Now more than ever, nurses and other medical professionals are working long hours. Many of them are entitled to overtime pay. A federal court recently approved a $160 million settlement in a class action lawsuit brought by nurse practitioners and physicians’ assistants employed by the U.S. Department of Veterans Affairs. The nurse practitioners and physicians’ assistants alleged that they were required to work overtime to update patient records and monitor and respond to patient-related notifications in the computer system, all without being paid. Under federal law, nurses, physicians’ assistants, and nurse practitioners are entitled to overtime pay in many cases.
Although the Massachusetts overtime law does not apply to individuals who work in “a hospital, sanitorium, convalescent or nursing home, infirmary, rest home or charitable home for the aged,” nurses, physicians’ assistants, and nurse practitioners who work outside of these settings may be entitled to overtime pay under Massachusetts law. Those who do work in places like hospitals and nursing homes can be entitled to overtime pay under federal law, specifically the Fair Labor Standards Act, or FLSA.
The FLSA, 29 U.S.C. § 203, is an employment law that, among other things, establishes minimum wage, time-and-a-half overtime pay, recordkeeping requirements, and child labor protections. Most relevant here, FLSA requires, with some exceptions, that employees be paid overtime pay at a rate of one-and-a-half times their regular hourly rate for all hours worked over 40 in a single workweek. However, like the Massachusetts overtime law, the FLSA does not apply to certain categories of employee, such as “learned professionals”.
Registered nurses are can be considered learned professionals in some circumstances because qualifying as a registered nurse typically requires specialized instruction and the passage of a licensing exam, and their primary job duties typically include consistent exercise of discretion and judgment in a field of science or learning. However, according to the regulation 29 C.F.R. § 541.3(e), which provides detail for exemptions and exceptions to the FLSA, in order to not be eligible for overtime pay under the FLSA, registered nurses must also be paid on a salary basis at a rate of no less than $684 per week. In other words, registered nurses who are paid hourly or who are paid on a salary basis but earn less than roughly $35,568 per year are still entitled to overtime pay whenever they work more than 40 hours in a workweek, even though they are learned professionals in terms of their job responsibilities. The Massachusetts overtime law has a nearly identical learned professional exemption, which has been largely interpreted to mirror the reach of the FLSA exemption.
In a 2006 case, Belt v. EmCare, Inc., a federal court determined that physicians’ assistants and nurse practitioners must also be paid overtime when they are paid at an hourly rate, just like registered nurses. The regulation 29 C.F.R. § 541.3(e) states that the requirement that a learned professional be paid a salary of at least $684 per week does not apply to employees who are licensed to practice law or medicine. Registered nurses are not considered “licensed to practice medicine”, so the salary requirement does apply to them. The court in Belt held that the salary requirement also applies to physicians’ assistants and nurse practitioners. In Belt, physicians’ assistants and nurse practitioners who worked in hospital emergency rooms and were paid an hourly rate sued their employer for not paying them overtime. The physicians’ assistants and nurse practitioners were paid the same hourly rate even when they worked more than 40 hours in a workweek. The employees brought the case as a class action.
The employer pointed out that physicians’ assistants and nurse practitioners perform many of the “traditional duties” of physicians and, unlike nurses and pharmacists, help develop treatment plans for patients. Because of this and because physicians’ assistants and nurse practitioners are required to have a license, the employer argued that physicians’ assistants and nurse practitioners are, in fact, licensed to practice medicine.
The court disagreed and held that physicians’ assistants and nurse practitioners, like nurses, “merely served” the medical profession, to use the language in the regulation. The court agreed with the employees that physicians’ assistants and nurse practitioners are more similar to employees in other medical occupations such as pharmacists, nurses, and therapists, who must be paid on a salary basis to not be eligible for overtime, than they are to dentists or optometrists, who are not eligible for overtime even when they are paid hourly. The court also noted that physicians assistants’ and nurse practitioners are not licensed to practice medicine under any state’s medical practices law. In other words, the FLSA requires that physicians’ assistants and nurse practitioners, like nurses, be paid overtime if they are not paid on a salary basis.
In this case, the court signaled strong support for medical employees’ rights under the FLSA to be free from what the court describes as “the evil of overwork as well as underpay.” The court made it clear that these rights apply even in positions with higher barriers of entry and increased responsibilities, like physicians’ assistants and nurse practitioners have.
If you want more information about the FLSA and overtime pay in medical settings, feel free to contact our office for a free and confidential consultation.