Update: December 15, 2009
Required for 2010 employer posting and awareness, GINA’s Title II affects employers of 15 or more employees immediately. Under review until the moment of enactment (originally targeted for November 21, 2009), several poster services sold posters prior to GINA’s finalization. While HRS has no specific knowledge that any posters were created out of compliance, please hold your services accountable. We are updating you as empowerment to do just that…
HHS Press Release Highlights:Individuals’ genetic information will have greater protections through new regulations issued (October 1, 2009) by the U.S. Departments of Health and Human Services (HHS), Labor, and the Treasury. The interim final rule will help ensure that genetic information is not used adversely in determining health care coverage and will encourage more individuals to participate in genetic testing, which can help better identify and prevent certain illnesses.
The interim final rule with request for comments and the notice of proposed rulemaking implement Title I of the Genetic Information Nondiscrimination Act of 2008 (GINA). Under GINA, and the interim final rule, group health plans and issuers in the group market cannot: increase premiums for the group based on the results of one enrollee’s genetic information; deny enrollment; impose pre-existing condition exclusions; or do other forms of underwriting based on genetic information. In the individual health insurance market, GINA prohibits issuers from using genetic information to deny coverage, raise premiums, or impose pre-existing condition exclusions.
Further, under GINA and the new interim final regulations, group health plans and health insurance issuers in both the group and individual markets cannot request, require or buy genetic information for underwriting purposes or prior to and in connection with enrollment. Finally, plans and issuers are generally prohibited from asking individuals or family members to undergo a genetic test.
Additionally, HHS, through its Office for Civil Rights (OCR), issued a notice of proposed rulemaking with a 60-day comment period, to propose changes to the Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule to prohibit health plans from using or disclosing genetic information for underwriting purposes.
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What This Means To Employers:Health care plans, data collection/consideration, health risk assessments, and wellness/well-check incentives are impacted by the ruling. With an interim rule allowing a 60-day comment period, this ruling has undergone tremendous scrutiny and appeal. HRS has always advocated caution and consultation of professional expertise in designing health plan, risk and well-check assessments, including those with wellness and risk-based incentives. This ruling validates that caution and furthers employer risk of error in the crafting of such highly valuable programs. The program practices, conditions and language crafting are a precise and careful exercise in avoiding any statutory or discriminatory complaint.