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certain adaptive equipment. The tax deduction is available to all businesses with a maximum deduction of $15,000.00 per year. The tax deduction can be claimed for expenses incurred in barrier removal and alterations. To learn more about the tax credit and tax deduction provisions,access the IRS Webpage at www.usdoj.gov\crt\ada\taxcred.htm. This article is presented for educational purposes only and should not be taken as a substitute for legal advice, which should be obtained from personal legal counsel. Nevertheless, the FMA hopes that the information provided here and in its other publications continues to assist physicians in answering many of their most common legal questions allowing them to treat patients, instead of addressing legal concerns. Last Update: December, 2009 ADA AND TREATMENT OF HIV INFECTED PATIENTS The decision of whether to treat an individual patient has traditionally been one left to the discretion of the individual physician. Federal legislation, however, has placed an obligation on physicians to treat certain types of individuals, most notably those individuals infected with HIV. As a result, physicians are torn between the desire to protect themselves and their staff, while simultaneously complying with federal antidiscrimination laws. According to a U.S. Supreme Court decision, HIV infection is considered to be a disability under the Americans with Disabilities Act of 1990 (ADA), even though the infection has not progressed to the symptomatic stage. Bragdon v. Abbott, 524 U.S. 624 (1998). In that case, the Supreme Court held that HIV infection constitutes a physical impairment that substantially limits one or more of the major life activities of an individual. Notwithstanding its holding that HIV infection is a disability under the ADA, the Court held that the Petitioner dentist could have refused to treat the HIV infected patient if her infectious condition “pose[d] a direct threat to the health or safety of others.” The Court held that the existence or nonexistence of a significant risk is determined from the standpoint of the health care professional who refuses treatment or accommodation, and the risk assessment is based on the medical or other “objective, scientific information available to him and others in his profession,” not simply on his good-faith belief that a significant risk existed. Bragdon, at 624.This article is presented for educational purposes only and should not be taken as a substitute for legal advice, which should be obtained from personal legal counsel. Nevertheless, the FMA hopes that the information provided here and in its other publications continues to assist physicians in answering many of their most common legal questions allowing them to treat patients, instead of addressing legal concerns. Last Update: August 2016 THINGS TO CONSIDER BEFORE SIGNING AN EMPLOYMENT CONTRACT There are many things to consider before entering into an agreement with a potential employer. Below is a short and certainly not an exhaustive list of some of the most important considerations. Of all the items below, the first one on the list should always be adhered to. 1. Consult a qualified healthcare attorney to review any employment agreement before you sign it. Sure this will cost you money, but a careful review from an attorney experienced with physician employment issues can prevent legal problems down the road and may end up saving you far more money than what the review costs. An experienced attorney will be able to discuss with you all of the points below, as well as others you probably would never think of, and help you to negotiate the best possible deal. 2. Compensation. Make sure the compensation is appropriate, and clearly stated. A set annual salary is most common, and the least problematic from a legal standpoint. Beware of percentage based compensation arrangements as these can violate state and federal self-referral (Stark) laws and patient brokering laws. Be sure that all items of compensation are clearly set forth in the contract, such as vacation and sick leave, cell phone/iPad service, reimbursement for required continuing medical education, car allowance, 401K (will the employer match employee contributions?), and the amount and types of insurance provided (health, dental, life, disability, etc.). In addition, if your expectation is that after a period of time, you will be made an owner of the practice, the “how’s” and “when’s” should be clearly spelled out in the contract. 3. Malpractice Insurance. Who will pay for your malpractice insurance? While this is usually related to the amount of compensation you receive, it deserves special attention. Make sure your contract clearly spells out whether your employer has in place or will procure medical liability insurance that covers you specifically, and what the extent of that coverage is. If the employer is providing liability coverage, you need to deal with the issue of tail coverage should the employment terminate. Tail coverage can be quite expensive, and at the least, you should ask that the employer pay for the tail if the contract is terminated for any reason other than a breach by the employee. 4. Emergency Room Call Coverage. Make sure that the agreement sets forth whether you will be expected to provide emergency room coverage as part of your duties, and whether your salary covers the time spent on call, or whether you are entitled to overtime pay. If the hospital pays for call coverage, your contract should specify whether such monies go to the employer, or whether you are entitled to receive this pay. 5. Office Hours. Will you have established office hours? Similar to ER call, make sure you know what is expected of you. Will there be set days and times you are expected to be in the office, or will you have the flexibility to see patients on your own schedule? 6. Restrictive Covenants. Be aware of restrictive covenants. If at all possible remove these from your contract. Many physicians will sign an agreement with a restrictive covenant in the belief that such clauses are unenforceable. While many states have outlawed these types of agreements, in Florida, a restrictive covenant that is reasonable in both time and area is enforceable. Please see the article titled “Noncompetition Clauses.” 7. Ownership of Medical Records. Florida law provides that absent an agreement to the contrary, medical records are owned by the person who generates them. If you agree, however, that your employer is the medical records owner for any records you generate, you will be stuck with that decision should you later wish to end the employment agreement. If you do agree that the employer is the records owner, you should insist that you be provided with full copies of all records that you generated should your employment terminate for any reason. 8. Stark Laws. Be aware of the Stark Law, 42 U.S.C. 1395nn. Hospital employment cannot be conditioned on referring patients, and incentive payments cannot vary based on the value or volume of referrals. The state and federal “Stark” laws are so complex that navigating its intricacies while negotiating your contract would be very difficult. Please refer back to item 1. 9. Outside Activities. Make sure that your contract states whether you will be allowed to engage in professional activities outside of your employment, such as providing expert witness testimony or speaking at medical seminars. If at all possible, make sure your contract states that you are entitled to keep the revenue generated from such engagements, at least for those done on your own time. For an excellent analysis on this subject, please see the FMA’s recent publication: “A Guide to Understanding and Negotiating a Physician Employment Contract From the Employee Perspective. This publication can be found on the FMA’s website.This article is presented for educational purposes only and should not be taken as a substitute for legal advice, which should be obtained from personal legal counsel. Nevertheless, the FMA hopes that the information provided here and in its other publications continues to assist physicians in answering many of