Last week, an Administrative Law Judge (“ALJ”) for the Department of Labor (“DOL”) issued a long-anticipated ruling addressing the issue of whether a health care provider’s participation in TRICARE (see note below) rendered it a federal subcontractor subject to the Office of Federal Contract Compliance (“OFCCP”) jurisdiction. In upholding an earlier ruling, the ALJ held that a Florida hospital is a federal subcontractor because it participates in a health care provider network established by Humana Military Healthcare Services, Inc. (“HMHS”), which has a federal contract with the Department of Defense (“DOD”) to provide medical services to individuals eligible for TRICARE coverage.
Implications of the Ruling
Health care providers should immediately determine whether they have contracts with health care maintenance organizations, insurers or HMOs in which they have agreed to provide medical services (i.e., as a participating hospital, network member) to administer TRICARE. If so, the health care provider should have legal counsel evaluate the contracts to determine whether, and to what extent, the health care provider is required to comply with the extensive and arduous requirements of Executive Order 11246, Section 503 of the Rehabilitation Act and the Vietnam Era Veterans’ Readjustment Assistance Act of 1974 (“VEVRAA”).
For more information, click here to review the Summary Decision and Order In the Matter of Office of Federal Contract Compliance Programs, United States Department of Labor v. Florida Hospital of Orlando.
For background information on this topic, click here.
Note: TRICARE f/k/a Champus is the health care program of the United States Department of Defense that provides civilian health benefits for military personnel, military retirees, and their dependents, including some members of the Reserve Component.
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