GINA

Are these groups covered under GINA? Labor unions and labor management programs

YES

Are these groups covered under GINA? Private employers

YES

Is AN INDIVIDUAL'S GENETIC TESTING considered genetic information?

YES

Is FAMILY MEMBER'S GENETIC TESTS considered genetic information?

YES

Is INDIVIDUAL/FAMILY PARTICIPATION IN GENETIC RESEARCH considered genetic information?

YES

Is PARTICIPATION IN EDUCATION AND GENETIC COUNSELING considered genetic information?

YES

Is THE OCCURENCE OF DISEASE IN FAMILY MEMBERS considered genetic information?

YES

Are Genotypes and polymorphisms considered genetic information?

Yes

Are chromosomal changes considered genetic information?

Yes

Are genetic characteristics of existing tumors considered protected information?

Yes

Are these groups covered under GINA? Local and state governments

Yes

Can an insurer require genetic information from a patient?

Yes. For example an insurer may request information about BRCA status to determine coverage for screening or prophylactic mastectomy. But individual can opt to pay out-of-pocket rather than provide the genetic info

Prior to GINA, which act may offer protections in the workplace if an employer discriminated based on a genetic trait strongly related to a particular ethnic group? a.Civil Rights Act of 1964 b.Americans with Disabilities Act c.Health Insurance Portability and Accountability Act d.All of the above

a.Civil Rights Act of 1964

Under GINA, who are referring to when they say "family members?"

up to and including fourth-degree relatives

True or False: GINA offer protection against discrimination in life, disability, and long term care insurance

False

True or False: Genetic information can be used for decisions regarding • Hiring • Firing

False

True or False?: GINA affects health insurance determinations based on manifested disease

False

Employers cannot request, require, or purchase genetic information about a ???, ???, or ???

Family member Fetus Embryo

When can employers collect genetic information?

For toxic-monitoring programs, wellness programs, or unintended acquisition of information

Family members - up to and including ??? degree relatives?

Fourth degree

What are three exemptions to Title 2 of GINA?

Genetic informatin may be used for 1) Toxic-monitoring programs 2) Wellness programs 3) Unintended acquisition of information

Before GINA: Prohibits use of health-related information, including genetic factors by group health insurance plans to deny coverage, determine eligibility, or increase premiums for individuals.

HIPAA

Why might an insurer be able to request genetic information? Limits?

Insurer can require genetic information for coverage determination of some procedures (ex. mastectomy), but only the minimum amount of information necessary for decision-making

What discrimination does GINA not offer protection from?

Life, disability, and long term care insurance

Are LIVER FUNCTION TESTS considered genetic information?

NO

Are Tests of metabolites or proteins directly related to a disease considered genetic information?

NO

Are these groups covered under GINA? Companies with fewer than 15 employees

NO

Are these groups covered under GINA? Federal employees

NO

Is AGE considered genetic information?

NO

Is BLOOD COUNT considered genetic information?

NO

Is CHOLESTEROL considered genetic information?

NO

Is GENDER considered genetic information?

NO

Is INFECTIOUS DISEASE TESTING considered genetic information?

NO

Can employers request genetic information about an employee or an employee's family member?

No

According to HIPAA, is genetic information a pre-existing condition?

No, if no symptoms are present

What protections do Military personnel, Veterans, and Federal Employees have against genetic discrimination?

Programs have internal regulations that provide protections

True or False: GINA does not affect health insurance determinations based on manifested disease or current health status.

True

True or False: Genetic information cannot be used for decisions regarding • Job assignments • Promotions

True

True or False?: GINA does not preempt more protective state laws.

True

True or False?: A health insurer engaged in reserach may request in writing that an individual undergo a genetic test.

True but they may not REQUIRE it

What is Genetic Discrimination?

Using genetic information to treat individuals differently or unfairly

HIPAA does not 1) Prevent... 2) Apply... 3) Prohibit...

1) Prevent charging higher premiums for a whole group 2) Apply to those seeking insurance in the individual market 3) Prohibit employers from refusing to offer coverage

Reseach is exempt from Title 1 of GINA if...(4)

1) Request, not require participation (voluntary) 2) Complies with federal regulations 3) Notify government about performing research 4) Declining cannot affect eligibility or premiums

Insurer cannot require and individual to provide genetic information or information on a family member for (3)

Eligibility/enrollment, Coverage, and Premium-setting

What does Title II of GINA apply to?

