Coalition of Attorneys General Petition OSHA to Adopt Emergency Temporary Standard for Extreme Heat

Posted by Steve Alder

The Occupational Safety and Health Administration (OSHA) has been petitioned by a coalition of 11 state attorneys general to implement an Emergency Temporary Standard to protect workers from excessive heat exposure on the job. The coalition is led by New York Attorney General Letitia James, who was joined by the state attorneys general from Arizona, Colorado, Connecticut, Illinois, Maine, Maryland, Massachusetts, New Jersey, Pennsylvania, and the District of Columbia.

The Centers for Disease Control and Prevention (CDC) has warned that extreme summer heat is becoming much more common, and climatologists predict that extreme heat events will increase in the coming years due to climate change. National Center for Health Statistics data shows that 1,700 people died from heat-related injuries in 2022 compared to 454 in 2000 and each year, 170,000 workers are made sick, injured, or killed due to exposure to excessive heat in the workplace.

Employers can’t change the weather but they can prevent injuries from extreme heat in the workplace. Some U.S. states have laws governing exposure or extreme heat in the workplace, and the Occupational Safety and Health Act of 1970 requires employers to provide a place of employment free from recognized hazards, but there is no federal law that specifically applies to extreme heat exposure. OHSA has uploaded information to its website on “Working in Outdoor and Indoor Heat Environments,” which educates employers and individuals about the dangers of working in hot environments, but the state attorneys general want OHSA to take action.

The state attorneys general wrote to Julie Su, Acting Secretary of Labor, and Douglas L. Parker, Assistant Secretary of Labor for Occupational Safety and Health at the United States Department of Labor calling for them to promulgate an emergency temporary standard for extreme heat beginning May 1, 2024, which should cover, at a minimum, farmworkers, and construction workers. OSHA has previously acknowledged that the enforcement of heat hazards under the General Duty Clause of the Occupational Safety and Health Act is difficult as there is no defined heat standard. It is therefore necessary for OSHA to prove on a case-by-case basis that a heat hazard existed in the workplace when the injury or fatality occurred. Employers have also not been provided with specific guidance on what constitutes a heat hazard under the Act. An emergency temporary standard would give OSHA stronger enforcement power and would provide employers with specific requirements and guidelines for protecting workers from extreme heat.

OSHA has been urged to issue an emergency temporary standard for occupational heat exposure that applies when the heat index reaches 80°F, after which point there are increased rates of serious heat-related illnesses. In an announcement about the petition, Attorney General James listed 5 cases of heat-related deaths in the workplace in the United States in the summer of 2023. The attorneys general are also calling for Congress to pass – and President Biden to sign – the Asunción Valdivia Heat Illness, Injury, and Fatality Prevention Act, which directs OSHA to establish short- and long-term measures to protect workers from extreme heat. Asunción Valdivia, was a farmworker who died of heatstroke after picking grapes for 10 hours in extreme heat.

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Dentist Sentenced for Theft of $8.5 Million from Medicaid

Posted by Steve Alder

A former Maryland dentist has been sentenced for practicing dentistry without a license and fraudulently billing Medicaid for $8.5 million. Seyed Hamid Tofigh, 57, of Potomac, MD, used the names, provider numbers, and professional credentials of four licensed dentists to submit claims to the Maryland Medicaid program, which is a state-run program that provides healthcare benefits to low-income individuals. The majority of Tofigh’s patients were children.

Tofigh had been a licensed dentist since September 1994 and operated several dental practices with two of his brothers. By 2015, the brothers had separated their ownership of the practices and Tofigh retained ownership of Greenbelt Family Dentistry in Greenbelt, MD, and Rockville Family Dentistry in Rockville, MD. In 2014, after receiving several complaints from patients, the Maryland Board of Dental Examiners suspended Tofigh’s license to practice dentistry due to there being a substantial likelihood that he posed a risk of harm to public health, safety, and welfare. In 2015, after a continued investigation, his license was revoked. The Maryland Board of Dental Examiners found Tofigh kept “consistently incompetent and egregiously deficient” dental records, provided incompetent and substandard treatment, billed for services that he never provided, and engaged in unprofessional and dishonorable conduct.

From 2015 through January 2023, Tofigh continued to practice dentistry on Medicaid recipients, but since he was not able to personally bill Medicaid for his services, used the stolen identities of other dentists – two of his brothers, a nephew, and a former colleague – to submit claims. Tofigh continued to provide substandard treatment, billed for procedures that were not performed, conducted unnecessary procedures such as extractions, fillings, and root canal treatments, and intimidated and bullied patients who complained.

On February 6, 2024, Tofigh pleaded guilty to one count of defrauding a state health plan (Medicaid) and one count of practicing dentistry without a license. The Honorable Carol Ann Corderre of the Circuit Court for Prince George’s County sentenced Tofigh to 5 years in jail, with all but 78 days suspended. Tofigh was placed on home detention for 18 months and will serve 5 years of probation for the Medicare fraud count. Tofigh was also sentenced to serve 1 year in jail and a five-year probation term for practicing dentistry without a license. The jail term was suspended, and the two sentences will run consecutively. Tofigh has been prohibited from providing healthcare services that are partially or wholly funded by state or federal governments and must permanently surrender his Maryland dental license. He has also been ordered to pay $8.5 million in restitution within 12 months, of which $4.5 million has already been paid.

“This case revealed a complex healthcare fraud scheme that not only drained taxpayer dollars away from our State’s Medicaid program but also placed Dr. Tofigh’s young patients in real danger,” said Attorney General Brown. “By stopping Dr. Tofigh, my office continues in its commitment to protecting patients and ensuring the integrity of State programs remains intact.”

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OCR Seeks Feedback on HIPAA Audits

Posted by Steve Alder

The Department of Health and Human Services (HHS) Office for Civil Rights (OCR) is conducting a HIPAA Audit Review Survey and is seeking feedback from entities that were subjects of HIPAA compliance audits to gather information to improve future audit programs.

Between 2016 and 2017, OCR conducted its second phase of HIPAA compliance audits. The desk-based audit program involves documentation requests on specific aspects of the HIPAA Privacy Rule, HIPAA Security Rule, and HIPAA Breach Notification Rule. The audits revealed which elements of the HIPAA Rules were proving problematic for HIPAA-covered entities and their business associates.

The audit review survey is being conducted to gather information about the effect of the audits on the audited entities and their opinions on the audit process. The aim is to determine the efficacy of the audit program in assessing the efforts made by HIPAA-covered entities and their business associates to comply with the HIPAA Rules and measure the effect of the audits on covered entities’ and business associates’ subsequent actions to comply with HIPAA.

The survey will provide the audited entities with the opportunity to comment on the usefulness of HHS HIPAA guidance and communications, how easy the online submission portal was to use when uploading documentation requested by auditors, and whether the communicated findings of the audits and the audits themselves actually helped to improve entity compliance.

OCR is also seeking feedback on the burden that the audits placed on covered entities and business associates regarding the requested documentation and responses to audit-related requests, including the impact on day-to-day business operations. Questionnaires will consist of 39 questions and will be sent to Privacy and Security Officers at 166 HIPAA-covered entities and 41 business associates. The information collected will be used to improve future HIPAA compliance audits.

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