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Starting in 2020, the Consolidated Appropriations Act, 2021 (CAA) bans health plans and insurers from using gag clauses in contracts that limit sharing information on provider prices and quality. This promotes transparency and allows for better-informed decisions without violating privacy rules.
Annual compliance attestations to the Departments of Labor, Health and Human Services, and Treasury (the Departments) are required, with the next submission due by December 31, 2024. Missing the deadline may result in enforcement action.
Action Steps
Employers should ensure their contracts with issuers, third-party administrators (TPAs), or health plan service providers do not include prohibited gag clauses. Fully insured employers are exempt from attestation if their issuer handles it. Self-insured employers can arrange attestation through TPAs, though responsibility stays with the health plan. Employers submitting their own attestations should follow the latest instructions. Access submission instructions, the user manual, and FAQs here. Download the bulletin for more details.
Resources
- FAQS from the Departments regarding the CAA’s prohibition on gag clauses in provider agreements
- CMS website for submitting gag clause attestations
- The latest instructions and user manual for submitting attestations available here
National Insurance Services is not a law firm and no opinion, suggestion, or recommendation of the firm or its employees shall constitute legal advice. Readers are advised to consult with their own attorney for a determination of their legal rights, responsibilities and liabilities, including the interpretation of any statute or regulation, or its application to the readers’ business activities.
