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Whistleblower Regulations under the ACA

Whistleblower Regulations under the ACA

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Published by Michael Pancier
Whistleblower Regulations Under the Affordable Care Act
Whistleblower Regulations Under the Affordable Care Act

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Published by: Michael Pancier on Feb 25, 2013
Copyright:Attribution Non-commercial


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Affordable Care Act 
(ACA) contains variousprovisions to make health insurance moreaordable and accountable to consumers. Tourther these goals, the
Affordable Care Act’s 
 section 1558 provides protection to employeesagainst retaliation by an employer or reportingalleged violations o Title I o the Act or or receivinga health insurance tax credit or cost sharingreductions as a result o participating in a HealthInsurance Exchange, or Marketplace.Title I includes a range o insurance companyaccountability requirements, such as theprohibition o lietime limits on coverage orexclusions due to pre-existing conditions. Title Ialso includes requirements or certain employers.Many o the provisions in Title I are not eectiveuntil 2014.
Covered Employers and Employees
The defnitions “employer” and “employee” underthis whistleblower provision are ound in the
Fair Labor Standards Act.
Thereore, this provisionprohibits retaliation by private and public sectoremployers.
Protected Activity
An employer may not discharge or in any mannerretaliate against an employee because he or she:
o Title I o the ACA, or any act that he or shereasonably believed to be a violation o Title I o the ACA to:
the employer,
the Federal Government, or
the attorney general o a state;
concerning a violation o Title I o the ACA, or isabout to do so; or
Filing Whistleblower Complaints underthe
Affordable Care Act 
Employees are protected rom retaliation or reporting alleged violations o Title I othe
Affordable Care Act.
Employees are also protected rom retaliation or receiving aederal health insurance income tax credit or a cost sharing reduction when enrollingin a qualifed health plan.
activity that he or she reasonably believed to bein violation o Title I o the ACA.In addition, an employer may not discharge or inany manner retaliate against an employee becausehe or she received a credit under section 36B o theInternal Revenue Code o 1986 or a cost sharingreduction under section 1402 o the ACA.I an employer takes retaliatory action against anemployee because he or she engaged in any o these protected activities, the employee can fle acomplaint with OSHA.
Unavorable Employment Actions
An employer may be ound to have violated theACA i the employee’s protected activity was acontributing actor in the employer’s decision totake unavorable employment action against theemployee. Such actions may include:
•Firingorlayingoff •Blacklisting•Demoting•Denyingovertimeorpromotion•Disciplining•Denyingbenets•Failuretohireorrehire•Intimidation•Makingthreats•Reassignmentaffectingprospectsforpromotion•Reducingpayorhours
Deadline or Filing Complaints
Complaints must be fled within 180 days ater analleged violation o the ACA occurs. An employee,or representative o an employee, who believes thathe or she has been retaliated against in violation o the ACA may fle a complaint with OSHA.

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