A community of 30,000 US Transcriptionist serving Medical Transcription Industry

I will keep posting this info until every affected MT sees it - Whistleblower

Posted: Nov 19, 2014

If you work on Veterans Administration (VA) accounts, you MUST be classified as an employee and earn the appropriate wage determination rate (in the neighborhood of $14 to $20-plus an hour depending on county). In addition, you must have a separate hourly rate of pay that is applied towards a benefits package.

If you are doing this kind of work and are not properly classified or you are not being paid what you're supposed to be paid, REPORT YOUR MTSO TO THE DEPARTMENT OF LABOR. Please do not contact the VA because it seems there is a nudge-wink going on between the VA and some of the MTSOs who have contracts with them. You can file an anonymous claim with the DOL to get any back-pay. The DOL will often audit the company, and depending on the scope of the audit, your coworkers may also get back-pay if it's due.

It's important to understand that silence enables this sleazy practice to go on unchecked and unremedied. There is no reason not to speak up for ourselves. Why would you want to sit back and let your company steal from you???

Nudge-wink - sm

[ In Reply To ..]
If you are being paid inappropriately, especially if you feel there is a nudge-wink going on, report it to the VA Office of the Inspector General. Their link is below.

I don't know how you reported this to the VA, or how you determined that there was nudge-wink collusion going on, but chances are you reported it to someone who had no idea what to do about it. That person needs to be reported to the IG.

I did not speak to anyone at the VA - Whistleblower

[ In Reply To ..]
The nudge-wink was the impression I got from Grandy who has posted about Alpha and IMedX. Apparently the VA has said to Grandy that they know the work may be going offshore but they're okay with it because Alpha serves as the American "front" for IMedX.

Hearsay - And also ...

[ In Reply To ..]
Well, that is hearsay. You don't know who she talked to or what they discussed.

However, that is entirely possible and would not be a violation of policy.

Just so you know, the VA requires that transcription contracts contain language that stipulates that the work will be performed by workers located in the United States working for companies located in the United States. Subcontracting is not allowed. Those are privacy and security issues.

The pay issue is separate from that. That applies to all VA contracts, not just transcription.

It is also worthwhile to mention that this may soon be a moot point. The VA contracted with Nuance to supply front-end SR to all their facilities. They have been fully electronic for more than a decade, and the bulk of their documentation is already completed by providers themselves using templates and Dragon. There isn't going to be anything left to contract out.

No, I don't know what was discussed or to whom Grandy spoke - Whistleblower

[ In Reply To ..]
I know what Grandy posted. What difference does it make if it's hearsay? I'm not presenting evidence in a legal proceeding. What I do know is that the Department of Labor is the entity to which I would complain in order to get back-pay I was owed for work I performed. The VA doesn't seem to be too concerned about US employees if they're okay with the work going offshore.

"However, that is entirely possible and would not be a violation of policy." If you're referring to the VA being okay with Alpha serving as an American front for iMedX, that may or may not be a violation of policy. However, I can tell you that there is no reason I can think of that a company would offshore its transcription other than the fact that they would be paying the MTs less. If that is the case, they are obviously NOT paying them what they're SUPPOSED to be paying them, which is the respective hourly wage determination rate, and that is a violation of LAW.

Regarding the issues of offshoring and subcontracting, there was a VA directive that said no work could be offshored, but that directive was set to expire in August of 2013. Do you have knowledge that it was renewed? In addition, as it is my understanding iMedX bought Alpha, the work technically is not being subcontracted. It's still ostensibly being performed by the same company. The problem is that it seems that the VA work the Alpha MTs had been performing is suddenly drying up after this buyout. It's a safe assumption that the work is going offshore and that iMedX is not paying those offshore MTs the proper wage.

Yes, in general the pay issue is separate, but in this case it's related. What Indian MTs are going to file complaints with the US DOL because they're not being paid what they're supposed to be paid? As I said, this is technically not subcontracting, and I have no knowledge that the no-offshoring directive was renewed after it expired last year. The remaining issue is the pay.

While at some point this may be a moot point, it is not an insignificant one for anyone who has worked on VA contracts or is currently working on them and not being paid properly. Those MTs might have a lot of money coming to them once an audit is conducted by the DOL. More money in an MT's pocket is a very big deal right now.

I'm aware that the rules for pay apply not only to all VA contracts, but all federal government service contracts (McNamara-O'Hara Service Contract Act).

If you have documentation demonstrating that the no-offshoring directive was renewed, please share it. I would love to add that to my burgeoning file on these outlaw MTSOs.

Answer - sm

[ In Reply To ..]
You are assuming that work is being offshored and that the VA somehow knows all about this and has agreed to keep quiet about it. Those assumptions are not necessarily valid. No, you are not making a legal case, but you have a better chance of someone paying attention to your complaint if it makes sense.

