Agencies Release of 3rd Surprise Billing Reminder Time Short For Health Plans To Prepare For 2022 Compliance Deadline; Learn More in 10/17 Briefing

September 30, 2021

Yesterday’s release by the Departments of Labor, Health and Human Services, Treasury and the Office of Personnel Management (“Agencies”) release yesterday (September 30, 2021) an a third interim final rule (“3rd Rule”) implementing requirements applicable to health plans and health care providers enacted under the No Surprises Act (the “Act) warns health plans, their employer and other sponsors, insurers, fiduciaries and service providers time is running out to update their plans, contracts and practices to prepare to meet comply with the Act when its rules take effect in 2022.

The release of the 3rd Rule yesterday follows the Agencies’ issuance of an interim final rule on consumer protections against surprise billing (“1st Rule”) in July and a proposed rule to help collect data on the air ambulance provider industry (“2nd Rule”) earlier in September, both of which take effect on January 1, 2022.The rules implement the Act’s ban on surprise billing for emergency services and ancillary care at in-network facilities, and limit high out-of-network cost sharing for emergency and non-emergency services by prohibiting them from being higher than if such services were provided in-network. In addition to the Act’s requirements implemented by these three rule packages, health plans and health providers also need to begin preparing to comply with new rules regarding prescription drug coverages and various other requirements of the Act, as well as a plethora of regulatory and market changes impacting health plans and their administration that have emerged over the past year.

Solutions Law Press, Inc. is hosting a complimentary briefing by Cynthia Marcotte Stamer on key requirements of the Act expected to impact health plans and their administration on Monday, October 18, 2021 from 11:30 a.m. to 1:00 p.m. Central Time. Registration is limited. Persons interested in attending should e-mail here to request registration as soon as possible.

Act’s Surprise Billing Ban

The Act seeks to protect patients from surprise bills and remove them from the middle of payment disputes between out-of-network providers, facilities, or providers of air ambulance services and health plans or issuers.

The Act seeks to protect patients from surprise bills and remove them from the middle of payment disputes between out-of-network providers, facilities, or providers of air ambulance services and health plans or issuers.

The 1st Rule published on July 1, 2021 states that, beginning in 2022, patients will only be required to pay cost sharing based on in-network rates for certain out-of-network emergency services, out-of-network non-emergency services at in-network facilities and out-of-network air ambulance services.

The 3rd Rule builds on this work and details how the total payment to an out-of-network provider or facility will be determined. In some cases – based on the law – state law or application of a state All-Payer Model Agreement will determine this amount. Where neither applies, the rule sets forth the federal process that will apply for determining the amount. When a payment dispute for items/services that fall under surprise billing protections occur, either a provider, facility, or air ambulance provider or plan/issuer may initiate a 30-day open negotiation period. If open negotiation fails, either party may initiate the federal independent dispute resolution process. This rule details how this process initiates, what is eligible for this process and how independent dispute resolution entities should consider factors when determining a payment amount.

Self Pay Patient’s Good Faith Estimate Requirements

In added consumer protections, today’s 3rd Rule also outlines key requirements related to uninsured (or self-pay) individuals. Self-pay individuals are individuals who have coverage but do not choose to have their care billed to their health plan or issuer. When individuals schedule an item or service with certain providers and facilities, those providers and facilities will be required to inquire about the individual’s health coverage status, and if the individual wants their care billed to their health plan or issuer.

The provider or facility must provide a good faith estimate of expected charges for the care they are scheduling for individuals deemed uninsured (or self-pay). An uninsured (or self-pay) individual may also request a good faith estimate, without scheduling an item or services. The rule also establishes a process for uninsured (or self-pay) individuals to initiate a payment dispute resolution process if they are ultimately billed substantially in excess of the good faith estimate they received.

Time Running Short To Complete Compliance Preparations

The Act’s restrictions on balance billing of out of network and self pay services, along with new rules regarding prescription drug coverage and various other health benefit rules are scheduled to take effect under the Act beginning in January, 2022 as well as a host of other statutory, regulatory and market changes impacting health benefit programs for the upcoming year. Aside from the complexities of meeting the direct requirements of the rules, health plans and their sponsors, fiduciaries, administrators and advisors working to update their plans also will need to determine and decide how to respond to state law regulatory surprise billing and other price transparency and balance billing rules that the Act and its implementing regulations incorporate. Employer and other health plan sponsors, health plan fiduciaries and their service providers need to confirm the necessary arrangement are prepared in a timely fashion to ensure their health plans are designed and administered to comply with these requirements. In addition to updating plan documents, contracts, and processes, health plans, their sponsors, fiduciaries, administrative service providers and others likely need to review budget forecasts, stop loss and other insurance, participant and provider communications, systems, and a host of other operating features of their programs. Given the emerging nature of the guidance, meeting current deadlines are likely to prove challenging. Accordingly health plan sponsors, administrators, fiduciaries, insurers, and advisors should move quickly to begin preparations.

More Information

We hope this update is helpful. For more information about the these or other health or other legal, management or public policy developments, please contact the author Cynthia Marcotte Stamer via e-mail or via telephone at (214) 452 -8297.  

Solutions Law Press, Inc. invites you receive future updates by registering on our Solutions Law Press, Inc. Website and participating and contributing to the discussions in our Solutions Law Press, Inc. LinkedIn SLP Health Care Risk Management & Operations GroupHR & Benefits Update Compliance Group, and/or Coalition for Responsible Health Care Policy.  

About the Author

Recognized by her peers as a Martindale-Hubble “AV-Preeminent” (Top 1%) and “Top Rated Lawyer” with special recognition LexisNexis® Martindale-Hubbell® as “LEGAL LEADER™ Texas Top Rated Lawyer” in Health Care Law and Labor and Employment Law; as among the “Best Lawyers In Dallas” for her work in the fields of “Labor & Employment,” “Tax: ERISA & Employee Benefits,” “Health Care” and “Business and Commercial Law” by D Magazine, Cynthia Marcotte Stamer is a practicing attorney board certified in labor and employment law by the Texas Board of Legal Specialization and management consultant, author, public policy advocate and lecturer widely known for 30+ years of health industry and other management work, public policy leadership and advocacy, coaching, teachings, and publications. As a significant part of her work, Ms. Stamer has worked extensively on pandemic, business and other crisis planning, preparedness and response for more than 30 years.

Scribe for the ABA JCEB Annual Agency Meeting with HHS-OCR, Vice Chair of the ABA International Section Life Sciences Committee, past Chair of the ABA Health Law Section Managed Care & Insurance Interest Group and the ABA RPTE Employee Benefits & Other Compensation Group, Ms. Stamer is most widely recognized for her decades of pragmatic, leading edge work, scholarship and thought leadership on health and other privacy and data security and other health industry legal, public policy and operational concerns.  Ms. Stamer’s work throughout her 30 plus year career has focused heavily on working with health care and managed care, health and other employee benefit plan, insurance and financial services and other public and private organizations and their technology, data, and other service providers and advisors domestically and internationally with legal and operational compliance and risk management, performance and workforce management, regulatory and public policy and other legal and operational concerns.  As a part of this work, she has continuously and extensively worked with domestic and international health plans, their sponsors, fiduciaries, administrators, and insurers; managed care and insurance organizations; hospitals, health care systems, clinics, skilled nursing, long term care, rehabilitation and other health care providers and facilities; medical staff, accreditation, peer review and quality committees and organizations; billing, utilization management, management services organizations, group purchasing organizations; pharmaceutical, pharmacy, and prescription benefit management and organizations; consultants; investors; EHR, claims, payroll and other technology, billing and reimbursement and other services and product vendors; products and solutions consultants and developers; investors; managed care organizations, self-insured health and other employee benefit plans, their sponsors, fiduciaries, administrators and service providers, insurers and other payers, health industry advocacy and other service providers and groups and other health and managed care industry clients as well as federal and state legislative, regulatory, investigatory and enforcement bodies and agencies.  

