Thursday, May 28, 2009

Gina, the First Wave


The first wave of GINA now goes into effect. This part goes directly to affect Heath Insurers. To review the law signed in May 21 2008 will directly affect Health Insurance and Employers.


For this wave we are regulating Insurers in such a way that:

Health insurers may not require individuals to provide their genetic information or the genetic information of a family member to the insurer for eligibility, coverage, underwriting, or premium-setting decisions. However, a health insurer may request that an individual provide genetic information if coverage of a particular claim may be appropriate only if there is a known genetic risk. For additional information, please read the Q&A portion below, entitled "What about submitting claims to my health insurance company?";

Health insurers may not use genetic information either collected with intent, or incidentally, to make enrollment or coverage decisions;

Health insurers may not request or require that an individual or an individual's family member undergo a genetic test; and

In the Medicare supplemental policy and individual health insurance markets, genetic information cannot be used as a preexisting condition.
It will certainly be interesting to see how the attorneys react to these regulations.
I am fairly certain that it will end up being a good thing for patients and perhaps a difficult thing for most insurers...

The Sherpa Says: Congratulations to the United States Government for at least getting something right. Watch out employers, you come under scrutiny in November of 2009.

1 comment:

Anonymous said...

http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1761120

suggests

http://en.wikipedia.org/wiki/Adverse_selection

could result.