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

Leave a Reply

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

Featured Webcasts

Mastering Principal Diagnosis: Coding Precision, Medical Necessity, and Quality Impact

Mastering Principal Diagnosis: Coding Precision, Medical Necessity, and Quality Impact

Accurately determining the principal diagnosis is critical for compliant billing, appropriate reimbursement, and valid quality reporting — yet it remains one of the most subjective and error-prone areas in inpatient coding. In this expert-led session, Cheryl Ericson, RN, MS, CCDS, CDIP, demystifies the complexities of principal diagnosis assignment, bridging the gap between coding rules and clinical reality. Learn how to strengthen your organization’s coding accuracy, reduce denials, and ensure your documentation supports true medical necessity.

December 3, 2025

Proactive Denial Management: Data-Driven Strategies to Prevent Revenue Loss

Denials continue to delay reimbursement, increase administrative burden, and threaten financial stability across healthcare organizations. This essential webcast tackles the root causes—rising payer scrutiny, fragmented workflows, inconsistent documentation, and underused analytics—and offers proven, data-driven strategies to prevent and overturn denials. Attendees will gain practical tools to strengthen documentation and coding accuracy, engage clinicians effectively, and leverage predictive analytics and AI to identify risks before they impact revenue. Through real-world case examples and actionable guidance, this session empowers coding, CDI, and revenue cycle professionals to shift from reactive appeals to proactive denial prevention and revenue protection.

November 25, 2025
Sepsis: Bridging the Clinical Documentation and Coding Gap to Reduce Denials

Sepsis: Bridging the Clinical Documentation and Coding Gap to Reduce Denials

Sepsis remains one of the most frequently denied and contested diagnoses, creating costly revenue loss and compliance risks. In this webcast, Angela Comfort, DBA, MBA, RHIA, CDIP, CCS, CCS-P, provides practical, real-world strategies to align documentation with coding guidelines, reconcile Sepsis-2 and Sepsis-3 definitions, and apply compliant queries. You’ll learn how to identify and address documentation gaps, strengthen provider engagement, and defend diagnoses against payer scrutiny—equipping you to protect reimbursement, improve SOI/ROM capture, and reduce audit vulnerability in this high-risk area.

September 24, 2025

Trending News

Featured Webcasts

AI in Claims Auditing: Turning Compliance Risks into Defensible Systems

As AI reshapes healthcare compliance, the risk of biased outputs and opaque decision-making grows. This webcast, led by Frank Cohen, delivers a practical Four-Pillar Governance Framework—Transparency, Accountability, Fairness, and Explainability—to help you govern AI-driven claim auditing with confidence. Learn how to identify and mitigate bias, implement robust human oversight, and document defensible AI review processes that regulators and auditors will accept. Discover concrete remedies, from rotation protocols to uncertainty scoring, and actionable steps to evaluate vendors before contracts are signed. In a regulatory landscape that moves faster than ever, gain the tools to stay compliant, defend your processes, and reduce liability while maintaining operational effectiveness.

January 13, 2026
Surviving Federal Audits for Inpatient Rehab Facility Services

Surviving Federal Audits for Inpatient Rehab Facility Services

Federal auditors are zeroing in on Inpatient Rehabilitation Facility (IRF) and hospital rehab unit services, with OIG and CERT audits leading to millions in penalties—often due to documentation and administrative errors, not quality of care. Join compliance expert Michael Calahan, PA, MBA, to learn the five clinical “pillars” of IRF-PPS admissions, key documentation requirements, and real-life case lessons to help protect your revenue.

November 13, 2025
E/M Services Under Intensive Federal Scrutiny: Navigating Split/Shared, Incident-to & Critical Care Compliance in 2025-2026

E/M Services Under Intensive Federal Scrutiny: Navigating Split/Shared, Incident-to & Critical Care Compliance in 2025-2026

During this essential RACmonitor webcast Michael Calahan, PA, MBA Certified Compliance Officer, will clarify the rules, dispel common misconceptions, and equip you with practical strategies to code, document, and bill high-risk split/shared, incident-to & critical care E/M services with confidence. Don’t let audit risks or revenue losses catch your organization off guard — learn exactly what federal auditors are looking for and how to ensure your documentation and reporting stand up to scrutiny.

August 26, 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. 1 with code CYBER25

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