This  involvement encompasses helping health care systems and organizations, group and individual health care providers, health plans and insurers, health IT, life sciences and other health industry clients prevent, investigate, manage and resolve  sexual assault, abuse, harassment and other organizational, provider and employee misconduct and other performance and behavior; manage Section 1557, Civil Rights Act and other discrimination and accommodation, and other regulatory, contractual and other compliance; vendors and suppliers; contracting and other terms of participation, medical billing, reimbursement, claims administration and coordination, Medicare, Medicaid, CHIP, Medicare/Medicaid Advantage, ERISA and other payers and other provider-payer relations, contracting, compliance and enforcement; Form 990 and other nonprofit and tax-exemption; fundraising, investors, joint venture, and other business partners; quality and other performance measurement, management, discipline and reporting; physician and other workforce recruiting, performance management, peer review and other investigations and discipline, wage and hour, payroll, gain-sharing and other pay-for performance and other compensation, training, outsourcing and other human resources and workforce matters; board, medical staff and other governance; strategic planning, process and quality improvement; meaningful use, EHR, HIPAA and other technology,  data security and breach and other health IT and data; STARK, ant kickback, insurance, and other fraud prevention, investigation, defense and enforcement; audits, investigations, and enforcement actions; trade secrets and other intellectual property; crisis preparedness and response; internal, government and third-party licensure, credentialing, accreditation, HCQIA and other peer review and quality reporting, audits, investigations, enforcement and defense; patient relations and care;  internal controls and regulatory compliance; payer-provider, provider-provider, vendor, patient, governmental and community relations; facilities, practice, products and other sales, mergers, acquisitions and other business and commercial transactions; government procurement and contracting; grants; tax-exemption and not-for-profit; privacy and data security; training; risk and change management; regulatory affairs and public policy; process, product and service improvement, development and innovation, and other legal and operational compliance and risk management, government and regulatory affairs and operations concerns. to establish, administer and defend workforce and staffing, quality, and other compliance, risk management and operational practices, policies and actions; comply with requirements; investigate and respond to Board of Medicine, Health, Nursing, Pharmacy, Chiropractic, and other licensing agencies, Department of Aging & Disability, FDA, Drug Enforcement Agency, OCR Privacy and Civil Rights, Department of Labor, IRS, HHS, DOD, FTC, SEC, CDC and other public health, Department of Justice and state attorneys’ general and other federal and state agencies; JCHO and other accreditation and quality organizations; private litigation and other federal and state health care industry actions: regulatory and public policy advocacy; training and discipline; enforcement;  and other strategic and operational concerns.  

Author of “Privacy and the Pandemic Workshop” for the Association of State and Territorial Health Plans, as well as a multitude of other health industry matters, workforce and health care change and crisis management and other highly regarded publications and presentations, the American Bar Association (ABA) International Section Life Sciences Committee Vice Chair, a Scribe for the ABA Joint Committee on Employee Benefits (JCEB) Annual OCR Agency Meeting and a former Council Representative, Past Chair of the ABA Managed Care & Insurance Interest Group, former Vice President and Executive Director of the North Texas Health Care Compliance Professionals Association, past Board President of Richardson Development Center (now Warren Center) for Children Early Childhood Intervention Agency, past North Texas United Way Long Range Planning Committee Member, and past Board Member and Compliance Chair of the National Kidney Foundation of North Texas, and a Fellow in the American College of Employee Benefit Counsel, the American Bar Foundation and the Texas Bar Foundation, Ms. Stamer also shares her extensive publications and thought leadership as well as leadership involvement in a broad range of other professional and civic organizations. For more information about Ms. Stamer or her health industry and other experience and involvements, see www.cynthiastamer.com or contact Ms. Stamer via telephone at (214) 452-8297 or via e-mail here.  

About Solutions Law Press, Inc.™

Solutions Law Press, Inc.™ provides human resources and employee benefit and other business risk management, legal compliance, management effectiveness and other coaching, tools and other resources, training and education on leadership, governance, human resources, employee benefits, data security and privacy, insurance, health care and other key compliance, risk management, internal controls and operational concerns. If you find this of interest, you also be interested reviewing some of our other Solutions Law Press, Inc.™ resources available here.  

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If you or someone else you know would like to receive future updates about developments on these and other concerns, please be sure that we have your current contact information including your preferred e-mail by creating your profile here.

NOTICE:   These statements and materials are for general informational and purposes only. They do not establish an attorney-client relationship, are not legal advice or an offer or commitment to provide legal advice, and do not serve as a substitute for legal advice. Readers are urged to engage competent legal counsel for consultation and representation in light of the specific facts and circumstances presented in their unique circumstance at any particular time. No comment or statement in this publication is to be construed as legal advice or an admission. The author and Solutions Law Press, Inc.™ reserve the right to qualify or retract any of these statements at any time. Likewise, the content is not tailored to any particular situation and does not necessarily address all relevant issues. Because the law is rapidly evolving and rapidly evolving rules makes it highly likely that subsequent developments could impact the currency and completeness of this discussion. The author and Solutions Law Press, Inc.™ disclaim, and have no responsibility to provide any update or otherwise notify anyone any such change, limitation, or other condition that might affect the suitability of reliance upon these materials or information otherwise conveyed in connection with this program. Readers may not rely upon, are solely responsible for, and assume the risk and all liabilities resulting from their use of this publication.  Readers acknowledge and agree to the conditions of this Notice as a condition of their access of this publication.  Circular 230 Compliance. The following disclaimer is included to ensure that we comply with U.S. Treasury Department Regulations. Any statements contained herein are not intended or written by the writer to be used, and nothing contained herein can be used by you or any other person, for the purpose of (1) avoiding penalties that may be imposed under federal tax law, or (2) promoting, marketing or recommending to another party any tax-related transaction or matter addressed herein.

©2021 Cynthia Marcotte Stamer. Limited non-exclusive right to republish granted to Solutions Law Press, Inc.™.


Group Health Plan Section 111 Medicare Secondary Payer (MSP) Records To Accept Future Effective Date

September 27, 2021

An impending change in the Medicare Secondary Payer (”MSP”) recordkeeping system could slightly lighten group health plan reporting burdens.

Effective October 4, 2021, Section 111 record submissions will accept effective dates up to three months in the future for Group Health Plan (GHP) claims. Because Medicare entitlement records may have effective dates up to three months in the future, CMS is updating the COB&R systems to accept these future MSP effective dates.

When a S111 GHP record is submitted and the Medicare Beneficiary’s entitlement is in the future (up to 3 months) and there are no errors, the system will now create an MSP record with a future MSP Effective Date. For S111 GHP records, a future MSP Effective Date (up to 3 months) will be accepted for beneficiaries with both current and future entitlement start dates (i.e., for prospective enrollments).

