The Center for Medicare and Medicaid Innovation, which was created under Section 1115A of the Social Security Act (added by section 3021 of the Affordable Care Act), has commenced the initial stages of tyrannizing the details of older peoples’ lives in the name of supposedly reducing heart disease risks. Its “Million Hearts®: CVD Model” will be recruiting 360 control and 360 intervention practices, with about 150,000 Medicare fee-for-service patients in each group. Needless to say, the American Heart Association is the primary instigator. And it’s coming under cover of the US Secretary of Health and Human Services announcement of their intention to shift 85% of all traditional (fee for service) Medicare payments to “quality and value” [sic] by 2016. Continue reading
On April 16, 2015, several federal agencies released a barrage of regulatory issuances and guidances that further clarify their position on wellness programs. First, the EEOC released a proposed rule on the application of the Americans with Disabilities Act to Wellness programs. With the proposed rule, the EEOC released a fact sheet for small businesses and a question and answer set for the general public.
Second, the HHS Office of Civil Rights, which enforces the HIPAA privacy rules, released FAQs on the wellness programs and HIPAA privacy and security. Third, HHS and the Departments of Labor and Treasury released a set of frequently asked questions on wellness programs. Fourth, HHS released a separate set of FAQs regarding the relationship between the ACA insurance reforms and wellness programs.
Finally, the Department of Labor released a research report on workplace wellness programs. (Workplace Wellness Programs: Federal Agencies Weigh In. By Timothy Jost. Health Affairs, Apr. 17, 2015.)
As usual, smokers’ rights concerns are poorly addressed, if not completely trampled, by all. An example is what the departments of HHS, Labor and the Treasury consider to be a “reasonably designed” wellness program. “A program that collects a substantial level of sensitive personal health information without assisting individuals to make behavioral changes such as stopping smoking, managing diabetes, or losing weight, may fail to meet the requirement that the wellness program must have a reasonable chance of improving the health of, or preventing disease in, participating individuals.” But what about the rights of people who don’t want to quit smoking? What about the inherent coercion of so-called “incentives?”
And what about the fact that Workplace Wellness is founded on scientific and economic fraud in the first place? At least the economic nonsense is addressed in the last two paragraphs, summarizing the Department of Labor research report:
The study found that lifestyle management programs did not result in reduced utilization of health care services or reduced cost. No evidence was found of reduced costs from smoking cessation or pre-disease management programs. Greater exposure to interventions through telephonic counseling programs increased rather than reduced costs. Lower cardiovascular events attributable to wellness programs reduced costs, but did not come close to offsetting increased costs of participation.
Wellness programs, in sum, do not reduce health program cost, contrary to the assertions of program vendors and the beliefs of employers.