Am I exempt from overtime if I'm a salaried NP at HCA?

Not automatically. Under the FLSA, exemption requires a salary of at least $684 per week and meeting a duties test. If your pay varies week to week based on hours worked, as alleged in the HCA suit, you may actually be considered hourly and non-exempt, regardless of a “salaried” label, and a federal court has ruled that NPs are entitled to overtime paya federal court ruling that NPs are entitled to overtime.

How is overtime calculated when I work variable hours?

Overtime is one and a half times your “regular rate,” which must include base pay plus shift differentials, holiday pay, and other extra wages. When hours change weekly, your regular rate can fluctuate. Employers must accurately recalculate it each workweek for all overtime hours.

What evidence do I need to file a wage claim as a nurse practitioner?

Collect pay stubs, time sheets, schedules, and any written communication about your pay. If you believe you were misclassified, document the exact hours you worked and the pay you received, highlighting any variations that suggest hourly pay rather than a true fixed salary.

Can I join the HCA overtime lawsuit if I no longer work there?

Yes. Former employees who worked for HCA Healthcare within the past three years and were subject to the alleged overtime practices may still be eligible. The attorneys in the case are actively seeking to speak with both current and former NPs and PAs.

What compensation can I expect from an overtime lawsuit?

If the lawsuit succeeds, you could recover unpaid overtime wages, possibly doubled as liquidated damages under the FLSA, plus attorneys' fees. The exact amount depends on the number of uncompensated overtime hours you worked during the relevant period.

What is the difference between exempt and non-exempt under the FLSA?

Exempt employees receive a fixed salary without regard to hours worked and satisfy a duties test; they are not entitled to overtime. Non-exempt employees must be paid overtime for hours beyond 40 in a workweek. A title like “salaried” does not control: if your pay is reduced for absences or fluctuates with hours, you may be non-exempt.

Can my employer retaliate if I join the lawsuit or ask about overtime pay?

No. The FLSA strictly prohibits retaliation. An employer cannot fire, demote, or penalize you for asserting your overtime rights, asking questions about your pay classification, or joining a wage lawsuit. Retaliation can lead to additional legal claims against the employer.

HCA Overtime Lawsuit: Wage Rights for NPs & PAs (2026 Guide)

Most important takeaways…

HCA Healthcare faces lawsuit for failing to pay overtime to hourly NPs and PAs.
Misclassified NPs can recover double unpaid overtime under the FLSA.
Variable paychecks often indicate misclassification and potential overtime claims.

In July 2026, a class action lawsuit was filed accusing HCA Healthcare of misclassifying nurse practitioners and physician assistants as exempt from overtime,¹ leaving them without time-and-a-half for hours worked beyond 40 per week. The financial shortfall for individual NPs and PAs can quickly climb into the tens of thousands of dollars, a hidden pay cut that shrinks your nurse practitioner salary with every weekend shift and on-call rotation.

At the heart of the case is a familiar pay practice: hourly wages disguised as salaries, shift differentials that inflate the regular rate, and paychecks that swing with patient volume. When variable compensation drives take-home pay, the FLSA often demands overtime. This lawsuit marks a critical moment for NPs and PAs nationwide, forcing employers to reconcile how they pay clinicians with what the law actually requires.

What Is the HCA Healthcare Overtime Lawsuit?

For many NPs and PAs, the distinction is simple: salaried employees are exempt from overtime, while hourly workers clock time-and-a-half. But a new lawsuit accuses HCA Healthcare of blurring that line, classifying advanced practice providers as exempt while functionally paying them by the hour. The result, plaintiffs say, is millions in unpaid overtime.

A Nationwide Collective Action

The proposed collective action, brought under the Fair Labor Standards Act, seeks to represent nurse practitioners and physician assistants who worked at HCA-affiliated hospitals within the last three years. While specific case details such as the docket number and federal district are not yet publicly available, ClassAction.org reports that the lawsuit was filed around July 2026.¹ The investigation is sponsored by the firm Berger Montague, whose attorneys are actively interviewing current and former HCA NPs and PAs to join the case.

