Paying Employees for Referring Healthcare Business

By Kim Stanger

Many healthcare employers may want to incentivize or compensate their employees for referring patients to or generating business for the employer, but they (appropriately) fear application of the federal Stark law or Anti-Kickback Statute.  The “Paying for Referrals” White Paper analyzes these laws and relevant exceptions that may permit referral-based compensation structures under certain circumstances.

Healthcare Employers and the Families First Coronavirus Response Act

By Brit (Brittany) MerrillS. Jordan Walsh, and Bradley Cave

The Families First Coronavirus Response Act (FFCRA) was signed into law on March 18, 2020 and becomes effective on April 2, 2020. As part of the FFCRA Congress enacted the Emergency Family and Medical Leave Expansion Act (“Expansion Act”) and the Emergency Paid Sick Leave Act (“Sick Leave Act”). Sections I and II below summarize how the Expansion Act and the Sick Leave Act will apply to employers generally. Please contact your Holland & Hart attorney for specific questions relating to your workforce. Read more

Mandatory Flu Vaccines Land Healthcare Facility In Court

By Bradley Cave

After rescinding a job offer to an applicant, a Michigan healthcare provider finds itself in federal court defending a religious accommodation claim. If your organization requires employees to get flu vaccines, your policy should address how to handle religious objections. Here are details from the complaint that resulted in this recent discrimination lawsuit and steps you should take when facing similar circumstances.

Prospective Employee Suggests Reasonable Accommodation to Flu Shot

According to the complaint filed by the Equal Employment Opportunity Commission (EEOC), Yvonne Bair applied for a medical transcriptionist position in early 2016 with Memorial Healthcare, a non-profit corporation located in Owosso, Michigan. The transcription position would involve working from home, but also required two months of training at Memorial Healthcare’s hospital in Owosso at the start of employment. Read more

Home Health Care Workers to Receive Minimum Wage and Overtime Protections

By Mark Wiletsky

If your organization is in the home health field, be aware that the rules for how to pay home care workers is going to significantly change.  Under a recently issued Final Rule, the U.S. Department of Labor (DOL) will extend FLSA pay protections to an estimated 1.9 million home care workers in the U.S. who currently are treated as exempt under the companionship exemption.  As a result, workers who provide in-home care to ill, elderly, or disabled individuals through a third party employer will be covered by the minimum wage and overtime provisions of the Fair Labor Standards Act (FLSA) beginning January 1, 2015.

Companionship Services Exemption Narrowed

The so-called “companionship exemption,” implemented in 1975, allowed organizations employing workers who provide home care assistance to elderly, ill, injured or disabled persons to treat these workers as exempt from the federal minimum wage and overtime pay provisions.  The new Final Rule narrows the exemption for companionship services in two key ways. Read more

Employee Education Subsidies: Tax Implications

By Kevin Selzer, Holland & Hart LLP

Educational reimbursement programs are a common employee benefit among health care organizations. Programs can be established to assist employees in paying for tuition, books and fees in the pursuit of continuing education while on the job. If your organization sponsors such an arrangement, is it getting the best bang for its buck? If structured correctly, these arrangements can provide tax-favored benefits from both an employee and employer perspective.

Generally, if an organization pays for an expense on behalf of an employee, the tax rules require the employee be taxed on the amount paid by the organization. If an educational assistance program meets certain requirements, however, the benefits may be tax free to the individual and the employer can avoid paying FICA and FUTA taxes on the value of the expense. There are currently two tax-favored structures available to health care organizations regarding educational assistance.

The first is a formal educational assistance program, often called a 127 plan, named after the section of the Internal Revenue Code which gives it beneficial tax treatment. Generally, a 127 plan must:

  1. have a written plan document;
  2. provide only educational assistance (i.e. no choice between cash or benefits);
  3. limit the amount of tax-free benefits paid on a calendar year basis to $5,250; and
  4. not discriminate in favor of highly compensated employees.

Educational coursework reimbursed under a 127 plan does not have to be work-related but sports, games or hobby-related courses are generally not eligible (unless part of a degree program). Both graduate and undergraduate programs are currently eligible under a 127 plan. In addition, there may be other important provisions that should be included in the written plan to reflect the mutual understanding of the terms between the parties, although not necessarily required from a tax perspective.

The second tax-favored arrangement is an educational reimbursement working condition fringe benefit. Unlike a 127 plan, this type of arrangement does not require a written plan document, does not have an annual dollar limitation and discrimination is not an issue, but the types of eligible activities are narrower in scope. The educational course is required to be job-related and either (1) expressly required by the employer or by law to remain in the occupation, or (2) maintains or improves job skills for the occupation.

Note that the employer-provided tax benefits under Section 127 are slated to expire on December 31, 2012 unless Congress acts to extend Section 127 as it has done for many years (sometimes retroactively).

If you would like more information on implementation of or compliance with these programs, or would like to discuss the specifics of your organization’s arrangements and ways to make them more tax favorable, please contact the Holland & Hart Employee Benefits Practice Group at 303-295-8094, or alternatively at kaselzer@hollandhart.com.


For questions regarding this update, please contact
Kevin Selzer
Holland & Hart, 555 17th Street, Suite 3200, Denver, CO 80202
email: kaselzer@hollandhart.com, phone: 303-295-8094

This publication is designed to provide general information on pertinent legal topics. The statements made are provided for educational purposes only. They do not constitute legal or financial advice nor do they necessarily reflect the views of Holland & Hart LLP or any of its attorneys other than the author. This publication is not intended to create an attorney-client relationship between you and Holland & Hart LLP. Substantive changes in the law subsequent to the date of this publication might affect the analysis or commentary. Similarly, the analysis may differ depending on the jurisdiction or circumstances. If you have specific questions as to the application of the law to your activities, you should seek the advice of your legal counsel.