FactSheet

Filing Whistleblower Complaints under 

the Affordable Care Act

Employees are protected from retaliation for reporting alleged violations of the 

Affordable Care Act’s health coverage reforms (Title I of the Act) and for receiving a 

premium tax credit or a cost sharing reduction for enrolling in a qualified health plan.

Summary of Title I of the 

Affordable Care Act

The Affordable Care Act offers new rights and 

protections. Title I of the Affordable Care Act

reduces health coverage costs for millions of 

families who don’t get coverage from an employer 

by providing tax credits to make coverage 

affordable. The law created the Health Insurance 

Marketplace, where people can shop for coverage 

and see what financial assistance is available 

to them. The law also includes protections for 

people who do get their coverage through an 

employer: it reduces what families will have to 

pay for health care by eliminating dollar limits on 

essential health benefits, capping out-of-pocket 

expenses, and requiring preventive care to be fully 

covered without copays or deductibles. Title I also 

prohibits health plans and insurance companies 

from denying coverage because of a person’s preexisting medical conditions. In addition, it gives 

consumers the right to appeal plan or insurance 

company decisions that deny doctor-ordered 

treatments covered under a plan. Title I includes 

many other reforms to health insurance. To read 

Title I and learn more about how the law affects 

you, visit www.healthcare.gov. 

Protected Activity

In addition to health insurance reforms, Section 

1558 of Title I also protects employees from 

retaliation for: 

• reporting violations of the various reforms found 

in Title I; and

• receiving a premium tax credit or a cost sharing 

reduction for enrolling in a qualified health plan.

Employees who believe they have been retaliated 

against in violation of Title I of the Act may file 

a complaint with OSHA. See “How to File A 

Whistleblower Complaint” on page 2 for details.

What is Retaliation?

Retaliation is not limited to firing an employee. 

Retaliation can include several types of actions, 

such as:

• Firing or laying off

• Reducing pay or hours

• Blacklisting

• Demoting

• Denying overtime or promotion

• Disciplining

• Denying benefits

• Failing to hire or rehire

• Intimidating

• Making threats

• Reassigning affecting prospects for promotion

What is NOT covered by the Affordable 

Care Act’s Whistleblower Provision? 

OSHA generally does not have jurisdiction over the 

following types of complaints:

• Medicare and Medicaid Fraud.

To report Medicare fraud or Medicaid fraud, 

contact the Department of Health and Human 

Services’ Office of the Inspector General. 

Visit www.stopmedicarefraud.gov for more 

information. If you have already reported 

Medicare or Medicaid fraud and you believe your 

employer is retaliating against you as a result, you 

may wish to contact an attorney for advice on any 

state or federal law protections.

• Patient abuse.

To report patient abuse, you may contact your 

State Survey Agency. Visit www.cms.gov/

Medicare/Provider-Enrollment-and-Certification/

SurveyCertificationGenInfo/ContactInformation.

html for more information. If you have already 

reported patient abuse and you believe your 

employer is retaliating against you as a result, 
you may wish to contact an attorney or your 

State Attorney General’s office for information on 

any state law protections. You may also contact 

the Department of Health and Human Services’ 

Office of the Inspector General.

Time Limits for Filing Complaints 

An employee, or representative of an employee, 

who believes that he or she has been retaliated 

against in violation of Title I of the Act may file a 

complaint with OSHA. Complaints must be filed 

within 180 days after the retaliation.

How to File a Whistleblower Complaint

An employee can file an Affordable Care Act

whistleblower complaint with OSHA by visiting or 

calling the local OSHA office or sending a written 

complaint to the closest OSHA office. No particular 

form is required and complaints may be submitted 

in any language.

Written complaints may be filed by fax, 

electronic communication, hand delivery 

during business hours, U.S. mail (confirmation 

services recommended), or other third-party 

commercial carrier.

The date of the postmark, fax, electronic 

communication, telephone call, hand delivery, 

delivery to a third-party commercial carrier, or 

in-person filing at an OSHA office is considered 

the date filed.

To file a complaint electronically, please visit 

www.osha.gov/whistleblower/WBComplaint.html.

To contact an OSHA area office, please call 

1-800-321-OSHA (6742) and they will connect you 

to the closest area office. Or visit our website 

at www.osha.gov/html/oshdir.html and click on 

Regional/Area offices to find your local office 

address and contact information.

When OSHA receives a complaint, OSHA will 

first review it to determine whether certain basic 

requirements are met, such as whether the 

complaint was filed on time. If so, the complaint will 

then be investigated according to the procedures 

required by the Act. See 29 C.F.R. 1984.104.

Results of the Investigation 

If the evidence supports an employee’s complaint 

of retaliation, OSHA will issue an order requiring 

the employer to, as appropriate, put the employee 

back to work, pay lost wages, restore benefits, and 

other possible relief. The exact requirements will 

depend on the facts of the case. If the evidence 

does not support the employee’s complaint, OSHA 

will dismiss the complaint.

After OSHA issues a decision, the employer and/

or the employee may request a full hearing before 

an administrative law judge of the Department of 

Labor. The administrative law judge’s decision may 

be appealed to the Department’s Administrative 

Review Board.

The employee may also file a complaint in federal 

court if the agency does not issue a final decision 

within certain time limits. Details on this provision 

can be found in OSHA’s regulations, at 29 CFR 

1984.114.

To Get Further Information 

For a copy of the Affordable Care Act’s whistleblower 

provision, the regulations (29 CFR 1984), and other 

information, go to www.whistleblowers.gov.

For information on the Office of Administrative 

Law Judges procedures and case law research 

materials, go to www.oalj.dol.gov and click on the 

link for “Whistleblower.”

For more specific information on the Affordable 

Care Act, go to www.healthcare.gov.

This is one of a series of informational fact sheets highlighting OSHA programs, policies, or standards. It 

does not impose any new compliance requirements. For a comprehensive list of compliance requirements of 

OSHA standards and regulations, refer to Title 29 of the Code of Federal Regulations (visit www.archives.gov/

federal-register/cfr). This information will be made available to sensory-impaired individuals upon request. 

Voice phone number: (202) 693-1999; teletypewriter (TTY) number: (877) 889-5627.

DWPP FS-3641 01/2014