EEOC’s Wellness Proposed Rule Diverges from HIPAA Requirements. The Equal Employment Opportunity Commission (EEOC) has acknowledged two key differences between its April 2. Americans with Disabilities Act (ADA), as compared to existing Health Insurance Portability and Accountability Act (HIPAA) requirements. One difference is the permitted percentage of incentives for wellness programs and the other is a notice requirement. HIPAA’s nondiscrimination provisions discuss participatory and health- contingent wellness programs. The provisions were previously amended by the Affordable Care Act (ACA), and the ACA changes were implemented by the final regulations issued in 2. Departments of Labor (DOL), Treasury, and Health and Human Services. The EEOC has separately provided parameters on incentives to help define what makes a wellness program voluntary and therefore, makes a disability- related inquiry or medical exam under the ADA permissible. The ADA generally prohibits both. As the EEOC explains, “Placing limits on the rewards employers may offer for employee participation (or penalties for nonparticipation) where participation requires employees to answer disability- related inquiries or take medical examinations promotes the ADA’s interest in ensuring that incentive limits are not so high as to make participation in the program involuntary.”Incentives. EEOC’s proposed rule differs from HIPAA’s wellness program incentives “in that it extends the 3. HIPAA places no limits on incentives for participatory wellness programs,” the EEOC noted.“Participatory wellness programs are not related to a health factor or achieving a result in relation to a health factor. The ACA, The ADA, And Wellness Program Incentives HIPAA and Wellness Programs. Posted by Fiona on 01.14.2008. Employers have many questions about the HIPAA rules as they relate to wellness programs and in particular types of rewards and participation requirements they can. EEOC's Final Rule on Employer Wellness Programs and Title I of the Americans with Disabilities Act. The ADA also regulates certain aspects of wellness programs that HIPAA and the Affordable Care Act do not. Health- contingent wellness programs are,” said Frank Morris Jr. Under the EEOC’s proposed rule, unlike the HIPAA regulations, the 3. Morris also observed in an April 2. The EEOC does not believe the change will have a big impact. These types of programs are not subject to the ADA incentive rules discussed here, although programs that qualify as health- contingent programs are subject to HIPAA incentive limits.” Regulations implementing HIPAA’s wellness provisions, as amended by the Affordable Care Act, allow covered entities to offer incentives as high as 5. ASSESSING THE HEALTH OF YOUR WELLNESS PROGRAM UNDER HIPAA, THE ADA. Wellness programs come in all shapes and forms. Trust wellness programs are subject to HIPAA. The Trust works to ensure that its wellness offerings comply with HIPAA. However, it is important to understand how these rules could impact your wellness program. Understanding these rules can also help you effectively. HIPAA applies to certain workplace wellness programs. Learn about a few important facts to help you understand how your health information is protected. Site wellness programs. When setting up a worksite wellness program, it is important. Worksite Wellness and HIPAA Nondiscrimination Regulations Example: A program requires partici-pants to lower their body mass index to. Agencies Issue Final HIPAA Wellness Program Rules. But a biometric screening or other medical examination that tests for the presence of nicotine or tobacco is a medical examination that would be subject to the 3. The proposed rule will cause a recalculation of limits among employers that offer wellness programs, noted J. D. Piro, the lead health group officer and senior vice president of Aon Hewitt in Norwalk, Conn.“If finalized, the rule could result in employers removing the testing requirement from the tobacco cessation components of their wellness programs if they wish to offer a reward that is greater than 3. Peter Marathas and Stacy Barrow, attorneys in Proskauer’s Boston office, in an e- mail. Employers may choose to restructure any programs that currently require disability- related inquiries or medical examinations if they want to offer incentives greater than 3. Notice Requirement. In addition to the new limits, the proposed rule recommends additional paperwork. Employers with wellness programs will be required to provide a notice to employees informing them: What medical information was obtained. How it will be used. Who will receive it. Restrictions on disclosure. The EEOC also asked whether prior, written and knowing confirmation that employees’ participation in a disability- related inquiry and/or medical examination be required. Wellness Programs under HIPAA. Businesses are increasingly introducing wellness programs to the workplace. Wellness programs can vary greatly depending on what kind of program an employer desires, as well as financial.Solander said during the webcast that this additional form “could inject a lot of complexity into the wellness program.” He said employers already have “a hard enough time getting employees to sign any document,” and predicted that such a form would make it “more difficult to get employees enrolled in wellness programs.”Recommended Changes. Morris and Solander recommended the following changes to the proposed rule: Making the EEOC regulations consistent with the ACA/HIPAA regulations and calculating the amount of incentive available for dependent coverage as opposed to just simply for employee- only coverage. Making the incentive for all tobacco cessation rewards consistent with the ACA regulations at 5. Eliminating redundant notice requirements in the EEOC rule. Ensuring the EEOC does not become an arbiter of program wellness design based on their notions of what promotes employee health. Marathas and Barrow noted that “One major disconnect between existing DOL guidance on wellness programs and the EEOC’s proposed rule is that the EEOC continues to prohibit employers from requiring that employees complete a health risk assessment (HRA) in order to enroll in the plan. The DOL has permitted this practice for years, as long as results of the HRA are not used for eligibility purposes. We’d recommend that the EEOC allow employers to require completion of an HRA and biometric screening in order to be eligible in group health plan coverage.”Comments are due June 1. Allen Smith, J. D., is the manager of workplace law content for SHRM. Follow him @SHRMlegaleditor. The HIPAA Privacy and Security Rules place restrictions on the circumstances under which a group health plan may allow an employer as plan sponsor access to PHI, including PHI about participants in a wellness program offered through the plan, without the written authorization of the individual.
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