Employment

Which of the following is true about GINA? a.GINA does not affect health insurance determinations based on manifested disease. b.As defined by GINA, family members are up to and including 5th degree relatives. c.When GINA went into effect, state laws regarding genetic discrimination were nullified. d.A health insurance company can require family members to have a genetic test if they are all covered under the same plan.

a.GINA does not affect health insurance determinations based on manifested disease.

Which of the following is genetic information under GINA? a.Polymorphisms b.Cholesterol levels c.Metabolites directly related to a disease d.Complete blood counts

a.Polymorphisms

John is one of 5,000 employees at a manufacturing company. During lunch one day, John mentions that his mother has Huntington disease and reveals that he has a 50% chance of developing this fatal condition. John is entirely asymptomatic and has not undergone testing. Subsequently, and for no other apparent reason, John is fired from his job. If he was fired because of this genetic information, does GINA offer protection to John in this scenario? a.Yes b.No c.It depends on his age. d.It depends on the demands of his job; John is not protected if his job requires fine motor skills.

a.Yes

Which of the following does GINA prohibit? a.Providing an employee with information about a genetic test as part of a wellness program. b.A health plan requiring a genetic test in conjunction with specific research activities. c.An individual's genetic test results being stored in their hospital's electronic medical record. d.Requiring a medical examination as a condition of employment.

b.A health plan requiring a genetic test in conjunction with specific research activities.

Which of the following is FALSE regarding the research exception in Title I of GINA? a.Insurers must notify government that they are performing research. b.Genetic test results must be disclosed to individual research participants. c.Genetic testing must be voluntary. d.Declining genetic testing cannot affect eligibility or premiums.

b.Genetic test results must be disclosed to individual research participants.

GINA/HIPAA prohibits use of health-related information, including genetic factors, by ____________________ to deny coverage, determine eligibility, or increase premiums for individuals. a.Life insurance plans b.Group health insurance plans c.Disability insurance plans d.Government assistance

b.Group health insurance plans

Under GINA, employers may... a.Request genetic information b.Inadvertently discover genetic information c.Require an employee to undergo a genetic test d.Purchase an employee's genetic information

b.Inadvertently discover genetic information

Jen is one of 12 employees at a software company. She has a strong family history of melanoma and is found to carry a mutation in the p16 gene. She discusses her increased risk of cancer with her coworkers. Subsequently, she loses her job. Does GINA offer protection to Jen in this scenario? a.Yes b.No c.It depends on her adherence to screening guidelines. d.It depends on how it would affect the company if she needed to take medical leave.

b.No

Which of the following is a FALSE about GINA/HIPAA? a.Does not prevent charging higher premiums for a whole group. b.Does not apply to those seeking insurance in the individual market. c.Does not apply to minors. d.Does not prohibit employers from refusing to offer coverage.

c.Does not apply to minors.

Which of the following is NOT a provision of GINA? a.Health insurers may not request genetic information. b.Health insurers may not require that an individual take a genetic test. c.Healthcare professionals may not recommend a genetic test d.Employers many not require that an individual take a genetic test.

c.Healthcare professionals may not recommend a genetic test

Prior to GINA, Americans with Disabilities Act (ADA) offered workplace and public service protections that prohibit discrimination against individuals with disabilities, including those associated with genetic disorders; however, the ADA does not offer protections for a.Congenital conditions of unknown etiology that result in physical disability b.Genetic conditions that result in intellectual disabilities c.Unexpressed genetic conditions d.Deafness

c.Unexpressed genetic conditions

Prior to GINA, Executive Order 13145 prohibited workplace genetic discriminaton in a.The service industry b.Publicly-traded companies c.Non-government organizations d.Federal departments and agencies

d.Federal departments and agencies

Maria is one of 30 employees at a credit union. She is currently pregnant. What information can her employer NOT request under GINA? a.Her genetic disease carrier status b.The results of her amniocentesis c.Her family history of genetic disease d.Her employer cannot request any of the above

d.Her employer cannot request any of the above

Arianna, age 46, was diagnosed with HFE-associated hereditary hemochromatosis at age 30 due to her family history of the condition. She has been treated with therapeutic phlebotomy and has not developed hepatic cirrhosis. Although her life expectancy is expected normal, she is denied life insurance due to her condition. Is Arianna's access to life insurance protected under GINA? a.Yes b.Yes, as long as she does not develop hepatic cirrhosis c.Yes, as long as she continues phlebotomy as needed d.No

d.No

Who does Title II of GINA not apply to?

employers with fewer than 15 employees, federal employees, VA individuals

Under GINA, what is considered genetic information that is protected?

inidividual or family member's genetic tests, the occurence of disease in family members, the individual or family member's participation in research that includes genetic testing, counseling, or education