Whistleblower Protections Under the ACA

Learn how the Affordable Care Act (ACA) protects whistleblowers from retaliation by employers, group health plans, and health insurance issuers. The ACA protects individuals who engage in protected activity under the ACA—e.g., reporting ACA violations or receiving tax credits or subsidies through government healthcare exchanges. This practice note provides an overview of the ACA whistleblower provisions and regulatory procedures. It further discusses steps employers can take to reduce their risk of facing an ACA whistleblower claim.

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Related Content

• ACA Summary of Benefits and Coverage Requirements Checklist
  Use this checklist to ensure compliance with ACA requirements regarding the content, appearance, delivery, and timing for Summaries of Benefits and Coverage, which apply to employer group health plans.
• ACA Nondiscrimination Rules for Health Programs and Activities (ACA Section 1557)
  Stay up to date on Section 1557 of the ACA, which prohibits health programs and activities funded or administered by the U.S. Department of Health and Human Services (e.g., providers that accept Medicaid or Medicare payments), as well as ACA exchanges and issuers, from discriminating against individuals based on protected characteristics like race, color, national origin, sex, age, and disability.
• ACA Cost Sharing Rules
  Understand ACA’s cost-sharing limitations, which impose caps on the out-of-pocket expenses covered individuals must pay for essential health benefits in any plan year. Quickly identify the plans and benefits subject to cost-sharing rules, the types of expenses impacted, and the applicable annual dollar amount limits.

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