third proposed regulation issued today by the Department of Health and Human Services (HHS) offers amendments to regulations, consistent with the Affordable Care
Act, regarding nondiscriminatory wellness programs in group health
coverage. Nondiscriminatory wellness programs generally allow premium
discounts, rebates, or modification to otherwise applicable cost sharing
(including copayments and deductibles) in return for adherence to certain
programs of health promotion and disease prevention.
these proposed regulations would increase the maximum permissible reward under
a health-contingent wellness program offered in connection with a group health
plan (and any related health insurance coverage) from 20% to 30% of the cost of
coverage. In addition, the proposed regulations would further increase the
maximum permissible reward to 50% for wellness programs designed to prevent or
reduce tobacco use. These regulations also include other proposed
clarifications regarding the reasonable design of health-contingent wellness
programs and the reasonable alternatives they must offer in order to avoid
Comments on this proposed rule are due on or around January 26, 2013.
related articles titled "HHS Releases Essential Health Benefits Proposed Rule" and "Proposed Rule Protects Patients From Discriminatory Policies."
Regulatory Affairs department will provide full summaries of the 3 proposed rules