For example, if a Responsible Reporting Entity submits an MSP record on 10/05/2021 and the beneficiary’s Medicare entitlement date is 01/01/2022, the Benefits Coordination and Recovery Center (BCRC) will now accept the Medicare entitlement date of 01/01/2022 as the MSP effective date.

Some health plans might find these new rules alleviate some of the burden of their reporting now or as part of an upcoming system upgrade.

More Information

This article is republished by permission of the author, Cynthia Marcotte Stamer.  To review the original work, see here.

Solutions Law Press, Inc. invites you to receive future updates by registering here and participating and contributing to the discussions in our Solutions Law Press, Inc. LinkedIn SLP Health Care Risk Management & Operations GroupHR & Benefits Update Compliance Group, and/or Coalition for Responsible Health Care Policy. If you or someone else you know would like to receive future updates about developments on these and other concerns, please be sure that we have your current contact information including your preferred e-mail by creating your profile here. For specific information about the these or other legal, management or public policy developments, please contact the author Cynthia Marcotte Stamer via e-mail or via telephone at (214) 452 -8297.

About the Author

Recognized by her peers as a Martindale-Hubble “AV-Preeminent” (Top 1%) and “Top Rated Lawyer” with special recognition LexisNexis® Martindale-Hubbell® as “LEGAL LEADER™ Texas Top Rated Lawyer” in Health Care Law and Labor and Employment Law; as among the “Best Lawyers In Dallas” for her work in the fields of “Labor & Employment,” “Tax: ERISA & Employee Benefits,” “Health Care” and “Business and Commercial Law” by D Magazine, Cynthia Marcotte Stamer is a practicing attorney board certified in labor and employment law by the Texas Board of Legal Specialization and management consultant, author, public policy advocate and lecturer widely known for 30+ years working as an on demand, special project, consulting, general counsel or other basis with domestic and international business, charitable, community and government organizations of all types, sizes and industries and their leaders on labor and employment and other workforce compliance, performance management, internal controls and governance, compensation and benefits, regulatory compliance, investigations and audits, change management and restructuring, disaster preparedness and response and other operational, risk management and tactical concerns.

Widely recognized for her work with health plan, managed care and other heath insurance, health care and life sciences health and other data and technology and related matters, organizations, she has worked extensively with other employer, employee benefits, insurance, trade and other association, financial, transportation, manufacturing, energy, real estate, accounting and other services, public and private academic and other education, hospitality, charitable, civic and other business, government and community organizations. and their leaders, on health and managed care and other employee benefits, related program design, documentation, contracting, insurance, administration, technology, compliance and internal controls, investigations and defense, regulatory and public policy and related matters. Ms. Stamer also has extensive experience published and spoken extensively on these and other human resources, employee benefits, compensation, worker classification and other workforce and other services; insurance; health care; workers’ compensation and occupational disease; business reengineering, disaster and distress; and many other performance, risk management, compliance, public policy and regulatory affairs, and other operational concerns. 

A former lead advisor to the Government of Bolivia on its pension  project, Ms. Stamer also has worked internationally and domestically as an advisor to business, community and government leaders on these and other legislative, regulatory and other legislative and regulatory design, drafting, interpretation and enforcement, as well as regularly advises and represents organizations on the design, administration and defense of workforce, employee benefit and compensation, safety, discipline, reengineering, regulatory and operational compliance and other management practices and actions.

Ms. Stamer also serves in leadership of a broad range of professional and civic organizations and provides insights and thought leadership through her extensive publications, public speaking and volunteer service with a diverse range of organizations including as Chair of the American Bar Association (“ABA”) Intellectual Property Section Law Practice Management Committee, Vice Chair of the International Section Life Sciences and Health Committee, Past ABA RPTE Employee Benefits & Other Compensation Group Chair and Council Representative and current Welfare Benefit Committee Co-Chair, Past Chair of the ABA Managed Care & Insurance Interest Group, past Region IV Chair and national Society of Human Resources Management Consultant Forum Board Member,  past Texas Association of Business BACPAC Chair, Regional Chair and Dallas Chapter Chair, former Vice President and Executive Director of the North Texas Health Care Compliance Professionals Association, past Board President of Richardson Development Center (now Warren Center) for Children Early Childhood Intervention Agency, past North Texas United Way Long Range Planning Committee Member, past Board Member and Compliance Chair of the National Kidney Foundation of North Texas, a Fellow in the American College of Employee Benefit Counsel, the American Bar Foundation and the Texas Bar Foundation and many others.

For more information about these concerns or Ms. Stamer’s work, experience, involvements, other publications, or programs, see www.cynthiastamer.com,  on  Facebook, on LinkedIn or Twitter or e-mail here.

About Solutions Law Press, Inc.™

Solutions Law Press, Inc.™ provides human resources and employee benefit and other business risk management, legal compliance, management effectiveness and other coaching, tools and other resources, training and education on leadership, governance, human resources, employee benefits, data security and privacy, insurance, health care and other key compliance, risk management, internal controls and operational concerns.

©2021 Cynthia Marcotte Stamer. Non-exclusive right to republish granted to Solutions Law Press, Inc.™


DOL Delay Of Planned Replacement Of Trump-Era FLSA Joint Employer Rule Good For Employers

September 20, 2021

No business wants to get hit with a bill or judgement for unpaid overtime or other wages and penalties under the Fair Labor Standards Act (“FLSA”). It’s even worse when the back pay and fines are for work performed by employees of another business that didn’t pay.

Today’s U.S. Department of Labor (“DOL”) announcement putting on hold for now its previously announced plan to replace the Trump-era “Joint Employer Status Under the Fair Labor Standards Act” final rule (“Joint Employer Rule”) with a much less business friendly rule is good for business.

Joint Employer Liability

Under the minimum wage and overtime rules of the Fair Labor Standards Act (“FLSA”), an employee can have more than one employer for the work they perform. Joint employment applies when – for the purposes of minimum wage and overtime requirements – the DOJ considers two separate companies to be a worker’s employer for the same work. When this happens, hours of work performed for any business considered within the joint employer group are aggregated for purposes of determining when overtime is worked and each business is jointly and severally liable for any unpaid minimum wage and overtime do regardless of whether those hours of work was performed for that particular business. The Joint Employer Rule governs when that can happen.

While both DOL and private litigants long have used the joint employer rules and precedent to nail businesses for other employer’s wage and hour liability, the Trump Administration adopted the Joint Employer Rule to overrule Obama Administration practices for interpreting and enforcing the rule that replaced the historically applied judicial tests with standards that significantly increase the likelihood of joint employer liability by unrelated businesses.

Historically, joint employer determinations were reached by applying highly subjective, fact specific analysis heavily reliant upon decades of court decisions which required some evidence that the alleged joint employer possessed or exercised some control over the employees to support the finding of joint employment. Under these historical tests, mere benefit from work performed by individuals employed by another employer did not establish a presumption, much less proof of joint employment.

As part of the Obama Administration’s pro-worker agenda, however, DOL made up and began applying new standards without formally issuing new regulations adopted interpretive and enforcement guidelines for finding joint employer status that that significantly broadened the employment relationships that the DOL treated as joint employers in a manner that presumed the existence of a joint employment relationship whenever the alleged joint employer benefitted from the performance of work. Contrary to decades of judicial precedent, these new standards asserted joint employer liability when the facts showed little or any evidence that the alleged joint employer possessed or exercised any control over the employee or the details of his work. A host of businesses were surprised to be nailed by DOL with wage and hour backpay orders and penalties arising from work performed by subcontractors, contractors, and other businesses including overtime liability attributable to work performed for the benefit of other businesses with no connection to the sanctioned business.

