In 2020, NALTO® began grassroots efforts to educate Members of Congress about the locum tenens industry. One key objective was to help ensure that any labor-related legislation Congress considers does not threaten the independent-contractor status of locum tenens providers.
Today more than 50,000 locum tenens physicians, nurse practitioners, and other clinicians provide care to some 7.5 million Americans every year.
In its ongoing relationship with lobbying firm McGuireWoods, NALTO continues to advocate for a permanent solution by asking Congress to enact legislation that would codify physicians and other advanced practitioners as independent contractors. This way, the estimated 20 million patient interactions that occur every year through them will continue uninterrupted.
Key Milestones
Here are several “wins” netted through NALTO’s grassroots campaign to date.
- First, NALTO’s lobbying campaign for HR 7881 – which would “clarify and codify the treatment of locum tenens physicians and advanced practitioners as ‘independent contractors’ ” for tax and legal purposes–was effective enough to secure its introduction by a pharmacist-turned-congressman [Earl “Buddy” Carter (R-GA)] on May 27, 2022.
- Second, NALTO grassroots efforts – which included hiring the McGuireWoods firm and funding industry representatives’ visits to some 20 congressional offices in two days in September – resulted in the co-sponsorship of retiring US Rep. Ted Deutch (D-FL22) as of Sept. 30, 2022. Rep. Deutch’s co-sponsorship afforded HR 7881 the moniker of “bi-partisan support,” which shows this is a non-partisan issue and will help the bill gain additional co-sponsors.
- NALTO and Locumpedia urge all Members of Congress to put politics aside and support this important bill designed to preserve the critical healthcare support provided by locum tenens providers nationwide, particularly in underserved areas.
- Third, more than 750 industry advocates reached out to 211 Members of Congress, indicating grassroots support for the legislation.
The Health Care Provider Shortage Minimization Act (HR 7881) awaits movement out of the House Ways and Means Committee – either as a stand-alone bill or as part of a larger rural healthcare access bill – at the recommendation of committee leadership.
As explained by NALTO President Matt Young, recently, “This short but very important bill is easy to understand, is imperative for patients throughout the nation and, thus, is a great opportunity for Congress to claim a ‘bipartisan win’ during a time when polarization has too often ruled the day.”
Some History
NALTO’s efforts to address this issue through the legislative process began as a response to California’s AB-5, which became effective on Jan. 1, 2020. Presumably unintentionally, AB-5 as originally passed would have treated locum tenens physicians and other clinicians the same as drivers for ride- or delivery-sharing services like Uber, Lyft, DoorDash, and Instacart.
Popularly known as “the gig worker bill,” AB-5 would have required many companies that hire independent contractors to reclassify them as employees.
Eventually, California wisely exempted locum tenens physicians from this or similar state legislation; however, it did not exempt locum tenens advanced practitioners (nurse practitioners, physician assistants, or CRNAs). Effectively, this law ended the option for advanced practitioners who prefer to work as ‘1099’ independent contractors in the Golden State.
“Legislation [like this] made it necessary to seek passage of this bill (HR 7881, The Health Care Provider Shortage Minimization Act of 2022) so we can eliminate any ambiguity at the federal level as to whether locum tenens providers will remain independent contractors, preserving this widely unknown, but critical, healthcare delivery system that has been in existence for decades,” Young said.
“Ultimately, it’s all about saving and improving lives, particularly in underserved communities that often have limited access to specialists.”
Why Legislation Is Needed
NALTO submits that, “Efforts to classify all independent contractors as employees cast far too broad a net and, to the extent locum tenens physicians and advanced practitioners are caught in this net, it will have severe, unintended consequences.
“NALTO respects Congress’ desire to consider proper protections for those who, arguably, need such protections. The organization does not take a formal position on the overall topic but feels it is imperative to appropriately segregate locum tenens physicians and advanced practitioners from such efforts.
“Simply put, locum tenens physicians and advanced practitioners are sophisticated, highly educated and well-paid independent contractors [who] don’t want to be employed by either the recruiting agencies (which are ill-equipped to oversee them in any manner) or the healthcare facilities (in which they are contracted to work), nor do they require the protections that those who favor employee classification deem appropriate.
“Indeed, a supermajority of locum tenens providers are fully employed elsewhere or are self-employed and do the nation a service by performing additional locum tenens work, for their own reasons, [that is] critical to healthcare facilities nationwide.”
How You Can Help
At the conclusion of an October 26 webinar sponsored by NALTO, Ryan Bernstein of McGuireWoods suggested ways members of the National Association of Locum Tenens Organizations could assist the industry lobbying effort including:
- Take action.
- Tell your story.
- Engage your network.
- Articulate real-world issues (perhaps related to the physician or clinician shortage in your area).
- Help NALTO identify potential healthcare-industry partners (like state or local hospital associations and physician groups).
NALTO has made it easy for industry advocates to send messages to their House members urging their support for this critical proposal. To send yours, click here.
Read the HR 7881 Fact Sheet
Below is a copy of the fact sheet supporting The Health Care Provider Shortage Minimization Act of 2022 that NALTO and McGuireWoods have sent to lawmakers in Washington, DC, to education them about this vital issue facing the healthcare industry.
