On October 7, 2009, the Internal Revenue Service, U.S. Department of Labor and the Centers for Medicare & Medicaid Services published interim final regulations under Title I of the Genetic Information Nondiscrimination Act of 2008 (GINA) to prohibit group health plans and health insurance issuers from discriminating based on genetic information. HHS' Office of Civil Rights (OCR) also released proposed regulations to amend the HIPAA Privacy Rule to preclude the use of genetic information for health plan or health insurance underwriting.
GINA generally prohibits employer-sponsored group health plans and health insurers providing group and individual health insurance from (1) increasing premiums or contribution amounts based on genetic information; (2) requesting or requiring an individual or family member to undergo a genetic test; and (3) requesting, requiring or purchasing genetic information prior to or in connection with enrollment, or at any time for underwriting purposes. In addition, GINA prohibits employers, labor organizations and employment agencies from taking adverse actions on the basis of genetic information or requiring a genetic test. Notwithstanding the limitations, a plan may condition payment for an item or service based on its medical appropriateness related to the genetic makeup of a patient.