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Where Workplace Safety, OSHA and Health Care Fraud Intersect


Where Workplace Safety, OSHA and Health Care Fraud Intersect

Hospitals need to be aware of complex laws to avoid liability

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It appears that hospital worker safety is becoming a primary concern and focus of the Occupational Safety and Health Administration (“OSHA”). Just last week, OSHA launched a web page dedicated to informing hospital workers of various forms of workplace safety issues that may be encountered while performing their jobs at hospitals.

According to OSHA, hospitals can be one of the most dangerous places to work, between work-related injuries and illnesses. According to the United States Department of Labor’s new initiative, the purpose of the web page is to “help hospitals prevent worker injuries, assess workplace safety needs, enhance safe patient handling programs, and implement safety and health management systems.”

Workplace Safety and OSHA

In the “understanding the problem” section, OSHA provides a summary of injury and illness rates, the major causes of workplace injuries and illnesses, costs to hospitals as a result of workplace injuries and illnesses, and possible solutions.

In a second section, safety and health management systems solutions, OSHA attempts to explain and provide relatable examples of how to determine the quantity and quality of safety measures already in the workplace and how these may be improved through best practices and successful implementation strategies.

Finally, there is a safe patient handling section, which even provides a poster directed towards patients and their families, as well as a checklist that they may look to when evaluating the patient care being provided to their loved ones. In this safe patient handling section, OSHA attempts to dispel any common myths about the inefficiency and unprofitability of treating patients with the proper, higher level of care they deserve for the fees that hospitals receive from private payers, Medicaid and Medicare reimbursements.

Health Care Fraud Implications

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What will be interesting to see in the near future is how the Patient Protection and Affordable Care Act (“ACA”) and the False Claims Act (“FCA”) will be impacted due to OSHA’s new focus on a Safe Patient Handling Program.

Under the FCA, fraud against the government can be pursued by private individuals who have, among other things, intimate knowledge of a company’s fraud and are the first to file the action. Such individuals are referred to as “whistleblowers” and the actions themselves are called False Claims Act cases or Qui Tam actions.

Simply put, there are many violations of the fraud and abuse provisions in the ACA that trigger a cause of action under the False Claims Act (“FCA”). Some examples relevant to this article are: failing to provide quality care to patients, failing to meet the expected standard of care and failure to maintain adequate compliance programs. Depending on the extent to which a whistleblower is aware of any fraud, s/he may be able to recover a substantial monetary award.

Hospitals need to be aware of these new OSHA initiatives, as well as the interplay between OSHA regulations, the FCA and ACA. Failure to understand these complex laws and what is required of hospitals and hospital workers may result in potential liability which could have been avoided with some informed insight.