Directives are valid until they are replaced. That one is still in force because it has not been replaced.

Offshoring is mostly invisible to the client. If you suspect that it is occurring, you need to report it. Not Grandy, YOU.

You cannot assume that offshoring is occurring because you see less work. VA contracts are time-limited. They expire and might not be renewed. It may be that the contracts are not being renewed because of the concern about offshoring , but it is more likely that you are seeing less work because THERE IS LESS WORK.

They are sending out less because their healthcare providers already have state of the art EHR systems that allow them to type it themselves, use custom templates, or dictate it to Dragon, and one facility after the other is converting to front-end SR. They are installing it throughout the VA. A growing number of them are hiring their own MTs to take care of what remains.

Facts, history, timing, and common sense - Whistleblower

[ In Reply To ..]

“You are assuming that work is being offshored and that the VA somehow knows all about this and has agreed to keep quiet about it. Those assumptions are not necessarily valid.”

Yes, for the purposes of recovering wages, which was the subject of my original post, my assumption that it is not a good idea to appeal to the VA is quite valid. Besides the fact that the DOL is the proper authority to address the issue of wages due, the VA doesn’t have a financial incentive to make sure its contractors are paying their employees properly.

“No, you are not making a legal case, but you have a better chance of someone paying attention to your complaint if it makes sense.”

The people to whom I was addressing the issue are MTs on this board who may be interested in filing a complaint for back-wages. No one else has suggested that what I repeated about Grandy's dealings with the VA did not make sense.

Again, if I were an employee working on VA contracts and not being paid properly, my complaint would be addressed to the DOL. In my experience, the DOL does pay attention to such complaints. What does not make sense to you about being paid the wrong wage for VA work instead of the correct wage and, therefore, filing a complaint? The DOL must think such complaints make sense since they have responded appropriately to such complaints in the past.

I never said I was filing a complaint about iMedX offshoring. That should be done by someone who has more detailed information about it than I have. I, having detailed information about another MTSO that I believe is illegally offshoring, have complained to the proper authorities about it and continue to follow up.

If one was going to file a complaint regarding suspicions of offshoring by iMedX, that would be addressed to another authority. My original post was about pay, and the offshore issue was only tangentially addressed, so I’m unclear why you seem especially sensitive about it. Given the account related by Grandy and MTs who are/were employed by Alpha of a sudden drop in workload immediately following iMedX’s acquisition of Alpha and subsequent laying-off of some of Alpha’s MTs who were transcribing VA work; the fact that iMedX employs a large number of MTs in India; the fact that offshoring is rampant in the MT industry because it is so lucrative; the fact that VHA directive 2008-042 that contained the provision that medical transcription work had to be physically performed in the US also stipulated that the directive would expire on August 31, 2013; the fact that I personally have knowledge of another MTSO that is very likely offshoring in violation of its contract with a state government; the fact that, despite a mountain of evidence supporting my allegation, government agencies to date have conducted the most inept investigations into the matter, repeatedly ignoring the very documentation that would either prove or disprove the allegation; and the fact that the VA has an incentive to NOT address offshoring because a contractor with the intent to offshore can submit a substantially lower bid than other MTSOs who plan to pay their employees the correct wage, and the VA seeks to “attain the most favorable pricing possible,” yes—my assumptions make perfect sense to anyone who looks at all the facts together and uses their common sense.

“Directives are valid until they are replaced. That one is still in force because it has not been replaced.”

Where is that documented? I do know that the referenced VHA directive specifically states that it will expire on August 31, 2013. Your claim that it is valid until it is replaced contradicts what the directive says, so it does not make sense unless you can provide a source that substantiates it. Please share.

What VAs were you doing that dried up? - Just curious

[ In Reply To ..]
Directives are assumed to continue in force until rescinded. If you don't know that, some of the other things you "know" might not be accurate, too.

Your contention that the VA has some nefarious intent to overlook wrongdoing in order to get a lower bid might have merit, but it is far-fetched. The bids have to be reasonable, not so suspiciously low that the bidder could be fraudulent.

You also seem to have missed the fact that the work dried up after the change in ownership, but too soon for the new company to have bid lower. The contracts that dried up were in force at the time. That is why I told you that the VA may have terminated the contracts due to the change in ownership.

You are completely not hearing the main reason your work dried up, which is that the contracts may have expired and not been renewed, and the second biggest which is the fact that they are eliminating the need to contract any transcription by using front-end SR. Every month, more facilities convert.

Yes, you should report wage fraud to the DOL, but either stop accusing the VA of encouraging it through collusion in fraud or put your money where your mouth is and report that, too.

