Healthcare Locum Agreement

HEALTHCARE LOCUM TENENS SERVICES AGREEMENT

This Locum Tenens Services Agreement (the Agreement) is entered into by and between Client Name: with primary address at (the Facility), and Locum Provider Name: , with address at (the Locum).

Effective Date: , .

1. Engagement and Scope of Services

Facility hereby engages Locum to provide temporary clinical services as a locum tenens practitioner as described below, and Locum accepts such engagement on the terms set forth herein.

2. Term and Scheduling

Term begins on , and continues until , unless earlier terminated in accordance with Section 10.

3. Compensation

Facility shall pay Locum as follows: Fee type: ; Rate/Amount: $ per .

4. Expenses

Facility will reimburse reasonable, preapproved travel, lodging and related expenses incurred by Locum in performance of services upon submission of itemized receipts. Reimbursement limit or policy:

5. Licensure, Credentialing and Background Checks

Locum represents and warrants that Locum holds all required licenses, board certifications, DEA and other registrations necessary to perform the services and will maintain them in good standing for the Term. Facility reserves the right to verify credentials and to require completion of Facility credentialing prior to commencement of services.

Locum consents to credentialing, verification of references, background checks and release of relevant records to Facility for credentialing purposes.

6. Malpractice Insurance

Locum shall maintain professional liability insurance with limits not less than: $ per occurrence and $ aggregate.

Locum acknowledges responsibility for procuring tail coverage for claims arising from services performed under this Agreement where required by Facility. Tail coverage responsibility:

7. Independent Contractor; Taxes

It is the intent of the parties that Locum perform services as an independent contractor and not as an employee. Locum shall be responsible for payment of all federal, state and local taxes arising from compensation paid to Locum hereunder. Nothing in this Agreement shall be construed to create an employment relationship, joint venture or partnership.

8. Confidentiality and HIPAA Compliance

Locum shall comply with all applicable federal and state privacy laws, including the requirements of the Health Insurance Portability and Accountability Act (HIPAA), and Facility policies regarding patient privacy and confidentiality. Locum shall use Protected Health Information only as permitted by Facility and shall execute any reasonable business associate agreement requested by Facility.

Locum acknowledges receipt of Facility privacy policies and agrees to comply with same.

9. Medical Records and Documentation

Locum shall prepare and complete medical records, charts, progress notes and other documentation in accordance with Facility policies and applicable law. All records created by Locum in connection with patient care remain the property of Facility and must be delivered to Facility upon request.

10. Termination

Either party may terminate this Agreement for convenience upon days' prior written notice. Facility may terminate immediately for cause, including but not limited to loss of licensure, material breach, or conduct reasonably likely to result in harm to patients.

11. Indemnification

Each party shall indemnify, defend and hold harmless the other party and its directors, officers and employees from and against claims, liabilities, losses and expenses arising out of the indemnifying party's negligence or willful misconduct in the performance of this Agreement, subject to applicable law and insurance limits.

12. Notices

13. Governing Law; Dispute Resolution

This Agreement shall be governed by and construed in accordance with the laws of the state where the Facility is located, without regard to conflict of law principles. Any dispute arising out of or relating to this Agreement shall be resolved by binding arbitration unless the parties mutually agree otherwise in writing.

14. Miscellaneous

This Agreement constitutes the entire agreement between the parties with respect to its subject matter and supersedes all prior agreements. Any amendment must be in writing and executed by both parties. If any provision is held invalid, remainder shall remain in full force and effect.

Authorization and Acknowledgments

Locum certifies that all information provided to Facility for credentialing is true and complete. Locum authorizes Facility to contact prior employers and licensing authorities for verification.

Locum acknowledgements:
No known conflicts of interest that would impair Locum's ability to provide services.
Not subject to any substance abuse restriction that would limit performance of duties.

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