The Siegel Law Group is investigating the pay practices used by Elevance Health, Inc. f/k/a Anthem, Inc. (“Anthem”) to pay its employees who performed case management duties while employed with Anthem at any time within the last three years. Specifically, the investigation is looking into pay practices used by Anthem to pay its LTSS Service Coordinators, Case Managers, Care Coordinators and similarly titled case management employees (“collectively, “Anthem Case Management Employees” or “CM Employee”).
We began this investigation based on information leading us to believe that Anthem may have violated federal overtime law by:
- Misclassifying Anthem Case Management Employees as exempt from overtime requirements;
- Paying Anthem Case Management employees on a salary-only basis; and
- Refusing to pay Anthem Case Management Employees overtime when they worked over 40 hours per week.
We invite current and former Anthem Care Coordinators, Service Coordinators, Case Managers and other individuals with helpful information to reach out to assist us with this investigation. You can give us a call, or text to set up a call, by calling (214) 790-4454. Also, feel free to email Jack directly at Jack@siegellawgroup.biz.
1. a Common Misconception Re Overtime Eligibility for Salaried Case Management Employees
Contrary to popular belief, employees paid a salary are not automatically exempt from overtime. Rather, an employee’s exempt status depends on whether or not their job duties qualify the employee for an exemption from federal overtime protections. As shown below, salaried care coordination, case management and utilization review employees have been found to perform non-exempt job duties and entitled to overtime. In those cases, courts have determined the managed care employees’ job duties did not meet the specific job duties requirements for the administrative and/or professional exemptions from the FLSA.
2. Courts & DOL Opinion Letters: Salaried Case Management Employees Perform Non-Exempt Job Duties & Are Entitled to Overtime
A. Managed Care Workers – Utilization Reviewers Misclassified as Exempt
Multiple courts have held that salaried case managers and utilization review nurses and similar managed care employees of different educational backgrounds, are entitled to overtime because of the nature of their job duties:
Rego v. Liberty Mut. Managed Care, LLC, No. 17-C-66, 2019 WL 1126109, at *10 (E.D. Wis. Mar. 12, 2019) (granting summary judgment to utilization review nurses, who were required to have Registered Nursing licenses, on professional exemption because the “standard prerequisite for utilization review work, as judged from the accreditation requirements of URAC, which is one of the largest accreditation organizations for companies performing utilization reviews, is LPN-level credentials.”)
Clark v. Centene Co. of Texas, L.P., 656 F. App’x 688, 689 (5th Cir. 2016)(affirming nurse case managers non-exempt under administrative or professional exemptions of the FLSA where their job duties consisted of utilization review, making referrals to supervisors, providing patient and provider education, and entering data related to assessments, authorizations, and reviews into computer systems)
B. Managed Care Workers – Care Coordinators Misclassified as Exempt
On August 28, 2024, the District of New Mexico granted summary judgment to a group of care coordinators represented by the Siegel Law Group. In that case, the court rejected the defendant’s argument that the care coordinators job duties—consisting of completing assessments and care plans—satisfied the administrative exemption. Deakin v. Magellan Health, Inc., No. 1:17-CV-00773-MLG-KK, 2024 WL 3992237, at *3 (D.N.M. Aug. 28, 2024). In concluding that the care coordinators were non-exempt, the Court relied heavily on the fact that the Department of Labor had repeatedly provided guidance that disability case managers and similar case management employees to be non-exempt in no less than three separate Opinion Letters.
C. DOL Finds Case Management Employees Are Non-Exempt
The U.S. Department of Labor (“DOL”) issues opinion letters in response to particular inquiries about compliance under federal overtime law. In fact, the DOL has found—on multiple occasions—that disability case managers and similar employees (1) should not be classified as exempt from overtime pay; and (2) should be paid overtime compensation pursuant to federal law. The three specific opinion letters addressing this issue are available in the links below.
Referenced Cases & Opinion Letters
Rego v. Liberty Mut. Managed Care, LLC, No. 17-C-66 (E.D. Wisc. Mar. 12, 2019)
Deakin v. Magellan Health, Inc., No. 1:17-CV-00773-MLG-KK (D.N.M. Aug. 28, 2024).
Clark v. Centene Co. of Texas, L.P., 656 F. App’x 688, 689 (5th Cir. 2016)
DOL Opinion Letter (August 9, 2005)
DOL Opinion Letter (September 8, 2006)
DOL Opinion Letter (September 8, 2006)
