We have contracted employees that have been seeing patients beyond the pre-authorized schedule of visits and we are not getting paid from medicare.

Under the Fair Labor Standards Act, if an employer "suffers [an employee] to work" the employer must pay the employee for all of the time the employee works. The pay must be at least at the minimum wage rate applicable to the state. The federal minimum wage is $7.25/hour. If an employee is breaking a rule, or disregarding an instruction by working outside of the scheduled hours, the employer must still pay the employee for all time worked; but it can also discipline the employee or even fire the employee.  The termination would not be for earning (or claiming) the minimum wage rate for all the hours worked. Rather the employer should consider the employee's action in working outside of your instructions as insubordination or disregard of the employer's instructions.   You must pay them, and you can fire them. You can't agree to withhold discipline in return for them waiving the right to be paid for the time they spent. Once they spend the time, you must pay them. It doesn't matter whether you get paid or reimbursed for what you pay them. Before you discipline them for doing this,you should announce in writing to them that working outside their scheduled visit hours will result in termination.  make sure that is clear to them. You also can dis-incentivize their working outside of scheduled times by adopting a "fluctuating work week" method of compensation.  You pay them a straight salary to cover all of the time they work. Once they have worked more than 40 hours in a pay period, you pay them an additional 50% of their "regular hourly rate of pay" (calculated by dividing the salary by the number of hours they worked in the work week) for each hour that they worked after they reached 40 hours.  This way, their hourly rate of pay decreases the more hours they work in a work week.  Michael Caldwell 404-979-3150