The Trump Administration adopted the Joint Employer Rule provide regulations to overrule the practices implemented during the Obama Administration By clarifying and regulation want it perceive to be the historical tests of joint employment established In decades of judicial precedent.

As finalized in January, 2020, the Joint Employer Rule uses a balancing test to the considers the following factors to determine whether a business sufficiently directly or indirectly controls a employee of another business to be liable as a joint employer:

  • hires or fires the employee;
  • supervises and controls the employee’s work schedule or conditions of employment to a substantial degree;
  • determines the employee’s rate and method of payment; and
  • maintains the employee’s employment records.

Not surprisingly, President Biden announced plans to reinstitute the pro-labor joint employment standards created and applied during the Obama Administration by issuing a new regulation that would have rescinded and replaced the Joint Employer Rule.

The U.S. District Court for the Southern District of New York stymied Biden‘s efforts by ruling his regulation defined joint employment contrary to statutory language and Congressional intent. and failed to take into account the department’s prior joint employment guidance. Accordingly, the court forced the Biden administration to reconsider by vacating Biden’s regulation. A strong joint employer standard is critical because FLSA responsibilities and liability for worker protections do not apply to a business that does not meet the definition of employer.

As the court’s ruling invalidated the regulation that would have withdrawn it, the Joint Employer Rule as adopted during the Trump Administration will take effect October 5, 2021.

Protect Your Business

The Joint Employer Rule mitigates but doesn’t eliminate joint employer liability risks under the FLSA. Accordingly, despite today’s announcement confirming the Joint Employer Rule will go into effect at least temporarily, businesses should use care to mitigate their exposure to joint employer liability.

First, employers should keep in mind the Biden Administration is not giving up. The announcement by the DOL today makes clear that the Biden Administration plans to take another stab at overturning the Joint Employer Rule when it states “Until the effective date of the rescission of the Joint Employer Rule, part 791 of Title 29 of the Code of Federal Regulations remains in effect.” (emphasis added). Accordingly even as businesses enjoy this reprieve, they must stay vigilant for the almost certainty more efforts to rescind or weaken the Joint Employer Rule, enforce joint employment inconsistently with the Joint Employer Rule like the Obama Administration or both.

Second, joint employment findings remain a real and significant risk for many businesses even under the Joint Employer Rule.

Joint employer determinations under the Joint Employer Rule continue to turn on highly subjective analysis of facts and circumstances that support joint employer findings in many circumstances surprising to many business owners,

For these reasons, virtually all businesses should critically evaluate their existing and prospective relationships for potential joint employer liability under the FLSA and respond as needed to mitigate risk both under the Joint Final Rule and under the standards the Biden Administration hopes to use.

As a further backstop to these risks, most businesses also will want to consider revising contracts and business practices to require companies providing services to give contractual guarantees of compliance, agreements to defend, indemnify and hold harmless for joint employer liability claims, and to provide records documenting compliance on an ongoing basis to mitigate or defend against liability should the DOL or a private litigant bring claims.

Before beginning these assessments, businesses and their leaders are encouraged to engage an attorney experienced in FLSA and other joint employer and other worker classification laws in light of the legally sensitive evidence and discussions inherently involved in this process.  Conducting this analysis within the scope of attorney-client privilege helps protector limit the discoverability of sensitive discussions and work product in the event of a Labor Department investigation or litigation.

For More Information

We hope this update is helpful. For more information about this or other labor and employment developments, please contact the author Cynthia Marcotte Stamer via e-mail or via telephone at (214) 452 -8297.

Solutions Law Press, Inc. invites you receive future updates by registering on our Solutions Law Press, Inc. Website and participating and contributing to the discussions in our Solutions Law Press, Inc. LinkedIn SLP Health Care Risk Management & Operations GroupHR & Benefits Update Compliance Group, and/or Coalition for Responsible Health Care Policy.

About the Author

Recognized by her peers as a Martindale-Hubble “AV-Preeminent” (Top 1%) and “Top Rated Lawyer” with special recognition LexisNexis® Martindale-Hubbell® as “LEGAL LEADER, Texas Top Rated Lawyer” in Law and Labor and Employment Law and Health Care; as among the “Best Lawyers In Dallas” for her work in the fields of “Labor & Employment,” “Tax: ERISA & Employee Benefits,” “Health Care” and “Business and Commercial Law” by D Magazine, and a Fellow in the American College of Employee Benefit Counsel, the American Bar Foundation and the Texas Bar Foundation, Cynthia Marcotte Stamer is a practicing attorney board certified in labor and employment law by the Texas Board of Legal Specialization and management consultant, author, public policy advocate and lecturer widely known for 30+ years of health industry and other management manage FLSA and other workforce, compliance, risk management, and other legal concerns as well as public policy leadership and advocacy, coaching, teachings, and publications.

As a part of this work she has continuously and extensively worked with domestic and international employer and other management, employee benefit and other clients to assess, manage and defend joint employer and other worker classifications and practices under the FLSA and other federal and state laws including both advising and and assisting employers to minimize joint employer and other FLSA liability and defending a multitude of employers against joint employer and other FLSA and other worker classification liability.

Author of hundreds of highly regarded books, articles and other publications, Ms. Stamer also is widely recognized for her scholarship, coaching, legislative and regulatory advocacy, leadership and mentorship on wage and hour, worker classification and a diverse range of other labor and employment, employee benefits, health and safety, education, performance management, privacy and data security, leadership and governance, and other management concerns within the American Bar Association (ABA), the International Information Security Association, the Southwest Benefits Association, and a variety of other international, national and local professional, business and civic organizations including highly regarded works on worker reclassification and joint employment liability under the FLSA and other laws published by the Bureau of National Affairs and others.

For more information about Ms. Stamer or her health industry and other experience and involvements, see www.cynthiastamer.com or contact Ms. Stamer via telephone at (214) 452-8297 or via e-mail here.

About Solutions Law Press, Inc.

Solutions Law Press, Inc. provides human resources and employee benefit and other business risk management, legal compliance, management effectiveness and other coaching, tools and other resources, training and education on leadership, governance, human resources, employee benefits, data security and privacy, insurance, health care and other key compliance, risk management, internal controls and operational concerns. If you find this of interest, you also be interested reviewing some of our other Solutions Law Press, Inc. resources

If you or someone else you know would like to receive future updates about developments on these and other concerns, please be sure that we have your current contact information including your preferred e-mail by creating your profile here.

NOTICE: These statements and materials are for general informational and purposes only. They do not establish an attorney-client relationship, are not legal advice or an offer or commitment to provide legal advice, and do not serve as a substitute for legal advice. Readers are urged to engage competent legal counsel for consultation and representation in light of the specific facts and circumstances presented in their unique circumstance at any particular time. No comment or statement in this publication is to be construed as legal advice or an admission. The author reserves the right to qualify or retract any of these statements at any time. Likewise, the content is not tailored to any particular situation and does not necessarily address all relevant issues. Because the law is rapidly evolving and rapidly evolving rules makes it highly likely that subsequent developments could impact the currency and completeness of this discussion. The author and Solutions Law Press, Inc. disclaim, and have no responsibility to provide any update or otherwise notify anyone any such change, limitation, or other condition that might affect the suitability of reliance upon these materials or information otherwise conveyed in connection with this program. Readers may not rely upon, are solely responsible for, and assume the risk and all liabilities resulting from their use of this publication.