The Core Allegations: Misclassification and Unpaid Overtime

The legal claim centers on the FLSA's professional exemption. To be exempt, an employee must earn a fixed weekly salary of at least $684, regardless of hours worked. The lawsuit alleges HCA violated this rule in several ways:

Misclassification: NPs and PAs were labeled as exempt even though their pay was hourly or effectively hourly, tying their take-home pay to the number of shifts or hours logged.
Variable base salaries: Some employees received a base salary, but their paychecks fluctuated week-to-week based on extra hours or differentials, eroding any claim to a true salary.
Miscalculated overtime rates: When overtime was occasionally paid, shift differentials, holiday pay, and other earnings were allegedly left out of the regular rate used to compute time-and-a-half.

The suit seeks back wages for all unpaid overtime, plus liquidated damages and attorneys' fees.

What's at Stake: Seeking Opt-In Plaintiffs

The case is still in its investigative phase. No class has been certified yet, so the number of potential plaintiffs remains fluid. However, HCA is one of the largest health systems in the U.S., operating over 180 hospitals , meaning the collective could encompass thousands of NPs and PAs. Attorneys are actively reaching out to providers who held any HCA role requiring them to work beyond 40 hours a week without proper overtime pay. If you fall into that group, your claim may still be timely under the FLSA's three-year statute of limitations for willful violations.

Are NPs and PAs Entitled to Overtime Pay Under the FLSA?

Nurse practitioners and physician assistants are not automatically exempt from overtime pay simply because they hold advanced credentials. While many NP and PA roles do satisfy the FLSA professional exemption guidelines, that status depends entirely on how an employer pays and structures the job, not on a job title or license.

The Two-Part Test for Professional Exemption

To classify an employee as exempt under the FLSA's learned professional exemption, an employer must prove both parts of a strict, two-part test:

Salary basis: The employee must be paid a predetermined, fixed salary that is not subject to reduction based on the quality or quantity of work.¹ The salary must meet the current weekly minimum of $684 (as of 2024)², up from the older $455 threshold.³
Duties test: The primary work must require advanced knowledge in a field of science or learning, customarily acquired by a prolonged course of specialized intellectual instruction, and must consistently involve the exercise of discretion and judgment.¹

The U.S. Department of Labor generally recognizes that NPs and PAs who hold accredited degrees and relevant certifications meet the duties portion of this test. However, the salary basis requirement is where many employers stumble, and where the HCA lawsuit gains traction.

Why HCA's Pay Structure Likely Fails the Salary Basis

The allegations against HCA Healthcare paint a picture of compensation that is fundamentally incompatible with exempt status. Workers who are truly exempt receive the same base salary each week regardless of the number of hours worked. HCA, according to the suit, paid NPs and PAs on an hourly basis or with a base pay that fluctuated because of extra pay tied to shifts, holiday hours, or deductions for partial-day absences. When a paycheck varies in direct response to the time an employee puts in, that employee is effectively an hourly worker and hourly workers are never exempt.

Federal courts have repeatedly put employers on notice that simply handing an NP or PA a salary label does not settle the exemption question.⁴ Multiple courts have found that NPs and PAs were owed back overtime when their pay structures included improper deductions or variable weekly amounts.

Title Isn't Destiny: What Actually Controls

The FLSA places the burden squarely on the employer to prove every element of the exemption.¹ That means an employer cannot argue that an NP is exempt merely because the position requires a master's degree or national board certification. If paychecks depend on the number of shifts covered, or if a "salary" can be reduced when patient volume is low, the exemption evaporates. NPs and PAs who suspect their compensation is illegally stripped of overtime protections should examine their pay stubs and discuss any variable pay patterns with an attorney familiar with FLSA claims.

The lawsuit's central argument: if your paycheck varies with the number of hours you work, you are likely non-exempt, and you may be owed overtime pay for every extra hour.

Not Just HCA: Other Major NP and PA Overtime Lawsuits

Healthcare facilities in Pennsylvania recently agreed to a $35.8 million settlement for unpaid overtime claims involving 6,000 workers across 15 nursing facilities. The HCA lawsuit is not an isolated incident; it joins a growing wave of wage and hour litigation targeting the misclassification of nurse practitioners and physician assistants.

