Compliance Alert: New Wellness Program Regulations Released

On June 3, 2013, the U.S. Departments of Treasury, Labor, and Health and Human Services released new regulations applicable to wellness programs. The new regulations clarify how the PPACA’s wellness rules interact with pre-existing rules established by the Health Insurance Portability and Accountability Act (“HIPAA”). The new regulations apply to plans and policies, including grandfathered plans, beginning  on or after January 1, 2014.

The new regulations draw a distinction between plans that are participatory and plans that are health contingent. Participatory plans are wellness programs that reward participation and are not outcome dependent. Premium reimbursements for fitness membership costs, premium discounts for attending no-cost health education seminars, and rewards for participating (whether successful or not) in smoking cessation programs are examples of wellness programs that should qualify as participatory. Participatory programs do not need to satisfy the HIPAA wellness rule requirements established under the PPACA , but participatory programs may be subject to restrictions under other statutes, such as the Americans with Disabilities Act. Unlike participatory programs, contingent wellness programs, which require the satisfaction of a health standard, need to meet several specific requirements. The potential benefits of operating a health contingent wellness program, along with some of the requirements for operating such programs, will be discussed in this blog’s next entry.

Wellness program operators should review their programs now to ensure their programs will comply with the new regulations before January 1, 2014.

About Bose McKinney & Evans LLP

Bose McKinney & Evans LLP is a business law firm, headquartered in Indianapolis, Indiana, serving both publicly held and privately held businesses, governmental entities and high-growth industries. Our clients include Fortune 100 companies, international manufacturers, national and regional financial institutions, agribusinesses, sports teams, university-incubated start-ups, media, utilities, cities and schools, to name a few. We strive to build strong relationships with our clients as key business advisors, to exceed expectations in the quality of our work, to be knowledgeable about our clients’ businesses and sectors, to be responsive to service needs and to continually seek to improve the delivery of client services. Our ultimate focus is on our clients.
This entry was posted in HIPAA, Patient Protection and Affordable Care Act, Wellness Programs and tagged , , , , , , , , . Bookmark the permalink.

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