Wellness efforts run afoul of federal law

2/5/2010

Many employers offer incentives to workers to complete health surveys and some use that information to offer health advice or direct employees to disease-management programs. That could be a problem under the Genetic Information Nondiscrimination Act, which took effect last year. As the Wall Street Journal notes, the law restricts employers' and health insurers' ability to collect and disclose genetic information. That includes not only genetic-test results, but family medical history, too. “Some employers say the law is stymieing their efforts to promote employee wellness because it bars them from offering workers financial incentives to complete health surveys that ask about family history,” the newspaper reported. It quotes a 2009 survey by PricewaterhouseCoopers LLP which revealed approximately 70% of employers offer wellness programs and most of them offer employees incentives to complete health-risk questionnaires. Critics say the incentives improperly encourage employees to disclose genetic details, such as family history. "People should not have to choose between their pocketbooks and participating in a wellness program or a health-risk assessment, particularly in this economy," says Jeremy Gruber, executive director of the Council for Responsible Genetics, a Cambridge, Mass., advocacy group. He was quoted in the Journal story. At least one manufacturer, truck maker Navistar International Corporation, has amended its practices. According to the Wall Street Journal, the company last year dropped questions about family medical history from its health questionnaire and that means it can’t direct employees to programs for managing diabetes or cardiac and respiratory ailments based on family history. Although wellness programs are seen as a promising intervention to improve health outcomes and reduce costs, there is widespread support for the new law. The Journal reports that in a November letter to U.S. agencies responsible for administering the law, “more than 250 medical and advocacy groups, including the American Medical Association and American Heart Association, endorsed the law and urged regulators not to exempt wellness programs from restrictions on collecting genetic information.” Wellness programs "need not collect and retain private genetic information to be effective," the letter said. The Journal reports the Equal Employment Opportunity Commission, the U.S. Labor Department, and other federal agencies are finalizing regulations to clarify matters for employers and insurers.