Pepper has a nationally recognized practice in advising clients on all aspects of employee benefit plans, including the design, drafting, implementation, communication and operation of wellness benefit programs. We counsel clients on how to take maximum advantage of the provisions of the PPACA that support wellness programs, including enhanced premium discounts and other financial incentives, without violating HIPAA discrimination and privacy requirements. We also advise on the creation of health savings accounts, health reimbursement arrangements, flexible spending accounts and similar employee-directed health benefits. We also assist health care providers in creating profitable, high-performance delivery systems for patient health and wellness.
Retail Care Centers
Consumers’ use of retail health clinics is increasing. We help clients interested in sponsoring or operating such clinics to navigate the financial, legal and marketplace issues for involvement in convenient care and help forge alliances and agreements between the clinics and hospitals, physicians, and other health-care entities.
We help physicians who partner with retail care centers as a means of providing a collaboration and referral system for patients who use the clinics, and assist the centers in responding to and complying with increasing calls from physician associations and medical standards groups for increased regulation of this growing industry.
We help clients navigate the rules regulating wellness programs, which are administered by three federal agencies, including the Health and Human Services Department, the Department of Labor and the Treasury Department. Federal laws governing the programs include the PPACA, Americans with Disabilities Act, HIPAA and the federal tax code. State labor laws also may apply. We also are well-versed in advising clients about various marketing guidelines that affect the operation of wellness plans.
We advise employers and health care providers on their contractual relationships with vendors and third-party administrators who assist in creating and operating wellness programs, including ensuring that they comply with HIPAA non-discrimination and privacy rules.
We advise clients on ensuring that wellness programs avoid violating the Genetic Information Nondiscrimination Act of 2008, which restricts employers’ and health insurers’ ability to collect and disclose genetic information, including information disclosed in a health-risk assessment or similar tool common to many wellness programs.