High-dollar settlements behind the headlines

A Colorado nurse wage settlement reached $14 million in 2026, while a New York City strike by travel nurses pushed a wage-theft suit claiming $5 million in aggregate damages for 40 nurses.¹ Just this year, a Pennsylvania healthcare management company was hit with a new misclassification suit specifically naming nurse practitioners. These cases underscore a nationwide pattern: advanced practice providers are routinely denied overtime pay they are legally owed.

Common triggers for these lawsuits

The allegations across these suits follow a familiar script. Pay practices that trigger litigation include hourly pay mislabeled as a salary, automatic meal deductions that remove pay even when employees work through breaks, and off-the-clock work that goes uncompensated. When paychecks vary week to week based on hours worked or include shift differentials and holiday bonuses without factoring those into the overtime rate, the employer’s exemption claim crumbles under scrutiny.

The same story, a new defendant

The HCA lawsuit leans on identical arguments: that NPs and PAs functioned as hourly workers despite a salaried label. Those arguments have succeeded before, and the outcomes of these prior suits add weight to the current case. For NPs and PAs at HCA or any large health system, the lesson is clear: a job title or a base salary number does not determine your right to overtime. The math on your paycheck does.

How to Spot Wage Violations: Checking Your Pay Stubs and Time Records

Hospitals and healthcare systems often have complex pay practices that can mask overtime violations. For nurse practitioners and physician assistants, understanding what to look for on your pay stub is the first line of defense against unpaid wages. The Department of Labor provides clear guidance in Fact Sheet #53, emphasizing that all hours worked must be recorded and paid, including time spent on pre-shift, post-shift, and interrupted meal breaks.

Red Flags on Your Pay Stub

Review every pay stub carefully. Common warning signs include:

Time rounding that always benefits the employer: Rounding is permissible only if it is neutral over time, averaging out in the employee's favor as often as the employer's. If a 6:53 a.m. clock-in rounds to 7:00 a.m. but 5:07 p.m. clock-outs never round up, that pattern may violate the law.
Automatic meal break deductions despite working through lunch: Many facilities deduct 30 minutes automatically. However, if patient care tasks interrupt you or you are called upon during that break, the time remains compensable. Any automatic deduction that captures such work is improper.¹
Missing overtime premium for hours beyond 40: Your pay stub should clearly show the overtime rate for each overtime hour worked in a workweek. If your total pay divided by total hours does not reflect a premium for those over 40, investigate further.

Calculating Your True Overtime Rate

The FLSA defines the "regular rate" as all remuneration divided by hours worked. That includes your base hourly rate plus shift differentials, holiday pay, on-call pay, and non-discretionary bonuses. Overtime is then 1.5 times that regular rate.

Consider an NP working a 50-hour week at a base of $65 per hour. If she works two 12-hour weekend shifts with a $5 differential, her regular rate calculation must include that extra pay. Suppose her total earnings for the week are: 50 hours × $65 = $3,250 plus 24 weekend hours × $5 = $120, for a total of $3,370. The regular rate becomes $67.40 per hour ($3,370 ÷ 50). Her overtime premium for the 10 hours over 40 would be an additional $33.70 per hour, not just the base $32.50. Missing that extra differential adds up fast, often resulting in hundreds of underpaid dollars each month.

Protect Yourself: Compare and Document

Request or download your timekeeping records, including clock-in and clock-out timestamps, every pay period. Compare those raw hours to what appears on your pay stub. Look for off-the-clock work: common examples include logging into electronic health records before shift start, attending quick huddles, or finishing notes after a shift ends. If you spot discrepancies, keep a personal log with dates, times, and brief descriptions. This contemporaneous record is powerful evidence if you need to raise a concern or join a collective action.² A small deviation each day may seem trivial, but over a year, it represents significant lost wages.

Questions to Ask Yourself

Does your paycheck amount change from week to week based on the number of hours you worked?

