Hey there everyone. It's Chris Davis with privacy Gremlin. I'm the InfoSec Institute instructor for its information privacy essentials for cybersecurity professionals and others that are interested in learning more about data protection or information privacy as they exist around the globe. We're going to continue our discussion here regarding US healthcare-related privacy laws and regulations. In this discussion, we're going to talk about GINA, the Genetic Information Non-Discrimination Act of 2008. That means HIPAA. Like I said in my opening statements for this course, that GINA is important to me from the aspect that both my parents died of cancer. My dad at 60, my mom at 62. What GINA does is, it provides me with protection from discrimination. It ensures that employers, trade unions, and others health care insurers don't discriminate against me because I might be predisposed to cancer, but it has not yet manifested itself. Now GINA made several laws we're going to talk about provide us with protection from a group health insurance perspective, individual health insurance perspective, medicare supplemental perspective. It's HIPAA that directs the Secretary of Health and Human Services to add genetic information to the list of 18 identifiers that define protected health information. We're going to have this discussion that really gives us greater insights on the GINA. We're going to talk about GINA from a Title 1 perspective it applies to group health insurance, individual health insurance policies, Medicare, supplementals, and we will talk about GINA's Title 2 implications. I'm tongue twisted, my apologies. They speak to some of the employment in trade union protection, educational protections that it provides individuals that might be predisposed to a genetic disorder, but it is not yet manifested itself. Let's get to it. If you remember anything about GINA, which you remember is Title 1 provisions Title 2 provisions. Each adjusted developed GINA and or promulgate the additional rules for GINA and a vacuum it'll work with the Department of Labor, the CMS, the Centers for Medicare and Medicaid Services, Department of Treasury. It works with the Equal Employment Opportunity Commission. When we talk about Title 1, it's the protection that protects us from discrimination based on health coverage, and health insurance ensures that we won't be discriminated against because we might be predisposed to what you did because order or illness that has had not yet manifested itself. We talked about Title 2, we'll talk about it through the lens up for Texas from discrimination from employment. Also gives certain protections with trade unions as they provide coverage group health insurers and also ensures that we're not denied training opportunities based on the fact that we might be predisposed to a genetic disorder that has not yet manifested itself. How does it define genetic information? Because remember, when we talk about these laws, they're important. What type of law, what type of data are we talking about? Now, I put a note there when we talk about genetic information is not information about the sex or age of any individual. It looks at genetic tests on individual family members, it looks at genetic tests on any fetus of a pregnant woman, looks at not only manifestations of genetic diseases or disorders as they apply to me as an individual, but also to my family members. It also talks about any information that's part of any request associated with clinical research that might also include genetic services. If you note t the bottom there again, I have another note that talks about, again, the applicability to these routine tests and when it makes GINA not applicable and also genetic testing. Big things here. I want you to remember this. Some students tend to confuse GINA with providing blanket coverage for all types of insurance. It doesn't do that. It's applicable to health care insurance coverage, and employment. Now, when we talk of it, it doesn't apply to long-term disability, short-term disability type of policies, life insurance policies it's not applicable there. Make sure that it puts those conditions in place or whether it's health insurance or health plan administrators can inquire me to go out to do additional casting my family members to go and to do additional testing. All for me, substandard rates are premiums based on the fact that I might be predisposed to a genetic disorder or illness that has not yet manifested itself. Sales employees can't use genetic information to make hiring promotion, training opportunities as they apply to my employment. I want you to remember this slide because again, this is when GINA's not applicable. I like to highlight the fact that it generally doesn't apply to employers that have fewer than 15 employees. It doesn't mandate coverage for any particular test or treatment. I want you to remember this doesn't extend the life insurance, disability insurance, long term care insurance policies. Now, if I have manifested signs and symptoms, it doesn't prohibit that the health care insurer then from determine my eligibility based on the manifestation of that disease or that disorder. Again, if I have manifested signs and symptoms and when it comes to group health plans, then employees have the right to increase those premiums based on their determination of that manifestation of disease or disorder. If you see the last one, it doesn't prohibit health insurers, health plan administrations from requesting genetic test results and making insurance payment determinations. But this is after the fact that again, it's been determined that I have manifested signs and symptoms of this genetic disorder or illness. Who enforces this law? If you talk about Title I, you got Department of Labor, Department of Treasury, and the US Department of Health and Human Services. If you have Title II, then we're talking about the EEOC. When we look at it, there are criminal penalties, corrective actions, civil monetary penalties, but when you talk about employment, you also have the private right of action or the right to sue in certain cases when there's a violation of GINA. It has these research provisions. We talk about provision and then we talk about exceptions. When we talk about the resource revisions, it says that again, they