Circular 230 Compliance. The following disclaimer is included to ensure that we comply with U.S. Treasury Department Regulations. Any statements contained herein are not intended or written by the writer to be used, and nothing contained herein can be used by you or any other person, for the purpose of (1) avoiding penalties that may be imposed under federal tax law, or (2) promoting, marketing or recommending to another party any tax-related transaction or matter addressed herein.

©2021Cynthia Marcotte Stamer. Non-exclusive right to republish granted to Solutions Law Press, Inc. For information about republication, please contact the author directly. All other rights reserved.


Beware Of & Manage Pension Funding Risk & Reporting Amid Economic Instability

September 15, 2021

With recent economic and other business disruptions causing insolvency or other business distress for many businesses, companies sponsoring or contributing to pension plans subject to the Pension Benefit Guarantee Corporation(“PBGC”) funding and insurance rules and those involved in their leadership, sale, liquidation or other resolution should use care to monitor these plans, their funding, and their funding obligations to avoid becoming subject to financial liabilities that typically result of these responsibilities are the mishandled.

As part of these safeguards, Section 4043 of ERISA requires that plan administrators notify PBGC of the occurrence of certain events that may present a risk to a plan sponsor’s ability to continue a pension plan. 

Reportable events likely to require a reportable event filing include the following events:

  • active participant reduction;
  • failure to make required funding payments; inability to pay benefits when due;
  • distribution to a substantial owner;
  • change in controlled group;
  • liquidation;
  • extraordinary dividend or stock redemption;
  • application for minimum funding waiver;
  • loan default;
  • insolvency or similar settlement;
  • large cumulative funding under payments; or
  • total under payments with interest in excess of $1 million. See 29 CFR Part 4043.

In most cases, reporting is due 30 days after the event occurs (i.e., “post-event” reporting). However, in certain cases involving nonpublic companies with large underfunding, advance notice of certain events must be given to PBGC. 29 CFR §4043.61.

Historically, reportable event filings could be made either in paper or since 2016, electronically. After September 30, 2021, PBGC requires all reportable event filings be prepared and submitted via the portal. Paper forms will remain on PBGC’s website for illustrative purposes only. The PBGC says the portal application is secure.

As funding or other violations of the of the funding, reporting and other rules l triggers significant penalties, businesses that sponsor or contribute to PBGC regulated pension plans, their plan administrators and fiduciaries, creditors, investors and trustees should use care to monitor plans for these events and ensure timely filings and other actions are taken minimize penalty and other liability risks.

More Information

In addition, businesses that are commonly controlled or affiliated, Investing in, by assets from, or involved in the resolution of businesses current or past participation in pension plan subject to the PBGC’s rules should carefully assess and manage their potential pension liability as the control group and lien rules create risks for these entities.

This article is republished by permission of the author, Cynthia Marcotte Stamer.  To review the original work, see here.

Solutions Law Press, Inc. invites you to receive future updates by registering here and participating and contributing to the discussions in our Solutions Law Press, Inc. LinkedIn SLP Health Care Risk Management & Operations GroupHR & Benefits Update Compliance Group, and/or Coalition for Responsible Health Care Policy. If you or someone else you know would like to receive future updates about developments on these and other concerns, please be sure that we have your current contact information including your preferred e-mail by creating your profile here. For specific information about the these or other legal, management or public policy developments, please contact the author Cynthia Marcotte Stamer via e-mail or via telephone at (214) 452 -8297.

About the Author

Recognized by her peers as a Martindale-Hubble “AV-Preeminent” (Top 1%) and “Top Rated Lawyer” with special recognition LexisNexis® Martindale-Hubbell® as “LEGAL LEADER™ Texas Top Rated Lawyer” in Health Care Law and Labor and Employment Law; as among the “Best Lawyers In Dallas” for her work in the fields of “Labor & Employment,” “Tax: ERISA & Employee Benefits,” “Health Care” and “Business and Commercial Law” by D Magazine, Cynthia Marcotte Stamer is a practicing attorney board certified in labor and employment law by the Texas Board of Legal Specialization and management consultant, author, public policy advocate and lecturer widely known for 30+ years working as an on demand, special project, consulting, general counsel or other basis with domestic and international business, charitable, community and government organizations of all types, sizes and industries and their leaders on labor and employment and other workforce compliance, performance management, internal controls and governance, compensation and benefits, regulatory compliance, investigations and audits, change management and restructuring, disaster preparedness and response and other operational, risk management and tactical concerns.

Widely recognized for her work with health plan, managed care and other heath insurance, health care and life sciences health and other data and technology and related matters, organizations, she has worked extensively with other employer, employee benefits, insurance, trade and other association, financial, transportation, manufacturing, energy, real estate, accounting and other services, public and private academic and other education, hospitality, charitable, civic and other business, government and community organizations. and their leaders, on health and managed care and other employee benefits, related program design, documentation, contracting, insurance, administration, technology, compliance and internal controls, investigations and defense, regulatory and public policy and related matters. Ms. Stamer also has extensive experience published and spoken extensively on these and other human resources, employee benefits, compensation, worker classification and other workforce and other services; insurance; health care; workers’ compensation and occupational disease; business reengineering, disaster and distress; and many other performance, risk management, compliance, public policy and regulatory affairs, and other operational concerns. 

A former lead advisor to the Government of Bolivia on its pension  project, Ms. Stamer also has worked internationally and domestically as an advisor to business, community and government leaders on these and other legislative, regulatory and other legislative and regulatory design, drafting, interpretation and enforcement, as well as regularly advises and represents organizations on the design, administration and defense of workforce, employee benefit and compensation, safety, discipline, reengineering, regulatory and operational compliance and other management practices and actions.

Ms. Stamer also serves in leadership of a broad range of professional and civic organizations and provides insights and thought leadership through her extensive publications, public speaking and volunteer service with a diverse range of organizations including as Chair of the American Bar Association (“ABA”) Intellectual Property Section Law Practice Management Committee, Vice Chair of the International Section Life Sciences and Health Committee, Past ABA RPTE Employee Benefits & Other Compensation Group Chair and Council Representative and current Welfare Benefit Committee Co-Chair, Past Chair of the ABA Managed Care & Insurance Interest Group, past Region IV Chair and national Society of Human Resources Management Consultant Forum Board Member,  past Texas Association of Business BACPAC Chair, Regional Chair and Dallas Chapter Chair, former Vice President and Executive Director of the North Texas Health Care Compliance Professionals Association, past Board President of Richardson Development Center (now Warren Center) for Children Early Childhood Intervention Agency, past North Texas United Way Long Range Planning Committee Member, past Board Member and Compliance Chair of the National Kidney Foundation of North Texas, a Fellow in the American College of Employee Benefit Counsel, the American Bar Foundation and the Texas Bar Foundation and many others.

For more information about these concerns or Ms. Stamer’s work, experience, involvements, other publications, or programs, see www.cynthiastamer.com,  on  Facebook, on LinkedIn or Twitter or e-mail here.

About Solutions Law Press, Inc.™

Solutions Law Press, Inc.™ provides human resources and employee benefit and other business risk management, legal compliance, management effectiveness and other coaching, tools and other resources, training and education on leadership, governance, human resources, employee benefits, data security and privacy, insurance, health care and other key compliance, risk management, internal controls and operational concerns.

