Health Care Providers, Tricare Reimbursement and the OFCCP: Hope for the Best but Prepare for the Worst


Recent Decisions Extend OFCCP Jurisdiction Over Many Health Care Providers

The Office of the Federal Contract Compliance Programs (“OFCCP”) is the federal agency responsible for enforcing affirmative action rules for federal government “contractors” or “sub-contractors.” An entity with a federal government “contract” or “sub-contract” of $50,000 or more must create or maintain an OFCCP – complaint affirmative action plan, which is significant burden. Over the years, there has been significant litigation concerning which types of financial arrangements with the federal government constitute “contracts” and which do not. Just receiving money from the government is not enough; but how much is required to convert a relationship into a “contract” and create an affirmative action duty? The answer to this question has just changed, dramatically, for some health care providers.

By now, most in the health care and legal professions are aware of several recent decisions expanding OFCCP jurisdiction over health care providers, resulting in the imposition of affirmative action obligations arising out of Executive Order 11246, Section 503 of the Rehabilitation Act and the Vietnam Era Veterans Readjustment Assistance Act (“VEVRAA”) and the possibility of intrusive OFCCP compliance audits. Decisions in OFFCP v. UPMC Braddock, ARB NO. 08-048 (2009) and OFCCP v. Florida Hospital of Orlando, 2009-OFC-02 (2010) extended OFCCP jurisdiction over a potentially huge number of previously uncovered health care providers.

The most significant of the decisions is Florida Hospital, which held that a hospital’s receipt of more than $50,000 in federal reimbursement under the Department of Defense’s Tricare Program for services rendered to active duty and retired military personnel and their families subjected it to the jurisdiction of OFCCP as a covered federal subcontractor. The decision in Florida Hospital rejected arguments raised by both the hospital and Department of Defenses that payments received by providers under Tricare were not contract or sub-contracts, but were federal finance assistance payments, much like Medicare and Medicaid, which have subjected the recipient providers to OFCCP jurisdiction.

Appeals are currently pending in both UPMC Braddock and Florida Hospital cases, but it could be months, or possibly even years, before the appeal process is concluded. Much has been written about these decisions, but little guidance has issued as to what health care providers who receive significant Tricare payments may expect or should do in the interim.

OFCCP Will Aggressively Assert Jurisdiction and Pursue Compliance Reviews

OFCCP has made clear that it will not defer its assertion of jurisdiction over or enforcement activities against health care providers who receive Tricare reimbursement pending resolution of the appeal in the FloridaHospital case. In fact, OFCCP is stepping up its identification of health care providers who are recipients of assistance payments under Tricare, and is issuing “scheduling letters” which initiate compliance reviews under the Executive Order, the Rehab Act and VEVRAA, always accompanied by a multi-page “itemized listing” demanding extensive records, supporting data an analyses covering several years.

Many health care providers, who have been the recipients of federal assistance payments under Medicare, Medicaid and even Tricare programs hove not developed federal affirmative action plans, and have not undertaken the recordkeeping, record retention and analysis responsibilities of “covered” federal contractors and subcontractors. Most find themselves shocked – and totally unprepared – when confronted with an OFCCP compliance review and demand for production of voluminous records, supporting data and analyses – all due in 30 days time.

While OFCCP may be persuaded to grant some additional time for the submission of requested data, and perhaps even a bit longer for the development of required affirmative action plans by newly covered health care providers, it is better for providers to plan for OFCCP’s letter before it comes.

What to Do Now?

Additional Defenses to Consider


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National Law Review, Volume , Number 329