Someone on this board has been warning you for months about their move to front-end SR, but it doesn't look like you heard the message. You should not expect there to be a lot of work from them in the future.

Wondering what accounts dried up. Maybe someone can explain what happened to them.

You completely missed a few things - Whistleblower

[ In Reply To ..]
"Directives are assumed to continue in force until rescinded."

Really? Because you say so? I have asked you repeatedly to provide a reliable source for your information, but you haven't. I have, on the other hand, accessed that particular directive online, and it says it expires on August 13,2013.

"Your contention that the VA has some nefarious intent to overlook wrongdoing in order to get a lower bid might have merit, but it is far-fetched. The bids have to be reasonable, not so suspiciously low that the bidder could be fraudulent."

Maybe in your opinion it is far-fetched, but I know better. This practice is not specific to the VA. It's the kind of thing that happens during the bidding process for contracts. What makes you think the procurement specialist has specific knowledge about exactly what the values are that go into the formula used by an MTSO to arrive at their bid amount? I can tell you that I know of an MTSO that was audited by the DOL, and it was found that they were paying their MTs incorrectly for YEARS. When it came to light that the MTSO was going to have to pay the correct WDR, they cried poverty because they claimed they would not be able to make a profit and would actually lose money. How in the world could that be if their original bid was deemed "reasonable" by the procurement specialist? Right--because it was NOT reasonable. The bid amount was arrived at with the intent to pay on a production basis by the line, and NOT the hourly WDR. How is it that the contract was awarded to this MTSO if that was the case? The criteria for what is deemed "reasonable" seem to be competing bid amounts and are not arrived at with a formula that uses values such as the WDRs and reasonable productivity rates. In order for bidders to compete with each other, they all low-ball with the intent to pay by the line and not by the hour. Very often, procurement specialists know little to nothing about the industry that will be providing services for a contract, and that is a big problem.

"You also seem to have missed the fact that the work dried up after the change in ownership, but too soon for the new company to have bid lower. The contracts that dried up were in force at the time. That is why I told you that the VA may have terminated the contracts due to the change in ownership."

'The fact that'? That there were US MTs who were laid off does not mean the work on those contracts completely stopped. It just means that THOSE MTs were no longer doing the work. You seem to have some inside information about this particular change in ownership at Alpha/iMedX, i.e, 'but too soon for the new company to have bid lower.' Your claim that it's a fact is quite interesting. Maybe this is part of the reason behind your dogged defense of the VA?

"You are completely not hearing the main reason your work dried up..."

My work never dried up. I never said I worked on those accounts. I never said I worked at Alpha. You did not read carefully, and then you made assumptions about where I work that are not true.

You keep bringing up the transition to front-end SR, which has absolutely nothing to do with the original post of this thread and is immaterial to the issue of back-pay.

I said I did not have the detailed information to report anything to the Inspector General about Alpha/iMedX. I never said I have not reported suspected malfeasance, ineptitude, and the ripping-off of American workers. You not only completely missed a few things, you got a few things completely wrong.

That clears it up. - sm

[ In Reply To ..]
You don't even work for them? Then you have no knowledge of what is going on at all. You just seem to have a vivid imagination and a tendency to see a conspiracy around every corner.

This hasn't been a legitimate concern. It is just rabble-rousing. You are trying to get other people to blow whistles on your direction. Looks like the new replacement for the "you all need to unionize" schtick.

legitimate concern - mtme

[ In Reply To ..]
Being paid correctly for working on VA contracts is a legitimate concern. The company I work for was audited by the DOL and now has to pay us an hourly rate, provide holiday pay, vacation pay, and medical insurance. That was the purpose of the original post above, to make others working on VA accounts aware of how they should be paid.

Yes, but it was not necessary to say the VA was - at fault in this.

[ In Reply To ..]
The problem is that she blames this on the VA itself ... the people who WANT you to be paid correctly ... by saying they have a "nudge-wink" going on, which she then supports with claims about work drying up, etc.

Yes, these are separate issues. Yes, you should be paid correctly. Call the DOL about it, but stop blaming the VA.

If Nuance is doing business with the federal government, would Nuance employees - get the new federally mandated minimum wage

[ In Reply To ..]
As I understand the legislation, it is supposed to apply to any company!

Nuance does not have transcription contracts - with them, do they?

[ In Reply To ..]
It only applies to the people doing the work on the contracted account. I do not think Nuance has any transcription accounts with them.

Whole company - NuanceEmployee

[ In Reply To ..]
I'm not a lawyer or any sort of legal expert, but my understanding was that both the nondiscrimination policies and the new minimum wage for federal contractors applied to the entire company who has a contract. The President was basically trying to say, "the Federal Gov't is setting an example that we expect companies doing business with us to pay their employees fairly and to not discriminate, period."

