Sunday, February 19, 2017

HIPAA and the Affordable Care Act Wellness Program Requirements

Before I dive into the specifics of different types of wellness programs, I wanted to look into the current regulation of wellness programs to ensure they comply with HIPAA and the ACA. This document from the Department of Labor explains the different types of wellness programs that comply with HIPAA and fall under the ACA.  The first two types of wellness programs are participatory and health-contingent.

Participatory programs are exactly what they sound like-they are programs where "Either no reward is offered, or none of the conditions for obtaining a reward are based on an individual satisfying a standard related to a health factor". Employees aren't required to participate in the programs and won't penalize employees for not participating. This complies with non-discrimination requirements of HIPAA. Health-contingent programs on the other hand " require participants to satisfy a standard related to a health factor in order to obtain a reward". Health-contingent programs can be divided further into activity-only and outcome-based. The article goes into more details about the individual requirements for health-contingent programs so that they comply with the  nondiscrimination rules.

Other factors wellness programs need to consider are whether or not they are "reasonably designed to promote health and prevent disease". A lot goes into healthcare regulations, and wellness programs are just another part of the overall system that has to make sure it meets ACA regulations and HIPAA guidelines. Read the document for more information!

Posted by at

5 comments:

  1. Dr. Suzie WeisbandFebruary 19, 2017 at 6:17 PM

    In your research, you cited this article, but thought you might want another look. Under cms.gov, I searched Workplace Wellness; there were 18 results that all look relevant.

    ReplyDelete
    Replies
    1. Dr. Suzie WeisbandFebruary 26, 2017 at 8:02 PM

      I like the direction you are taking... I have learned a lot already!

      Delete
    2. AddisonFebruary 26, 2017 at 8:13 PM

      There is a lot to learn that is for sure! I'm actually getting a little lost on my direction the more I research. Since my topic is IT based wellness programs, I'm trying to circle my focus back to technology. There are just so many other outside factors! Hopefully you'll be able to help guide me after reading my project proposal.
      Thanks Suzie!

      Delete
  2. Dr. Suzie WeisbandMarch 4, 2017 at 2:44 PM

    It is perfectly fine to post anything that is related to this topic without worrying so much about "sticking to one focus." It is a complex topic, so whatever you read that might affect the outcome of wellness programs, both positive and negative, are all perfectly fine.

    ReplyDelete

Subscribe to: Post Comments (Atom)