©2021 Cynthia Marcotte Stamer. Non-exclusive right to republish granted to Solutions Law Press, Inc.™


Justice Department & Wisconsin Officials Warn Falsifying COVID Vaccination Records Is Federal Crime

September 13, 2021

Federal and Wisconsin officials warned buying or selling fake COVID-19 vaccination records is federal crime and cautioned citizens to protect their records from fraudulent use in a joint press release on Friday.

The warning followed President Biden‘s announcement last week of plans to implement COVID-19 vaccination mandates for healthcare workers, federal government contractors, employers with more than 100 employees and all federal employees. See Biden’s Impending Employer Vaccine Mandates: What Is Known Now.

In the joint press release, attorneys from the US Department of Justice and Wisconsin officials warned the public that any act of creating, distributing, selling, or buying of fake COVID-19 vaccination record cards and any act of forging COVID-19 vaccination information is illegal and punishable under federal law.

The unauthorized use of an official government agency’s seal, such as the Centers for Disease Control and Prevention (CDC), is a crime and may be punishable under federal law under Title 18 United States Code, Section 1017, and other applicable laws.

The press release also reminds Wisconsinites to not post vaccine cards on social media as the information could be stolen to commit fraud.

“If you have not been vaccinated, do not make your own cards or buy fake cards,” said Wisconsin Inspector General Anthony Baize. “If you were vaccinated and your card was not filled out correctly, do not fill in the card yourself. Instead, call your vaccine provider.”

“Public and private institutions, including employers, universities, schools, and businesses, need to be able to rely on the legitimacy of COVID-19 vaccine cards.  Our office will use all available tools to prosecute individuals who knowingly falsify vaccine cards,” said Acting U.S. Attorney Richard Frohling.

“Legitimate COVID-19 vaccine cards—like the vaccines themselves—are crucial tools to prevent illness and death.   People who are foolish or selfish (or both) enough to supply bogus vaccination cards, allowing others to circumvent COVID-19 curtailment efforts, will be prosecuted to the full extent of the law,” said Timothy M. O’Shea, Acting U.S. Attorney for the Western District of Wisconsin.

The press release also invites persons who know or suspect that any healthcare provider, pharmacy, private business, or Wisconsin resident is creating, distributing, selling, buying or forging COVID-19 vaccination cards in-person or online, to report such conduct to the Wisconsin Department of Health Services, Office of Inspector General (877-865-3432 or http://www.reportfraud.wisconsin.gov); U.S. Department of Health and Human Services, Office of Inspector General (1-800-HHS-TIPS or http://www.oig.hhs.gov); or the Internet Crime Complaint Center (www.ic3.gov).

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Solutions Law Press, Inc. invites you to receive future updates by registering here and participating and contributing to the discussions in our Solutions Law Press, Inc. LinkedIn SLP Health Care Risk Management & Operations GroupHR & Benefits Update Compliance Group, and/or Coalition for Responsible Health Care Policy. If you or someone else you know would like to receive future updates about developments on these and other concerns, please be sure that we have your current contact information including your preferred e-mail by creating your profile here. For specific information about the these or other legal, management or public policy developments, please contact the author Cynthia Marcotte Stamer via e-mail or via telephone at (214) 452 -8297.

About the Author

Recognized by her peers as a Martindale-Hubble “AV-Preeminent” (Top 1%) and “Top Rated Lawyer” with special recognition LexisNexis® Martindale-Hubbell® as “LEGAL LEADER™ Texas Top Rated Lawyer” in Health Care Law and Labor and Employment Law; as among the “Best Lawyers In Dallas” for her work in the fields of “Labor & Employment,” “Tax: ERISA & Employee Benefits,” “Health Care” and “Business and Commercial Law” by D Magazine, Cynthia Marcotte Stamer is a practicing attorney board certified in labor and employment law by the Texas Board of Legal Specialization and management consultant, author, public policy advocate and lecturer widely known for 30+ years working as an on demand, special project, consulting, general counsel or other basis with domestic and international business, charitable, community and government organizations of all types, sizes and industries and their leaders on labor and employment and other workforce compliance, performance management, internal controls and governance, compensation and benefits, regulatory compliance, investigations and audits, change management and restructuring, disaster preparedness and response and other operational, risk management and tactical concerns.

For more information about these concerns or Ms. Stamer’s work, experience, involvements, other publications, or programs, see www.cynthiastamer.com,  on  Facebook, on LinkedIn or Twitter or e-mail here.

About Solutions Law Press, Inc.™

Solutions Law Press, Inc.™ provides human resources and employee benefit and other business risk management, legal compliance, management effectiveness and other coaching, tools and other resources, training and education on leadership, governance, human resources, employee benefits, data security and privacy, insurance, health care and other key compliance, risk management, internal controls and operational concerns.

©2021 Cynthia Marcotte Stamer. Non-exclusive right to republish granted to Solutions Law Press, Inc.™


Biden’s Impending Employer Vaccine Mandates: What Is Known Now

September 12, 2021

Employers that employ more than 100 employees, are in the health care industry or that are federal government contractors or subcontractors should begin preparing to comply with impending Occupational Health and Safety Administration (“OSHA”) emergency rules that will require employers to enforce vaccine mandates for their employees and possibly a paid time off mandate for workers taking off to get vaccinated.

Along with the impending mandates for large and other employers, OSHA recommends employers use “multiple layers of protection,” including mask-wearing, distancing and testing, to safeguard unvaccinated and otherwise at-risk workers and to mitigate the spread of COVID-19. It remains to be seen whether the Administration will tighten these restrictions if the virus spread continues or fails to abate.

President Biden announced last week that OSHA would issue the emergency rules as part of his use of regulatory powers to substantially increase the number Americans covered by vaccination requirements.

Impending Federal Mandates

Although the actual requirements won’t be confirmed until the regulations are published, the vaccination plan calls for

  • OSHA to issue emergency rules that would require all employers with more than 100 employees to get vaccinated or be tested at least weekly;
  • OSHA and other federal regulations to require vaccinations for all federal workers, contractors and subcontractors;
  • OSHA and the Centers for Medicare and Medicaid Services (“CMS”) rules to require COVID-⁠19 vaccinations for all health care workers at Medicare and Medicaid participating hospitals and other health care settings;
  • Using Department of Education and federal funding measures to support vaccination and masking in schools; and
  • Calling on large entertainment venues to require proof of vaccination or testing for entry.

Employment Focused Mandates

Regarding the OSHA mandate, President Biden’s “Path out of the Pandemic COVID-19 Action Plan” states OSHA is developing an Emergency Temporary Standard (ETS) that will require all employers with 100 or more employees to ensure their workforce is fully vaccinated or require any workers who remain unvaccinated to produce a negative test result on at least a weekly basis before coming to work.

Concerning federal workers and employees of federal contractors and subcontractors, the plan notes the President has signed an Executive Order to require all federal executive branch workers to be vaccinated. The President also signed an Executive Order directing that this standard be extended to employees of contractors that do business with the federal government. As part of this effort, the Department of Defense, the Department of Veterans Affairs, the Indian Health Service, and the National Institute of Health will complete implementation of their previously announced vaccination requirements that cover 2.5 million people.

