Mandatory wellness program?

[Guest Alley]

Can an employer require its employees to undergo a health screening if there is no requirement that an employee do anything other than be screened? Meaning that if an employee has high blood pressure, he will get those results, but is not required to do anything about it? He can do something about it, and nurses will be available to assist if he so chooses, but the program doesn't require any such action. I don't see this addressed in the HIPAA proposed regs, but I may be missing something.

[mroberts]

I think that could be perceived as sketchy. I suppose if there are enough firewalls in place and the health screenings are done by an outside vendor and nothing on an individual basis is relayed back to the employer, it could possibly work. But I don't think it's worth the potential drawbacks (lawsuit) if some employee disagrees.

[GBurns]

Why bother to "require" it or otherwise make it mandatory?

Requiring it leaves the possibility of employee disagreement, resentment or litigation. It also has the danger of the accidental releasing of PHI etc.

If the employees are not required to do anthing with the results, it serves no purpose to make screening mandatory and it makes no sense to spend money on something that is not wanted nor appreciated.

If it is left as an optional benefit, those employees who see value and who will use the results, will make use of the screening. Those who see no value etc will not go and would have discarded the results anyhow. Why waste the money?

There are many people who do not want to know and who feel better not knowing. There are also those who could be affected financially if the screening reveals a serious condition. If the screening shows a condition, this employee will now have a pre-existing condition which could seriously affect their ability to secure both health insurance and life insurance in the future. I would hate to be the employer who "forced" an employee into a position of having a known pre-existing condition.

[david rigby]

How about an incentive? If the EE meets certain criteria (weight, blood pressure, cholesterol, etc.) then the EE cost of medical insurance and/or life insurance is reduced. (Methinks these are called "wellness programs".)

[Kirk Maldonado]

PAX:

Methinks the type of arrangement you are suggesting would violate the Americans with Disabilities Act. (Because certain disabled persons could never qualify for the "discount" so that they are necessarily charged for the coverage.)

[david rigby]

Hmmm. My current employer has just such a program.

[jeanine]

Who's doing the screening? The employer or the health plan?

As far as the incentives, I believe that you are clear under HIPAA non-discrimination requirements to offer incentives for bona fide wellness participation as long as there is a mechanism to allow those not able to make the modification able to benefit from the incentive. For example, if you offer an incentive (or waiver of a negative incentive) to stop smoking, and someone tries but can't overcome his/her addiction can demonstrate this, you have to treat them the same as a smoker who does overcome his/her addiction in terms of incentives.

[Guest Alley]

Thanks for the replies. The question has arisen as to whether either an employer or its health plan could require the screening. The screening would be paid for by the employer and would be performed by an outside vendor with only aggregate results reported to the employer (such as you have __% of employees with high cholesterol so you might want to consider some education programs targeting cholesterol issues. . . . .) Participants are offered the opportunity to consult with nurses after they receive their results if they want additional information or guidance, but that piece is voluntary. The HIPAA nondiscimination rules don't seem to prohibit a mandatory screening program, but also don't seem to bless it either. I agree that there are serious human relations issues if it is made mandatory. I just wondered if there was guidance out there that I haven't yet found. Thanks again for your thoughts.

[401 Chaos]

PAX:

Methinks the type of arrangement you are suggesting would violate the Americans with Disabilities Act.  (Because certain disabled persons could never qualify for the "discount" so that they are necessarily charged for the coverage.)

Kirk & Jeanine,

What if everybody that participates in the wellness program gets an incentive regardless of results and the results are not shared with the employer. Any problem there?