HR7686-119

What This Bill Does

The Rural and Underserved Health Care Staffing Act creates a uniform federal independent-contractor rule for qualified locum tenens physicians and advanced care practitioners providing temporary services at one site for no more than one continuous year. For the listed federal laws and programs, the clinician is not an employee, the health facility, staffing agency, or payor is not an employer, and payment is treated as independent-contractor remuneration.

The rule applies under the Fair Labor Standards Act, National Labor Relations Act, Title VII, Americans with Disabilities Act, Family and Medical Leave Act, ERISA, Public Health Service Act, and HHS programs that require an employment-status decision for participation, certification, or compliance. It covers properly licensed physicians, dentists, podiatrists, optometrists, nurse practitioners, physician assistants, and certified registered nurse anesthetists working under a written agreement. The parties may instead sign a written contract expressly creating an employer-employee relationship.

The bill preserves state professional licensing and scope-of-practice law, federal payroll and self-employment tax rules, Social Security wage and benefit rules, unemployment programs, Medicare or Medicaid eligibility and reimbursement, and treatment of services performed before enactment. Federal agencies must implement the rule in their programs, and a severability clause preserves the remainder if one provision is invalidated.

Who Benefits and How

Health facilities and locum staffing agencies benefit from a predictable federal contractor classification and reduced exposure to employer obligations under the listed statutes. Qualified temporary clinicians benefit from clearer contracting status and continued ability to negotiate written employment when desired. Rural and underserved health facilities may find it easier to obtain temporary licensed clinicians when classification rules are uniform across federal programs.

Who Bears the Burden and How

Locum tenens clinicians classified as contractors lose employee-based protections or benefits under the listed federal labor, antidiscrimination, leave, and retirement statutes unless they negotiate written employment. Federal labor and HHS program administrators must revise employment-status guidance and compliance decisions. Health facilities and staffing agencies must maintain written agreements and confirm each assignment meets the profession, licensure, site, and one-year conditions.

Key Provisions

• Establishes independent-contractor status for qualified locum tenens clinicians under specified federal laws.
• Provides that the facility, staffing agency, or payor is not the clinician's employer for those purposes.
• Limits a qualifying temporary assignment to one site for no more than one continuous year.
• Expands the rule across specified physicians, dental professionals, podiatrists, optometrists, nurse practitioners, physician assistants, and nurse anesthetists.
• Authorizes the parties to choose employment through an express written contract.
• Extends the classification rule across major federal labor, civil-rights, leave, retirement, public-health, and HHS program rules.
• Protects existing tax, Social Security, unemployment, licensing, Medicare, Medicaid, and other supported-health-program rules.
• Requires prospective implementation and protects the remaining provisions through severability.