A consistent salary is a hallmark of exempt status. If your pay fluctuates with hours, you may actually be an hourly employee entitled to overtime wages under the FLSA.

Are you ever docked for leaving early or arriving late?

Deductions for partial-day absences are generally reserved for non-exempt staff. If your employer docks your pay for short absences, you likely qualify for overtime protections.

Do you receive shift differentials, holiday pay, or on-call payments that are not included in an overtime rate?

These extras must be added to your regular rate when computing overtime. If they're missing, your employer may be underpaying you for overtime hours worked.

The Cost of Misclassification: NP & PA Salary With and Without Overtime

When nurse practitioners are misclassified as exempt from overtime, they lose out on significant additional compensation for hours worked beyond 40 per week. The chart below shows the typical annual base salary, but does not include the overtime wages that may be owed.

Nurse practitioners mean annual wage of $132,000 in 2024, not including unpaid overtime.

State-By-State Overtime Rules for NPs and PAs

Colorado stands out with a daily overtime rule: after 12 hours in a day or 12 consecutive hours, regardless of the 40-hour week.¹ In contrast, most states rely on the federal FLSA standard. Texas, for example, has no separate state overtime statute and defaults to the 40-hour weekly rule.² Florida similarly follows the federal framework.³ Nevada offers a middle ground: overtime kicks in after 40 hours in a workweek or 8 hours in a workday for employees earning less than 1.5 times the minimum wage.¹ While state overtime laws can offer stronger protections than the FLSA, they only apply to non-exempt employees. For nurse practitioners and physician assistants, who are often classified as exempt learned professionals, a misclassification dispute can suddenly make these state rules relevant. An NP or PA paid hourly or with variable weekly pay may, upon reclassification, gain the protections of whichever state they work in. Understanding these state-by-state differences can help providers evaluate their own employment situations.

What Compensation Can You Expect From an Overtime Lawsuit?

If you were misclassified and denied overtime, the Fair Labor Standards Act (FLSA) provides a clear framework for recovering what you are owed.¹ The two main components are back pay and liquidated damages, which together can significantly increase your recovery.

Components of FLSA Damages

Back pay covers all unpaid overtime wages for the time you were misclassified. Liquidated damages are an additional amount equal to your back pay, essentially doubling the recovery. Courts award liquidated damages automatically unless the employer can prove they acted in good faith and had reasonable grounds to believe their classification was correct, a difficult standard to meet. Your employer may also be required to pay your attorney fees and court costs.² The FLSA has a statute of limitations of two years from the date of the violation, extended to three years if the employer's violation was willful.¹

A Concrete Example: Calculating Potential Owed Wages

Imagine a nurse practitioner earning a base salary of $120,000 per year. That breaks down to roughly $57.69 per hour for a standard 40-hour week. If this NP regularly worked five unpaid overtime hours each week, the weekly overtime pay owed would be about $432.70 (5 hours at $86.54, the 1.5x rate). Over one year, that's roughly $22,500 in back pay, with an equal amount in liquidated damages, totaling around $45,000 for just one year. For claims spanning three years, the figures can climb much higher.

What Settlements Look Like in Practice

Real-world healthcare overtime cases show a wide range of outcomes. In a 2025 Department of Labor action against North Central Health Care, 68 employees recovered an average of about $1,195 each in back pay, plus equal liquidated damages.³ A larger case involving TriMED HealthCare resulted in $3.8 million in total damages for 433 workers, averaging nearly $8,800 per person.⁴ Analysts tracking nursing overtime lawsuits note that the typical individual recovery across multiple settlements falls around $3,744.⁵ These numbers illustrate that while some workers recover substantial sums, your own outcome depends heavily on your specific hours, pay rate, and the length of the violation period.

The Importance of Legal Guidance

Each claim is fact-specific, and estimating damages without a full review of your records can be misleading. An experienced employment attorney can evaluate your situation, calculate potential back pay and liquidated damages, and advise you on the strongest legal strategy. Because settlements often cover a defined class period, early contact with counsel may help ensure your claim is included and maximized.