Along with ordering the vaccine mandates, the plan also calls for ensuring that no worker loses any pay for taking time off too get vaccinated, OSHA is developing a rule that will require employers with more than 100 employees to provide paid time off for the time it takes for workers to get vaccinated or to recover if they are under the weather post-vaccination. Statutory basis for this new paid leave requirement remains to be specified.

Because it appears the emergency rule calls for covered employers go require employees either to be vaccinated or submit a weekly testing, employers should still be prepared to evaluate request for waivers of these requirements by persons claiming to be disabled for purposes of the Americans With Disabilities Act by offering reasonable accommodation.

These new mandates are in addition to continuing to encourage employers to use and train workers on usingmultiple safeguards to avoid And contain the spread of COVID-19 in their workplaces.

Noncompliance with the mandates could put covered employers at significant risk.

First, of course, is the potential OSHA liability. OSHA already has made clear it’s willingness to sanction employers for violating CoVID emergency standards by nailing AMA Health Holdings LLC, for and Lakewood Resource and Referral Center Inc. (“CHEMED”) for failing to comply with COVID-19 safety protocols issued in June.

In June OSHA issued an emergency temporary standard to protect healthcare workers from contracting coronavirus. In March, OSHA launched a national emphasis program focusing enforcement efforts on companies that put the largest number of workers at serious risk of contracting the coronavirus. The program also prioritizes employers who retaliate against workers for complaints about unsafe or unhealthy conditions, or for exercising other rights protected by federal law. 

OSHA cited the facility’s operator, AMA Health Holdings LLC, with two citations for failing to develop and implement effective measures to mitigate the spread of the virus and not recording each work-related illness.

The AMA Holdings OSHA actions demonstrate OSHA’s commitment to investigate complaints of violations is its COVID emergency standards and fine employers that violate them.

The citations against AMA Health Holdings follow OSHA’s earlier citation of CHEMED for retaliating against employees for questioning the adequacy of COVID safety at the dental practice where they worked.

Government contractor and healthcare employers also could face program exclusions or penalties.

Additionally, employers should keep in mind that improperly handled employee questions or statements of concern about the adequacy of workplace COVID -19 safeguards could create retaliation or whistleblower risks. The threat for retaliation liability extends well beyond employers actually covered by the impending mandates. Regardless of what the rules actually eventually provide, employees of covered and uncovered employers are likely to have questions about the adequacy of safeguards and their workplace rights. These questions could come from people believing their entitled to work without being vaccinated, employees a certain rate to takeoff time for vaccination or other reasons with or without pay, employees asking or asserting rights to paid time off for vaccination or other reasons or a host of other matters. Retaliation protections can arise even when the employee doesn’t qualify for the rights asserted as long as the employee can demonstrate that the request is based in a good faith belief that the right might exist. Consequently, employers should use care to investigate and respond carefully to these concerns.

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Solutions Law Press, Inc. invites you to receive future updates by registering here and participating and contributing to the discussions in our Solutions Law Press, Inc. LinkedIn SLP Health Care Risk Management & Operations GroupHR & Benefits Update Compliance Group, and/or Coalition for Responsible Health Care Policy. If you or someone else you know would like to receive future updates about developments on these and other concerns, please be sure that we have your current contact information including your preferred e-mail by creating your profile here. For specific information about the these or other legal, management or public policy developments, please contact the author Cynthia Marcotte Stamer via e-mail or via telephone at (214) 452 -8297.

About the Author

Recognized by her peers as a Martindale-Hubble “AV-Preeminent” (Top 1%) and “Top Rated Lawyer” with special recognition LexisNexis® Martindale-Hubbell® as “LEGAL LEADER™ Texas Top Rated Lawyer” in Health Care Law and Labor and Employment Law; as among the “Best Lawyers In Dallas” for her work in the fields of “Labor & Employment,” “Tax: ERISA & Employee Benefits,” “Health Care” and “Business and Commercial Law” by D Magazine, Cynthia Marcotte Stamer is a practicing attorney board certified in labor and employment law by the Texas Board of Legal Specialization and management consultant, author, public policy advocate and lecturer widely known for 30+ years working as an on demand, special project, consulting, general counsel or other basis with domestic and international business, charitable, community and government organizations of all types, sizes and industries and their leaders on labor and employment and other workforce compliance, performance management, internal controls and governance, compensation and benefits, regulatory compliance, investigations and audits, change management and restructuring, disaster preparedness and response and other operational, risk management and tactical concerns.

For more information about these concerns or Ms. Stamer’s work, experience, involvements, other publications, or programs, see www.cynthiastamer.com,  on  Facebook, on LinkedIn or Twitter or e-mail here.

About Solutions Law Press, Inc.™

Solutions Law Press, Inc.™ provides human resources and employee benefit and other business risk management, legal compliance, management effectiveness and other coaching, tools and other resources, training and education on leadership, governance, human resources, employee benefits, data security and privacy, insurance, health care and other key compliance, risk management, internal controls and operational concerns.

©2021 Cynthia Marcotte Stamer. Non-exclusive right to republish granted to Solutions Law Press, Inc.™


Biden-Harris To Require many Employers To Mandate Employee Vaccinations

September 9, 2021

The Biden- Harris Administration today announced it will require a multitude of US employees to adopt and enforce workplace COVID-19 vaccination mandates for their workers.

The mandate requirement generally will apply to all federal workers, government contractors and subcontractors, health care workers of facilities participating in Medicare or Medicaid And any employer with more than 100 employees.All Medicare and Medicaid certified health care facilities, and a broad range of other employers must prepare to meet impending new federal COVID-19 vaccine mandates announced by the Biden-Harris Administration today.

According to today’s announcements all healthcare facilities participating in Medicare or Medicaid, Federal government employees, federal government contractors or subcontractors and any business employing 100 or more employees will be required to ensure all staff are vaccinated against COVID-19.

The Biden-Harris Administration says the new health industry COVID-19 vaccine will be implemented through emergency regulations to be issued in October.

According to today’s announcement, the Centers for Medicare & Medicaid Service (“CMS”) in collaboration with the Centers for Disease Control (“CDC”) will issue an Interim Final Rule with Comment Period for health care providers in October that will apply vaccine mandates hospitals, dialysis facilities, ambulatory surgical settings, nursing homes and home health agencies, among others, as a condition for participating in the Medicare and Medicaid programs. This announcement expends the healthcare industry mandate beyond it’s originally planned applicability to nursing homes when announced last month.

In addition to the health industry mandate, the Biden-Harris Administration also announcementI it would impose new vaccine mandates for all federal government workers, government contractors and subcontractors, and all employers employing more than 100 employees.

In it’s announcement of the impending vaccination requirements, CDC urged health care facilities to prepare now to meet the new mandate in October. CMS expects certified Medicare and Medicaid facilities to act in the best interest of patients and staff by complying with new COVID-19 vaccination requirements. 

The Administration is urging covered workers not currently vaccinated to begin the vaccination process immediately and facilities and employers to use all available resources to support employee vaccinations, including employee education and clinics, as they work to meet new federal requirements.

Beyond potential federal program participation losses, the new vaccine mandates likely adds vaccination to the list of safety safeguards that employers can expect to be required to enforce as part of the occupational safety rules of the Occupational Safety and Health Administration (“OSHA”).

While legal challenges to the mandate requirements are likely, most business andw that have not already adopted vaccine mandates are expected to adopt these mandates rather than face business losses and other sanctions.

