GINA Begins November 21st – Medical Histories And Financial Benefits Not Allowed

The provisions of the GINA law begins next week, right in the middle of open enrollment. This interpretation was perhaps not meant to come through with the interpretation we have, but it is what it is now. Medical history is now considered part of what could be analyzed and interpreted as GINA discrimination. Last month I covered the “left hook” that appeared and how HHS was determined to give out a proper interpretation.

Wellness Programs Get Thrown a Left Hook From GINA – No Family Medical History Allowed on a Health Risk Assessment

HHS Attempts to clarify GINA Laws

Wellness programs are the only ones allowed to collect family history, and again with no financial rewards given. There are some loop holes in the law with employers perhaps learning information from an obituary in a paper, with a parent passing from a heart attack where the article may state there had been a history, but this is not always conclusive and there’s the possibility of lifestyle contributions to some diseases before a wellness group places an employee in a “disease group”. If your employer asks for this information, as of next week, it cannot be given in order to garner any kind of incentives.

This is really one more item that throws a monkey wrench into the quest for better information in some areas and can have an effect on the type of care consumers receive through their employers health and wellness plans. Wellness programs appear to need to have a disassociation with insurers as far as the type of information exchanged. Insurers though, through claims and other medical information shared still have quite a gold mine of information available and many use medication records to determine chronic disease groups, those are becoming increasingly used and do not fall under HIPAA and are sold from pharmacy benefit managers. BD

We might stand to see some changes in some wellness programs soon with creating patient health profiles. BD

The most important new antidiscrimination law in two decades — the Genetic Information Nondiscrimination Act — will take effect in the nation’s workplaces next weekend, prohibiting employers from requesting genetic testing or considering someone’s genetic background in hiring, firing or promotions.

The act also prohibits health insurers and group plans from requiring such testing or using genetic information — like a family history of heart disease — to deny coverage or set premiums or deductibles.

The biggest change resulting from the law is that it will — except in a few circumstances — prohibit employers and health insurers from asking employees to give their family medical histories. The law also bans group health plans from the common practice of rewarding workers, often with lower premiums or one-time payments, if they give their family medical histories when completing health risk questionnaires.

The act takes effect Nov. 21 for all employers with 15 or more employees. It applies to group health insurers whose plan years begin on or after Dec. 7, and it took effect for individual health insurance plans last May. The act does not apply to life insurers.

Sharon F. Terry, chairwoman of the Coalition for Genetic Fairness, a group that backed the legislation, told of a woman who had informed her office she was having a genetic test to learn whether she was predisposed to breast cancer. She was soon fired, with her boss saying the company could not afford to keep her if the results were positive.

Under the rules, group health plans, in seeking information for wellness programs, cannot attach a request for family medical history to any penalty or, as is far more common, any benefit.

But wellness programs can request family medical history if there is no financial benefit attached.

“This can be a big deal,” said Mr. Stivarius, the Atlanta lawyer. “A lot of people incentivize employees to provide this family medical information. They give them some extra paid time off if they participate in surveys. Now they can’t do that.