apply, they're going out and compelling individuals or family members who go out and do casting or participate in clinical research as it applies is a genetic disorder or illness. We talk about the research exception. There are specific research exceptions that do allow in limited cases. For health insurers or group health plans that are engaged in research to request that an individual. It's not required but they request that an individual voluntarily submit themselves for genetic tests. When we talk about the specific research exception, then these are some of the conditions. It has to be in compliance with applicable laws, HIPAA, other laws themselves. It has to be applicable with state laws, local laws. That it has to be documented that my participation is voluntary. That if I don't want to participate in this research, it doesn't impact me on enrollment in plans or premiums. Can't use any information if I participate in this research. You can't use the results of that for insurance underwriting purposes. It directs the secretary of health to human service to require these health insurers or group health plans, especially if you're talking about wellness programs or research programs and whether collecting this information to notify HHS that the participation was voluntary and any of the information obtained during the research wouldn't be used to adversely affect the individual. Then it says that really, they got to be anticipatory in their conduct of these research to adapt their processes to changes in the law. We're going to talk about this. We're going to talk about the laws that are amended by GINA. If we talk about the Employee Retirement Information Security Act, ERISA, which administered by the Department of Labor that says that it oversees and assures the equitable and fair management of employee pension programs. We got the Public Health Service Act, that it amends the Social Security Act and Civil Rights Act. When we talk about the Public Health Service Act, we're talking about conditions where group health insurers cannot discriminate against me because I might be predisposed to cancer but it has not manifested itself. We talk about Social Security Act, it amends individual insurance policies, Medicare, supplemental programs to make sure that again, there's no discrimination there. When we talk about the Civil Rights Act, we're talking about protection from employment. Let's talk about ERISA. Remember, when we talk about ERISA and some meme where is it mine? A group health plan. Health insurance ensure says that you can't because it might be predisposed to a genetic disorder, a genetic illness. You can't offer me substandard premiums for that based on the information. You can't compel me or my family members to go out and do testing. You can't require us to go out and do testing or required and information for underwriting purposes. When we talk about the Public Health Service Act, it says, and we're talking about individual insurers that they too can't go out and compel me to go with my family members to go out and purchase or conduct genetic tests. They can't offer me substandard testing or premiums, can't compel me to pay more from a contribution standpoint. Says that you can't use pre-existing excludable conditions to deny me rights under this law. We talked about the social security act and that's where, again, we have protection from Medicare Supplemental Policies. It says that you can't compel me or my family members abroad and do genetic tests and you can't purchase this information. You can't offer me substandard premiums. You can't use pre-existing excludable conditions to deny me benefits under this law. When we talk about the Civil Rights Act, we're talking about its applicability employers. Says that based on my predisposition to a specific genetic disorder illness that has not manifested itself, you can't deny me employment. You can't deny me the right to employment opportunities, training opportunities. Applies to you, trade unions also, or the denial of certain types of insurance. You can't like I said, under most concessions, you can't go out and buy information, genetic information then use that because there are exceptions. Said you can't go out and like I said do that or my family members because I might be predisposed to a genetic disorder, illness has not yet manifested itself. No, it also looks at it like I said, if you're a union, says that you can't go out and compel me to go out and take genetic tests or other types of tests my family members. You can't deny me the right to participate, and a union based on the fact that I might be predisposed to the information, you can't go out and acquire it and then use that. But there are exceptions. A key thing is I'm going to highlight the bottom part that you can't deny me training or retraining based on the fact that I might be predisposed, and tie that to employment opportunities. Because I might be predisposed to cancer, the case of my parents, but it is not yet manifested itself or any signs or symptoms. I think GINA's important law. It has a significant effect that it has genetic information to the list of 18 identifiers instead of provide those protections. I want you to remember title l and title II applies a group health insurance policies and practices, title II to employment. We talked about the laws that were admitted, I want you to remember those, ERISA, PHSA. Let me break down the acronyms for you. The Employee Retirement Income Security Act, the Public Health Service Act, the Social Security Act, and then the Silver Rights Act. We talked about vacancies that help, a minister GINA. We talked about Department of Labor, Department of Treasury. We talked about the Equal Employment Opportunity Commission, of course, we talked about HHS. It does this important show. We said that again, it doesn't apply to life insurance, disability insurance, long-term care insurance, companies with less than 15 employees. I hope you've enjoyed the discussion. I look forward to seeing you in our next discussion. As always, I hope you, your family members and significant others are safe and well on this wonderful planet of ours. Wherever you are I hope you and they have a wonderful day. This is Chris Stevens, the privacy Gremlin signing off. Stay safe and take care.
