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New OSHA Guidance for Workplaces Not Covered by the Healthcare Emergency Temporary Standard

Client Alert

On June 10, 2021, OSHA issued an Emergency Temporary Standard (ETS) for occupational exposure to COVID-19, but it applies only to healthcare and healthcare support service workers. For a detailed summary of the ETS applicable to the healthcare industry, please visit https://youtu.be/vPyXmKwOzsk.

All employers not subject to the ETS should review OSHA’s contemporaneously released, updated Guidance on Mitigating and Preventing the Spread of COVID-19 in the Workplace. The new Guidance essentially leaves intact OSHA’s earlier guidance, but only for unvaccinated and otherwise at-risk workers (“at-risk” meaning vaccinated or unvaccinated workers with immunocompromising conditions). For fully vaccinated workers, OSHA defers to CDC Guidance for Fully Vaccinated People, which advises that most fully vaccinated people can resume activities without wearing masks or physically distancing, except where required by federal, state, or local laws or individual business policies.

OSHA reminds employers that they are subject to Section 5(a)(1) of the Occupational Safety and Health Act, commonly known as the “General Duty Clause,” which requires an employer to furnish a place of employment that is free from recognized hazards which are likely to cause death or serious physical harm. In other words, in the event a workplace outbreak of COVID-19 comes to the attention of OSHA, OSHA will scrutinize the employer’s COVID-19 mitigation plan to ensure that it is consistent with the new Guidance. If not, a General Duty Clause citation may be forthcoming.

The good news for employers is that existing COVID-19 policies developed and implemented in response to prior OSHA guidance should suffice under the new Guidance for unvaccinated and otherwise at-risk workers. Though nearly one-half of the U.S. population is fully vaccinated and state and local officials continue to ease COVID-19 restrictions, employers should be careful to not allow their COVID-19 policies and practices to become stale for unvaccinated workers and at-risk workers. For such workers, OSHA continues to recommend that employers:

  • Provide face coverings free of charge;
  • Separate from the workplace all persons who are infected, experiencing symptoms, or had close contact with someone with COVID-19;
  • Implement physical distancing;
  • Maintain ventilation systems;
  • Ensure proper use of face coverings or personal protective equipment where appropriate;
  • Perform routine cleaning and disinfect areas encountered by workers testing positive for COVID-19;
  • Install physical barriers where proper physical distancing cannot be maintained;
  • Provide training:
    • To managers on how to implement and monitor COVID-19 policies;
    • Frequently and “via multiple methods” to workers; and
  • Consider and implement where appropriate administrative mitigation strategies such as:
    • Telework;
    • Flexible schedules; and
    • Staggered shifts and breaks

The Guidance also emphasizes that employers should implement effective processes for workers to report COVID-19 concerns, including means to make such reports anonymously. OSHA also expects employers to clearly inform workers that they will be free from retaliation for voicing reasonable concerns to the employer, a government agency, or the public through print or social media outlets.

Though OSHA recording standards continue to require recording of work-related cases of COVID-19, the new Guidance reiterates that OSHA has suspended until at least May 2022 recording of adverse reactions to COVID-19 vaccines, even if the employer requires workers to receive a vaccine.

The new Guidance concludes with an Appendix which strongly encourages employers to implement steps for unvaccinated workers working in close contact to one another, such as on production or assembly lines. Such steps may include:

  • Staggering break times;
  • Staggering work shifts;
  • Providing temporary break areas and restrooms to avoid congregation of workers;
  • Maintaining at least 6 feet of separation from one another at all times, including breaks; or
  • Providing visual cues, such as floor markings and signs, to remind workers to maintain physical distancing.

For most employers, the above recommendations will sound very familiar and are most likely already included in the employer’s COVID-19 mitigation plan. But how do employers distinguish between vaccinated and unvaccinated workers? OSHA provides no answer and the “honor system” is likely insufficient.

Several states, such as Michigan and Washington, have provided guidance as to when an employer may deem a worker to be fully vaccinated and thus relieved of the state’s mandate that unvaccinated workers continue to wear face coverings. Michigan deems sufficient posting signs in the workplace reminding unvaccinated workers to wear masks. Washington requires formal evidence of vaccination, such as a copy of the worker’s vaccination card or an attestation from the worker.

Federal OSHA is silent on the issue, but one can reasonably infer that OSHA would not find acceptable the “honor system” or posting of signs. Unless an employer chooses to continue to enforce its COVID-19 plan for all workers, the employer should consider requiring workers to provide evidence of vaccination, such as a copy of the vaccination card or a sworn statement, before the worker will be relieved from face coverings, physical distancing, and other mitigation practices.

If you have any questions regarding the new Guidance or would like any assistance with your COVID-19 plan, please feel free to contact BMD Member Stephen Matasich at 330-253-9146 or sematasich@bmdllc.com.


No Surprises Act Update: The IDR Portal is Open

The No Surprises Act (“NSA”) became effective January 1, 2022, and has been the subject of lawsuits and criticisms since its inception. The goals of the No Surprises Act are to shield patients from surprise medical bills, provide to uninsured and self-pay patients good faith estimates of charges, and create a process to resolve payment disputes over surprise bills, which arise most typically in emergency care settings. We have written about Part I and Part II of the NSA previously. This update concerns the Independent Dispute Resolution (“IDR”) procedure created by Part II but applicable to claims covered by Part I. The Centers for Medicare & Medicaid Services (“CMS”) finally opened the Portal for providers to submit disputes to the IDR process following some updated guidance regarding the arbitration process itself.

Updated FAQs for the No Surprises Act - Good Faith Estimates

The No Surprises Act (“NSA”) became effective January 1, 2022. Meant to protect consumers from surprise medical bills, the new law is good for consumers, but vexatious for health care providers and facilities. One particular source of frustration is the operationalization of the Good Faith Estimate (“GFE”) requirement, governed by Part II of the regulations that implement the NSA. The GFE requirements apply broadly to all healthcare providers and facilities that practice within the scope of their state-issued license.

IMPORTANT PRF UPDATE! HRSA Allows Providers the Opportunity to Correct Missed Period 1 Reporting

Late Wednesday, April 6, HRSA announced that it was going to allow providers with extenuating circumstances that prevented them from preventing a completed Period 1 Report to submit a Request to Report Late Due to Extenuating Circumstances.

Advanced Practice Providers and Telemedicine Start-Up Surge

Throughout the COVID-19 pandemic, we heard a lot about “surges” that happened all over the country regarding the virus. One of the other interesting “surges” we have followed is the “surge” in new healthcare business start-ups, particularly businesses owned by advanced practice providers, such as nurse practitioners, physician assistants, certified nurse midwives, clinical nurse specialists, and certified registered nurse anesthetists (“Advanced Practice Providers” or “APPs”). One of the hottest areas in the healthcare start-up surge has been the creation of practices that are telemedicine focused.

Ohio Department of Health Releases Updated Charge Limits for Medical Records

Under Ohio law, a healthcare provider or medical records company that receives a request for a copy of a patient's medical record may charge an amount in accordance with the limits set forth in Ohio Revised Code Section 3701.741. The allowable amounts are increased or decreased annually by the average percentage of increase or decrease in the consumer price index for all urban consumers, prepared by the United States Department of Labor, Bureau of Labor Statistics, for the immediately preceding calendar year over the calendar year immediately preceding that year, as reported by the Bureau. The Director of the Ohio Department of Health makes this determination and adjusts the amounts accordingly. The list is then published, here.