Seyfarth Synopsis: The Second
Circuit has affirmed summary judgment for the employer, Aetna, in
an exempt misclassification overtime claim brought by a nurse
reviewer. Agreeing that the plaintiff was properly classified as a
"professional" employee and thus exempt from the FLSA,
the Second Circuit explained that clinicians who do not directly
provide medical care qualify for the exemption if they make the
final decision to approve payment for medical services.
Background
Plaintiff Isett worked as an appeals nurse, reviewing claims for
coverage of medical services for which Aetna had denied coverage,
in order to determine whether to override the denial and approve
payment for the services. Working remotely from home without much
oversight, Isett reviewed patients' medical files to determine
whether the requested services were medically necessary, as defined
in the insurance plans and clinical guidelines. If so, she approved
payment without further review, thus
