CMS Reveals State-Level Wellness Program Demonstration

CMS released an informational bulletin announcing the opportunity for 10 states to apply to participate in a wellness program demonstration project. This bulletin gives states and issuers new flexibility to design and offer wellness programs for individual market health plans that provide people with direct incentives to make healthier choices and achieve better health outcomes.

Under this demonstration project, participating states may permit a broader range of wellness programs for those in the individual market than are currently available under the law. States will be able to develop innovative ideas to improve their residents’ health by permitting issuers to offer premium cost savings or other incentives for people if they choose to engage in healthy activities and improve their health outcomes through “health-contingent” wellness programs. While rewards may be offered to enrollees who meet certain health standards, participating states must ensure that a reasonable alternative is offered to people who cannot achieve the wellness program standard because of a medical condition, including a pre-existing condition.

Click here to read the press release from CMS.