How to Take Action: Joining the Lawsuit and Protecting Your Rights

You have a clear path to recovering unpaid overtime, and the law protects you every step of the way. Instead of sitting on the sidelines, you can take concrete actions now to protect your rights through nurse practitioner advocacy and potentially join the HCA lawsuit.

Gather Your Evidence First

Start by collecting documents that show your work hours and pay structure. This includes pay stubs, time records, personal time logs, and any emails about compensation or classification.² If your employer didn’t keep accurate records, you can still prove overtime through a “reasonable inference” from your own notes and testimony.² Organize these records by pay period to make calculating your unpaid overtime easier.

Reach Out to the Attorneys Investigating HCA

For NPs and PAs who worked at HCA Healthcare in the past three years, attorneys at Berger Montague are actively investigating potential FLSA violations. You can submit your information through ClassAction.org to be contacted about joining the case. This step does not commit you to anything, but it starts the conversation while your claim is still timely.

Know Your Deadlines and Defend Against Retaliation

Under the FLSA, the standard statute of limitations is two years, but it extends to three years if the employer’s violation was willful.² In Pennsylvania and many other states, these federal deadlines apply. Even more important, the FLSA explicitly prohibits retaliation. Your employer cannot legally fire, demote, reduce your hours, change your shift, or harass you for asking about overtime, filing an internal complaint, contacting an attorney, or joining a lawsuit.³ If retaliation happens, you can sue for lost wages and reinstatement. A recent Fifth Circuit case, Belt v. EmCare, confirmed that hospital-based NPs and PAs are entitled to overtime when misclassified¹, and courts have upheld strong anti-retaliation protections for healthcare workers who speak up.

Frequently Asked Questions About NP and PA Overtime Rights

Understanding your overtime rights is essential for nurse practitioners and physician assistants, especially in light of the HCA Healthcare lawsuit. Below are answers to the most common questions about exemption status, wage calculations, and your legal protections.

Am I exempt from overtime if I'm a salaried NP at HCA?: Not automatically. Under the FLSA, exemption requires a salary of at least $684 per week¹ and meeting a duties test. If your pay varies week to week based on hours worked, as alleged in the HCA suit, you may actually be considered hourly and non-exempt, regardless of a “salaried” label, and a federal court has ruled that NPs are entitled to overtime pay a federal court ruling that NPs are entitled to overtime.
How is overtime calculated when I work variable hours?: Overtime is one and a half times your “regular rate,” which must include base pay plus shift differentials, holiday pay, and other extra wages. When hours change weekly, your regular rate can fluctuate. Employers must accurately recalculate it each workweek for all overtime hours.
What evidence do I need to file a wage claim as a nurse practitioner?: Collect pay stubs, time sheets, schedules, and any written communication about your pay. If you believe you were misclassified, document the exact hours you worked and the pay you received, highlighting any variations that suggest hourly pay rather than a true fixed salary.
Can I join the HCA overtime lawsuit if I no longer work there?: Yes. Former employees who worked for HCA Healthcare within the past three years and were subject to the alleged overtime practices may still be eligible. The attorneys in the case are actively seeking to speak with both current and former NPs and PAs.
What compensation can I expect from an overtime lawsuit?: If the lawsuit succeeds, you could recover unpaid overtime wages, possibly doubled as liquidated damages under the FLSA, plus attorneys' fees. The exact amount depends on the number of uncompensated overtime hours you worked during the relevant period.
What is the difference between exempt and non-exempt under the FLSA?: Exempt employees receive a fixed salary without regard to hours worked and satisfy a duties test; they are not entitled to overtime. Non-exempt employees must be paid overtime for hours beyond 40 in a workweek. A title like “salaried” does not control: if your pay is reduced for absences or fluctuates with hours, you may be non-exempt.
Can my employer retaliate if I join the lawsuit or ask about overtime pay?: No. The FLSA strictly prohibits retaliation. An employer cannot fire, demote, or penalize you for asserting your overtime rights, asking questions about your pay classification, or joining a wage lawsuit. Retaliation can lead to additional legal claims against the employer.