Don’t Forget About Your Gag Clause Attestations
Compliance News
Thursday, December 05 2024
this (Nov 20, 2024) When the Consolidated Appropriations Act, 2021 (CAA) was enacted on December 27, 2020, it included a provision that prohibits group health plans and health insurance carriers from entering into certain agreements that, either directly or indirectly, restrict the release of certain information related to provider networks and de-identified encounter data, among other things. Such restrictions are commonly referred to as “gag clauses.” The CAA also requires plans and carriers to attest annually that their agreements do not include such impermissible gag clauses.
The first gag clause attestation was due on December 31, 2023, with the next one coming due by December 31, 2024, which covers the period between the last attestation and the date this year that the attestation is submitted. The attestation was modified somewhat for 2024, including, among other things, a new requirement to include an attestation year (i.e., the year the attestation is submitted), a new requirement to include the attestation period (i.e., the date range for the attestation, which is the period between when the last gag clause attestation was submitted and the current gag clause submission) and a section to include the plan type (ERISA plan, non-federal governmental plan, or church plan).
Key gag clause attestation requirements and considerations are described below, though more extensive FAQs can be located (along with the instructions, forms and user manuals for submitting the attestations) on the CMS website.
To Read More Click Here
The first gag clause attestation was due on December 31, 2023, with the next one coming due by December 31, 2024, which covers the period between the last attestation and the date this year that the attestation is submitted. The attestation was modified somewhat for 2024, including, among other things, a new requirement to include an attestation year (i.e., the year the attestation is submitted), a new requirement to include the attestation period (i.e., the date range for the attestation, which is the period between when the last gag clause attestation was submitted and the current gag clause submission) and a section to include the plan type (ERISA plan, non-federal governmental plan, or church plan).
Key gag clause attestation requirements and considerations are described below, though more extensive FAQs can be located (along with the instructions, forms and user manuals for submitting the attestations) on the CMS website.
To Read More Click Here