Gag Clause Prohibition- Attestation – Due 12/31

Gag Clause Prohibition- Attestation – Due 12/31

The Gag Clause Attestation is a newly required process requiring health plans and employer plan sponsors to annually attest to the absence of a gag clause in their health plan.  The Consolidated Appropriations Act of 2021 (CAA) prohibits employer sponsored group health plans from entering into agreements that contain “gag clauses.”  It prohibits group health plans and health insurance issuers offering group health insurance coverage from entering into an agreement between a plan or issuer and a healthcare provider, network or association of providers, third-party administrator, or another service provider offering access to a network of providers that would directly or indirectly restrict a plan or issuer from disclosing or accessing certain price and quality information. The goal is to allow more access and to publish cost and quality information in the directive toward transparency in health care.

Attestation Timing

The first annual attestation is due by December 31, 2023. This first attestation is to cover the period from December 27, 2020, through 2023. Subsequent attestations are due by December 31st of each year.

Who Submits the Attestation

Fully Insured Plans: In general, most insurance carriers will agree to submit the attestation on behalf of the employer.

Self-Funded and Level Funded Plans: The employer is responsible for complying with the attestation process.

Where to Submit the Attestation

The Centers for Medicare and Medicaid Services is collecting the attestations.

Instructions for submitting the GCPCA (PDF)

User Manual for submitting the GCPCA (PDF)

Enter Webform Now for a GCPCA