Onsite Solutions and Liability Issues

Physical therapyMany companies either have or are considering an onsite wellness solution for their employees.  In fact, it has been reported that over 15% of all US companies already have an onsite health center.  These onsite solutions can range from a room with some fitness equipment to a full scale medical center with physicians and medical personnel.   The end goal is to have a healthier workforce and it is no surprise that with these types of solutions, many benefits come from them.  The most obvious is an increase in employee health which leads to the many underlying benefits. A healthier employee has decreased injuries, decreased healthcare expenditures, increased productivity, increased morale and decreased absenteeism.  However, there are also a few things to consider prior to implementing a wellness solution; such as the legal ramifications and any liabilities that could be exposed.

Compliance Issues:

  • Employee Retirement Income Security Act (ERISA)- makes provisions for medical services provided for employees (that go beyond first aid).  Basically, this will extend the requirements of offered health care plans to cover the services of the wellness center.  Example: COBRA policy extensions.
  • Tax Income Issues- with the new health care plan in Congress, this issue may get even blurred.  The issues that can come into play are the fact that healthcare can be provided on a tax-free basis.  However, onsite centers do not always follow the same rules/guidelines that are put in place under the “tax-free” code.  Example: Non-medically necessary procedures, and highly compensated executives.
  • Health Insurance Portability and Accountability Act (HIPAA)- which offers legal protection from release of personal medical information to anyone non-vital to their treatment.  This comes into play when release of information is made in billing/statistics/reports on prognosis.  Example: Returning to work, limitations, or pre/post hiring evaluations that are not properly authorized for release.
  • Genetic Information Nondiscrimination Act (GINA)- puts limits on ways that genetic information is acquired.  This becomes of greater concern when family members are included in the wellness program.
    Even if these aren’t enough, there are various other federal and state laws that muddy the waters even more.  Programs such as Return to Work, Pre/Post Hire Testing, Medical Leave, and Drug Testing etc, have other sides to the legal minefields.

What can you do?

  • 3rd Party Vendor – Consider a 3rd party vendor for your wellness solution management.  This offers a more defined line between employer and provider.  This can be offered as a benefit to the employees.
  • HIPAA Training – Ensure that employees who are a part of the wellness center understand their roles and pitfalls.
  • Periodic Quality Audits – Do checkups to ensure that HIPAA forms are being appropriately used, and that all health records are guarded per HIPAA rules and regulations.
  • HIPAA Communications – Ensure that employees who are a part of the wellness solution are aware of their rights and informed that their personal health history will be kept private and confidential.
  • Carry Medical Malpractice Insurance – If using a 3rd party, make sure they have a policy. If you choose to use your own employees, make sure that the policy is adequate and well written to protect the company and its assets.

As more and more companies look to onsite wellness, there will be even more scrutiny of laws and regulations.  It is clear that wellness is an added value and should be considered as a viable business strategy to stay competitive and even increase the competitive advantage.  Healthy employees are more productive, leading to an increased bottom line.  However, it should be designed properly and legal ramifications should be considered and planned for.  With this taken into consideration, a successful wellness program can reap substantial benefits!