An employment relationship is established if all of the following criteria are sufficiently documented:
- The employer has the power to hire and fire;
- The employer has the power to direct the work done by the employee and has ultimate responsibility for the manner of his/her performance;
- The employer has the duty to pay wages, fringe benefits, and establish the level of compensation;
- The employer is personally responsible for withholding federal income tax and social security contributions and is personally responsible for making contributions for the employee under the Pennsylvania Unemployment Compensation Act and is personally responsible for insuring the employee's liability under the Pennsylvania Workmen's Compensation Act; and
- There is no compensation received by any facility for the services of the employee during the period of employment by the employer.
See Medical Policy Bulletin Z-27 for information on services performed by an employee under the supervision of an eligible provider. |