HHS Attempts Clarifications on GINA – Time to Further Confuse This Issue Too With Insurance Access?

The fines for doing so could easily be upgraded as for a $500.00 fine, their algorithms ran for risk management could calculate out to pay the fine and get the information needed. The fine can also go up as high as $50,000 too. But there are exceptions on the rule for example:

“For example, an insurer may request to use genetic information about an individual on payment matters for certain treatment decisions that could be informed by pharmacogenomic testing.”

Many lab tests are already DNA based, such as used by Quest and Labcorp, so how do we now clarify this? Is a specific test that is not an entire human sequence still open for insurance companies to view and issue risk management decisions for or against? Many of the tests used now are specific to find evidence with specific proteins and chromosomes.

The Genomic Test for BRACAnalysis (Breast Cancer) Rules are changing

Ok so are setting pace to perhaps mess up the GINA law too? Is this going to become as clear as mud as the rest of healthcare. Again, I’ll go back to what I have stated before, we need algorithmic centric laws, who in the heck has time to read all of this from the start and two, some nice algorithms would help clarify things for both consumers and Congress. Insurance companies sure use their algorithms, and in fact they suggest new algorithms for better health care which they can easily create with their software. Wendell Potter knows algorithms.

“Department of Algorithms – Do We Need One of These in the US Government

Earlier this year I had the opportunity to interview Rosetta Genomics who have cancer RNA based lab tests, so ok, these are base on RNA, again still genomics, but being they are using a process that derives the interpretations with their algorithms in this manner, where does this come in with GINA? I think this is a good question. You may want to read the interview as they have a genomics based test that identifies cancer of the unknown in the lungs and colon, which helps by far with treatment as you could have liver cancer that migrates to the lung and it may not have it’s origins in the lung, this makes a huge difference in drugs and treatment plans and the success and survival rates – IMPORTANT!!!

Rosetta Genomics Interview – microRNA for ...

Once more if this law had some algorithmic centric publishing attributes, well guess what, it might make sense and be interpretable without needing an attorney, especially in the area of cancer. BD

NEW YORK (GenomeWeb News) – The US government moved closer yesterday to fully implementing rules that will protect Americans from having genetic information used by health insurers or by employers to deny them coverage, change their rates, and discriminate against them in the workplace.

These protections were made into law with the passage of the Genetic Information and Nondiscrimination Act of 2008, and the Department of Health and Human Services now has released a specific set of rules that will change the existing regulations and codes, such as those covered by the Health Insurance Portability and Accountability Act's Privacy Rule.

HHS has posted the interim final rules for a 60-day public comment period. Dealing with the sections of GINA that applies to health insurers, or Title I, the rules include definitions of the key terms on which parts of the law will rest and penalties for violating the laws.

Under GINA and the proposed rule, group health plans and issuers in the group market cannot raise premiums for the group based on results of one enrollee's genetic information, deny enrollment, exclude consumers due to pre-existing conditions, or use genetic information in other forms of underwriting. Likewise, for the individual health insurance market, GINA prohibits issuers from using genetic information to deny coverage, raise premiums, or impose pre-existing condition exclusions.

Under GINA and the new rules, insurers in both group and individual markets would be prohibited from requesting, requiring, or buying genetic information, and they are generally prohibited form asking individuals or family members to undergo a genetic test.

HHS Offers GINA Clarifications for Health Insurance | GenomeWeb Daily News | GenomeWeb