With that being said, there's a thread on the Nuance board that brought up a good question, asking if Nuance Transcription Services was even the same company as Nuance that makes Dragon. I know that I've personally seen the ads about the VA using Dragon and how they're saving money and such, but I also know that my paycheck and W2 says "Transcend DBA Nuance Transcription Services." In other words, they are NOT Nuance, but are just "doing business as them."

I agree with that thread that they have probably purposefully set it up this way to avoid things just like this.

Again, I could be wrong about the difference between just the employees working on a contract and the entire company, but I think it would be very hard to clarify who is working for that company and who isn't. As in, if a cleaning company was hired to clean the White House, and the cleaners got the higher rate, would their supervisor who also supervised cleaning of 5 other companies/buildings?

Anyway, just my 2 cents.

I do not think Nuance has any VA transcription - contracts.

[ In Reply To ..]
NM

Actually, I THINK they might. A while back - IMANMT2

[ In Reply To ..]
I was rolling though the awards and solicitations and I saw a couple of sole source (not open to bidding) awards and I also saw where a company that I believed to historically offshore outsource was awarded a contract. I thought it was Nuance or M-Modal. I can't really remember anything exactly but I came away with the impression of well, hmmm. Nuance.

The sole source is another form of nudge-wink. ;)

Possible explanation - sm

[ In Reply To ..]
M*Modal is unlikely, since they were penalized for offshoring and are now banned.

Nuance gets sole-source contracts because they are the only source for a number of HIM software products. Just not MT.

Sole source does not mean the VA is issuing the contract "nudge wink" to just one company. It means there is only one company that has what they need. For instance, Nuance is the only source for the coding software the VA uses.

There cannot be a sole source for transcription because more than one company can provide it. The VA has several MTSOs contracted to do transcription, too. They are smaller MTSOs due to the requirement for using veteran-owned small businesses when possible. Nuance would not be able to compete because they are too big..

(Yes, I do know what I am talking about. Unlike you, I am not just speculating.)

better in old times - anon

[ In Reply To ..]
The pay can be as low as $12 an hour (also, which account do you want to work on, the $12 one or the $20 one).

You have to have a crazy high line count for the company to afford it.

Even if you do easily surpass the line count, you don't get extra pay, it's PURE hourly.

You can't work overtime.

You get crappy health insurance (indemnity).

You do get holiday and vacation pay!!

hourly pay? - bugger

[ In Reply To ..]
Have worked VA accts for years, never got an hourly wage OR a decent wage. That not decent wage didn't even reach minimum wage for where I live.

Then you need to report that. - sm

[ In Reply To ..]
The Department of Veterans Affairs does not want you to be paid that way. They require that you make at least the hourly rate that similar workers in your area make.

To Bugger - file an anonymous claim with the DOL for back pay - Whistleblower

[ In Reply To ..]

Your MTSO has stolen money from you by not paying you what you were supposed to be paid according to the law. There may be a statute of limitations on how far back you can go (maybe 2 years?), but put in for as much as you think you are owed and let the Department of Labor take care of the rest of it.

You can find out what the hourly rates are by using the link below and going to the government's Wage Determinations OnLine website.

You also might want to read up on the McNamara-O'Hara Service Contract Act. Know your rights and exercise them!!!

You can find out what the hourly rates are by using the link below and going to the government's Wage Determinations OnLine website.

You also might want to read up on the McNamara-O'Hara Service Contract Act. Know your rights and exercise them!!!

to whistleblower - bugger

[ In Reply To ..]
already did....some got reimbursed others of us did not. I was not a happy camper

The issue may be due to the fact that there are many accounts - Whistleblower

[ In Reply To ..]
For example, if an MT who works on accounts A, B, C, and D files a complaint, the DOL will probably only audit the MTSO's operations in regard to those specific accounts. Therefore, MTs who work on those accounts will be reimbursed. If other MTs at that company work on other accounts (E, F, G, H, etc.) but not on A, B, C, and D, they will not be reimbursed. That's why it's important that each and every MT should file a complaint if they are owed back-pay.

Is that what happened in your situation?

By the way, your MTSO may have told you that the matter is closed - Whistleblower

[ In Reply To ..]
now that some people have been paid back wages in hopes that other MTs would not file complaints and force them to pay out more money. That is true only in regard to the specific accounts which were audited. You can still file claims for back wages for work you performed on other accounts, depending on the statute of limitations. Something else just occurred to me: If your MTSO led you to believe you had no further recourse in regard to the other accounts that had not been audited and now the statute of limitations has run out, you might have grounds for a suit against your MTSO. I really don't know, but I am for any and all plans of action to hold outlaw MTSOs' feet to the fire.

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