Businesses that were supportive of mandates but fearful of the burdens of administering required accommodations under the Americans with Disabilities Act (”ADA”) or other civil rights laws are likely to welcome the Administration‘s new position. Unlike voluntary mandates, the ADA accommodation requirements do not apply to vaccination requirements required by law.

The new mandates also mean that businesses generally need to be concerned about potential OSHA exposure for failing to implement or enforce the mandates. OSHA already is sanctioning employers for violating COVID-19 related OSHA requirements. For instance, OSHA nailed Lakewood Resource and Referral Center Inc., dba Center for Education Medicine and Dentistry (CHEMED) with heavy fines for allegedly violating applicable COVID-19 safety guidelines in January, 2021.

In a July 23, 2021 citation letter, OSH proposes to fine CHEMED $273,064.00 for willfully violating OSHA by not providing a medical evaluation to determine each employee’s ability to use a N95 respirator, before the employee was fit tested or required to use the respirator in the workplace to protect against SARS-CoV-2 virus while testing suspected COVID-19 individuals.

In addition to the proposed fine, the citation also orders CHEMED to take a series of corrective actions and to post notices in the workplace informing workers of the violation. 

Along with the CHEMED citation, OSH also cited a staffing agency contracted to provide nursing staffing to CHEMED, Homecare Therapies for also failing to conduct medical evaluations and fit tests. It received two violations and a proposed fine of $13,653.

In the face of these potential consequences, most covered health care facilities and other employers impacted by the mandate are likely to implement mandates unless and until these requirements are struct down by the courts or withdrawn.

Assuming the Administration follows appropriate procedures to adopt the rules, most legal commentators do not expect the legal challenges opposing the mandate orders to be successful in the courts particularly after the Supreme Court refused to overturn or hear arguments for overturning a unanimous decision of a three-judge panel of the United States Court of Appeals for the Seventh Circuit in Klassen v. Trustees of Indiana University that refused to enjoin a vaccine mandate imposed by Indiana University as a condition of student or staff in person participation in classes or other activities.

While most healthcare and other covered businesses are not expected to challenge the rules, compliance us likely to trigger backlash from some unvaccinated workers strongly opposed to becoming vaccinated. Employers may find that some employees will resign their employment or take other tactics to avoid becoming vaccinated. Even those who elect to become vaccinated to retain their employment are likely to express opposition and dissatisfaction that could create liability exposures for the employers if it becomes a basis for retaliation claim.

Employers in Texas and certain other states that have adopted rules restricting or prohibiting vaccine, mask or other mandates also may face challenges based on the state rules. 

In light of these and other uncertainties and challenges, Healthcare and Other or Employers generally should seek legal advice and assistance from legal counsel experienced with the relevant health care, labor and employment, privacy and other concerns. 

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This article is republished by permission of the author, Cynthia Marcotte Stamer.  To review the original work, see here.

Solutions Law Press, Inc. invites you to receive future updates by registering here and participating and contributing to the discussions in our Solutions Law Press, Inc. LinkedIn SLP Health Care Risk Management & Operations GroupHR & Benefits Update Compliance Group, and/or Coalition for Responsible Health Care Policy. If you or someone else you know would like to receive future updates about developments on these and other concerns, please be sure that we have your current contact information including your preferred e-mail by creating your profile here. For specific information about the these or other legal, management or public policy developments, please contact the author Cynthia Marcotte Stamer via e-mail or via telephone at (214) 452 -8297.

About the Author

Recognized by her peers as a Martindale-Hubble “AV-Preeminent” (Top 1%) and “Top Rated Lawyer” with special recognition LexisNexis® Martindale-Hubbell® as “LEGAL LEADER™ Texas Top Rated Lawyer” in Health Care Law and Labor and Employment Law; as among the “Best Lawyers In Dallas” for her work in the fields of “Labor & Employment,” “Tax: ERISA & Employee Benefits,” “Health Care” and “Business and Commercial Law” by D Magazine, Cynthia Marcotte Stamer is a practicing attorney board certified in labor and employment law by the Texas Board of Legal Specialization and management consultant, author, public policy advocate and lecturer widely known for 30+ years working as an on demand, special project, consulting, general counsel or other basis with domestic and international business, charitable, community and government organizations of all types, sizes and industries and their leaders on labor and employment and other workforce compliance, performance management, internal controls and governance, compensation and benefits, regulatory compliance, investigations and audits, change management and restructuring, disaster preparedness and response and other operational, risk management and tactical concerns.

Most widely recognized for her work with health care, life sciences, insurance and data and technology organizations, she also has worked extensively with health plan and insurance, employee benefits, financial, transportation, manufacturing, energy, real estate, accounting and other services, public and private academic and other education, hospitality, charitable, civic and other business, government and community organizations. and their leaders.

Ms. Stamer has extensive experience advising, representing, defending, and training domestic and international public and private business, charitable, community and governmental organizations and their leaders, employers, employee benefit plans, their fiduciaries and service providers, insurers, and others has published and spoken extensively on these concerns. As part of these involvements, she has worked, published and spoken extensively on these and other human resources, employee benefits, compensation, worker classification and other workforce and other services; insurance; health care; workers’ compensation and occupational disease; business reengineering, disaster and distress; and many other performance, risk management, compliance, public policy and regulatory affairs, and other operational concerns. 

A former lead advisor to the Government of Bolivia on its pension  project, Ms. Stamer also has worked internationally and domestically as an advisor to business, community and government leaders on these and other legislative, regulatory and other legislative and regulatory design, drafting, interpretation and enforcement, as well as regularly advises and represents organizations on the design, administration and defense of workforce, employee benefit and compensation, safety, discipline, reengineering, regulatory and operational compliance and other management practices and actions.

Ms. Stamer also serves in leadership of a broad range of professional and civic organizations and provides insights and thought leadership through her extensive publications, public speaking and volunteer service with a diverse range of organizations including as Chair of the American Bar Association (“ABA”) Intellectual Property Section Law Practice Management Committee, Vice Chair of the International Section Life Sciences and Health Committee, Past ABA RPTE Employee Benefits & Other Compensation Group Chair and Council Representative and current Welfare Benefit Committee Co-Chair, Past Chair of the ABA Managed Care & Insurance Interest Group, past Region IV Chair and national Society of Human Resources Management Consultant Forum Board Member,  past Texas Association of Business BACPAC Chair, Regional Chair and Dallas Chapter Chair, former Vice President and Executive Director of the North Texas Health Care Compliance Professionals Association, past Board President of Richardson Development Center (now Warren Center) for Children Early Childhood Intervention Agency, past North Texas United Way Long Range Planning Committee Member, past Board Member and Compliance Chair of the National Kidney Foundation of North Texas, a Fellow in the American College of Employee Benefit Counsel, the American Bar Foundation and the Texas Bar Foundation and many others.

For more information about these concerns or Ms. Stamer’s work, experience, involvements, other publications, or programs, see www.cynthiastamer.com,  on  Facebook, on LinkedIn or Twitter or e-mail here.

About Solutions Law Press, Inc.™

Solutions Law Press, Inc.™ provides human resources and employee benefit and other business risk management, legal compliance, management effectiveness and other coaching, tools and other resources, training and education on leadership, governance, human resources, employee benefits, data security and privacy, insurance, health care and other key compliance, risk management, internal controls and operational concerns.

©2021 Cynthia Marcotte Stamer. Non-exclusive right to republish granted to Solutions Law Press, Inc.™