factors are important, but I want to focus first on degree of permanency. Again, during the PHE, providers were relying on a lot of short-term contracts just to keep up with the demand for services, and in a lot of cases, those short-term contracts got renewed multiple times. I want to encourage providers to take inventory of their independent contractor arrangements, keeping these six factors in mind, and consider whether they may need to reassess any current worker classifications. Employers should correct any misclassifications they find, since enforcement can be retroactive, and they may be responsible for back pay.

If someone is misclassified, the biggest risk of liability usually arises from state or federal labor investigations and enforcement actions. However, individuals themselves who think they have been misclassified (and, for instance, should be owed overtime) often have the independent ability to bring a lawsuit, either in state or federal court. These violations of wage and hour laws are often really costly, and most statutes mandate double or triple damages for violations and mandatory payments of a plaintiff’s attorney’s fees.

So, the takeaway is to pay attention to how providers are classified – and if you can, conduct an internal audit and fix any past misclassifications. And, of course, be prepared for increased audits by the Department of Labor.

Facebook
Twitter
LinkedIn

Cara Ludwig, Esq.

Cara Ludwig is an expert healthcare attorney with nearly a decade of experience. She currently is a partner with Nelson Mullins, and got her degree from Washington and Lee University School of Law.

Related Stories

Looming Medicaid Cuts in 2026

Looming Medicaid Cuts in 2026

Although specifics remain under negotiation, early outlines and House resolutions suggest that Medicaid will face significant reductions, likely through a combination of structural funding changes

Read More

Leave a Reply

Please log in to your account to comment on this article.

Featured Webcasts

The Cost of Ignoring Risk Adjustment: How HCCs Impact Revenue & Compliance

The Cost of Ignoring Risk Adjustment: How HCCs Impact Revenue & Compliance

Stop revenue leakage and boost hospital performance by mastering risk adjustment and HCCs. This essential webcast with expert Cheryl Ericson, RN, MS, CCDS, CDIP, will reveal how inaccurate patient acuity documentation leads to lost reimbursements through penalties from poor quality scores. Learn the critical differences between HCCs and traditional CCs/MCCs, adapt your CDI workflows, and ensure accurate payments in Medicare Advantage and value-based care models. Perfect for HIM leaders, coders, and CDI professionals.  Don’t miss this chance to protect your hospital’s revenue and reputation!

May 29, 2025
I050825

Mastering ICD-10-CM Coding for Diabetes and it’s Complications: Avoiding Denials & Ensuring Compliance

Struggling with ICD-10-CM coding for diabetes and complications? This expert-led webcast clarifies complex combination codes, documentation gaps, and sequencing rules to reduce denials and ensure compliance. Dr. Angela Comfort will provide actionable strategies to accurately link diabetes to complications, improve provider documentation, and optimize reimbursement—helping coders, CDI specialists, and HIM leaders minimize audit risks and strengthen revenue integrity. Don’t miss this chance to master diabetes coding with real-world case studies, key takeaways, and live Q&A!

May 8, 2025
2025 Coding Clinic Webcast Series

2025 ICD-10-CM/PCS Coding Clinic Update Webcast Series

Uncover critical guidance. HIM coding expert, Kay Piper, RHIA, CDIP, CCS, provides an interactive review on important information in each of the AHA’s 2025 ICD-10-CM/PCS Quarterly Coding Clinics in easy-to-access on-demand webcasts, available shortly after each official publication.

April 14, 2025

Trending News

Featured Webcasts

Medicare Advantage 2026: Navigating New Rules, Denial Protections & SDoH Shifts

Medicare Advantage 2026: Navigating New Rules, Denial Protections & SDoH Shifts

Stay ahead of Medicare Advantage’s 2025-2026 regulatory changes in this critical webcast featuring expert Tiffany Ferguson, LMSW, CMAC, ACM. Learn how new CMS rules limit MA plan denials, protect hospitals from retroactive claim reopenings, and modify Two-Midnight Rule enforcement—plus key insights on omitted SDoH mandates and heightened readmission scrutiny. Discover actionable strategies to safeguard revenue, ensure compliance, and adapt to evolving health equity priorities before the June 2025 deadline. Essential for hospitals, revenue cycle teams, and compliance professionals navigating MA’s shifting landscape.

May 28, 2025
Navigating the 3-Day & 1-Day Payment Window: Compliance, Billing, and Revenue Protection

Navigating the 3-Day & 1-Day Payment Window: Compliance, Billing, and Revenue Protection

Struggling with CMS’s 3-Day Payment Window? Join compliance expert Michael G. Calahan, PA, MBA, CCO, to master billing restrictions for pre-admission and inter-facility services. Learn how to avoid audit risks, optimize revenue cycle workflows, and ensure compliance across departments. Critical for C-suite leaders, providers, coders, revenue cycle teams, and compliance teams—this webcast delivers actionable strategies to protect reimbursements and meet federal regulations.

May 15, 2025
Audit-Proof Your Wound Care Procedures: Expert Insights on Compliance and Risk Mitigation

Audit-Proof Your Wound Care Procedures: Expert Insights on Compliance and Risk Mitigation

Providers face increasing Medicare audits when using skin substitute grafts, leaving many unprepared for claim denials and financial liabilities. Join veteran healthcare attorney Andrew B. Wachler, Esq., in this essential webcast and master the Medicare audit process, learn best practices for compliant billing and documentation, and mitigate fraud and abuse risks. With actionable insights and a live Q&A session, you’ll gain the tools to defend your practice and ensure compliance in this rapidly evolving landscape.

April 17, 2025
Utilization Review Essentials: What Every Professional Needs to Know About Medicare

Utilization Review Essentials: What Every Professional Needs to Know About Medicare

Dr. Ronald Hirsch dives into the basics of Medicare for clinicians to be successful as utilization review professionals. He’ll break down what Medicare does and doesn’t pay for, what services it provides and how hospitals get paid for providing those services – including both inpatient and outpatient. Learn how claims are prepared and how much patients must pay for their care. By attending our webcast, you will gain a new understanding of these issues and be better equipped to talk to patients, to their medical staff, and to their administrative team.

March 20, 2025

Trending News

Happy National Doctor’s Day! Learn how to get a complimentary webcast on ‘Decoding Social Admissions’ as a token of our heartfelt appreciation! Click here to learn more →

CYBER WEEK IS HERE! Don’t miss your chance to get 20% off now until Dec. 2 with code CYBER24