CVS Caremark Corporation has come under fire for asking employees covered under the company’s health care plan to disclose a range of personal information in a “wellness review” — from their weight to blood pressure — or face a financial penalty.  According to company statements, CVS is giving its 200,000 employees an ultimatum: submit your height, weight, body fat percentage (Body Mass Index, aka “BMI”), blood pressure, glucose levels, and other health indicators or suffer an on-going financial penalty of $50 per month.

Not only is CVS Caremark demanding that workers get “wellness reviews” under threat of financial penalty, CVS is also asking workers to give permission to the insurer to turn over that information to a firm that provides benefits support to CVS, the Boston Herald reports. CVS says it will pay for the weight, body fat and blood screenings. But in exchange, workers must sign a form saying the screening is voluntary, and that the insurer can give test results to WebMD Health Services Group (the firm provides health management programs and benefit support to CVS).

An internal CVS document leaked to the press warns that, “[Our CVS Caremark] Colleagues who take action to stay healthy or improve their health, and get results, will be rewarded. Those [CVS Caremark colleagues] who don’t take accountability will have to pay more in the future.” And although the CVS says the medical exams are completely voluntary, anyone who chooses not to weigh in will end up paying an extra $50 per month, or $600 a year more for benefits. And CVS employees don’t have a lot of time to decide what they’ll do; their screening results are due by May 1, 2013.

However, CVS Caremark is far from the only private or public employer one pushing workers to reveal detailed medical information. As health care costs tick up and employers rush to comply with new requirements tied to President Obama’s Affordable Care Act, many companies are asking their workers (and in some cases, workers’ spouses) to undergo rigorous health care screenings aimed at encouraging healthier living — and boosting the company’s bottom line.

At Home Depot, for example, workers covered by the company insurance plan are encouraged to fill out on an online questionnaire and take a “hidden health risk screening” that measures their waistline, triglycerides, HDL cholesterol, blood pressure and glucose levels. They’re also given targets: Women should aim for a waistline under 35 inches, while men should try to stay below 40 inches. While no one is required to participate, those who do (regardless of whether or not they hit their targets) can earn an extra $25 every two weeks. Spouses covered by the plan can also participate.

Public entities are also collecting medical and health information about employees, spouses, and family members covered under their insurance plans.  In 2012, The employees of the City of Chicago were given a similar requirement to undergo medical screening (“wellness reviews”) in an attempt to control spiraling health care costs. A spokesperson for Mayor Rahm Emanuel said that the policy has worked for the city, and that in the last year they saved over $20 million in health care costs as a result.

Passage of the health care reform law, The Patient Protection and Affordable Care Act (aka, Obamacare), could make the practice of employer-sanctioned “wellness reviews” much more common. The health care reform law allows employers to levy a higher penalty against workers who don’t participate in company wellness programs. In some cases, workers could also have to pay more if they don’t meet certain health targets like appropriate body mass index.

The idea is that employees, inspired either by the promise of extra cash or the threat of losing cash, will work harder to be healthier. And healthier employees are both more efficient and cost the company less money.

While health care costs have always been an important consideration for executives, they’ve become an even bigger priority since the Supreme Court upheld the president’s health care overhaul law last year. In 2018, a provision of the law will kick in that taxes companies 40% for any coverage that exceeds a certain threshold — $10,200 for individuals or $27,500 for families each per year. To avoid the tax, employers are encouraging their workers to lead healthier lifestyles, and are asking them to pay more for their health coverage.

More than two-thirds of employers already offer financial rewards to encourage workers to participate in health and wellness programs, according to a survey released earlier this year by Towers Watson/National Business Group on Health. Sixteen percent of the 583 employers polled said their companies use rewards or penalties to gather specific biometric information from their workers, and another 31 percent said that they were considering implementing such a strategy for 2014.

Critics fear such programs encroach on employees’ privacy and could lead to discrimination against unhealthy or disabled workers. CVS Caremark said in a statement that “all personal health data from these screenings are collected and reviewed by a third party administrator” and that the data “is never shared with CVS Caremark.”

However, Dr. Deborah Peel, the founder of Patient Privacy Rights, expressed doubts about CVS’s assurances. “There’s no chain of custody for health data,” she told the Boston Herald. “So there’s no way to verify that they don’t really look at it.”

In addition, Peel said the $600 noncompliance penalty shows the program isn’t voluntary. “How is it voluntary if you are a low- or medium- wage person?” she said.

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