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Fam Pract Manag. 2002 May;9(5):74.

Benefits trends

Q

What are some of the current trends in benefits for employed family physicians?

Retirement plans, life insurance, paid vacations and health insurance continue to be common benefits offered to family physicians; however, two items are becoming more popular:

1. Long-term care insurance. If a practice is a C corporation (i.e., it’s not a partnership, S corporation, sole proprietorship or limited liability company (LLC)), it can deduct 100 percent of the premiums it pays for long-term care insurance without creating any tax liability for the individual. If a physician pays for long-term care insurance personally (or as a partner, S corporation shareholder, sole proprietor or LLC member), he or she can deduct only a portion of the premiums if his or her total medical expenses are greater than 7.5 percent of adjusted gross income.

2. Cost-sharing of health insurance premiums. Since health insurance premiums are skyrocketing again, many practices are beginning to ask their employees to pay a higher portion of the costs. Some employers are also selecting plans with higher co-payments, which means higher out-of-pocket costs for the individual. In addition, practices that provide different levels of health insurance (e.g., family coverage for some, individual coverage for others and no coverage for those insured under a spouse’s plan) often count such premiums as part of the physician compensation.

One item that continues not to be popular is disability insurance. When it is paid for by the practice, the practice is able to deduct those premiums on its tax return, but any insurance proceeds collected are subject to federal income tax. On the other hand, if disability insurance is paid for personally by the physician, it is not tax deductible, but any insurance proceeds received are tax free.

Medicare recredentialing forms

Q

I’m a hospital-employed physician planning to start my own practice. I’ve become very confused about the process of recredentialing with Medicare because the application form is so complicated. If I am changing only certain information (such as my tax ID number, business name and address) is the HCFA-855C change-of-information form adequate for this purpose?

Since you will be starting a new practice, you will likely need to complete a new Medicare enrollment form (e.g., CMS-855B or CMS-855I). You can find the forms online at www.hcfa.gov/medicare/enrollment/forms or obtain them by contacting the provider relations staff of your Medicare carrier. Note that any HCFA-855 forms postmarked after Dec. 31, 2001, are no longer valid since new forms went into effect Nov. 1, 2001.

If your information changes at any point after you’ve completed a new enrollment form, you should report it within 90 days of the change using the appropriate CMS-855 form for physicians (there is no longer a separate change-of-information form). To report changes, you only need to complete the first section of the form and those sections that reflect the changes, additions or deletions you are making.

Collaborating with an NP

Q

In my state, nurse practitioners (NPs) may practice independently but are required to have a collaborative relationship with a physician. I have been approached by an NP who would like to enter into such a relationship. Are there any steps I need to take to protect myself?

When you enter into a collaborative relationship with an independent NP, you are performing a quality-control function under state licensure laws. Before you enter into such a relationship, you should do the following:

  • Inform your malpractice carrier of the relationship. Since you are not the NP’s employer, you will not have direct liability for any errors the NP commits, but you will have increased liability because you will be supervising someone who may create harm to a patient that you could have prevented.

  • Review state licensure law to ensure that you understand the rules for collaboration. For example, under a collaborative relationship, you cannot bill for the NP’s services but you can bill for patient encounters you have as a result of the relationship.

  • Develop a contract that details the nature of the relationship, including what the NP may and may not say about you or your relationship in advertising or any other communication with the public.

  • Establish protocols and policies to govern the relationship, particularly for coverage and emergency situations.


* Denotes member of FP Assist, the AAFP’s online clearinghouse for consultants and attorneys.


 

Copyright © 2002 by the American Academy of Family Physicians.
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