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2024 Resources for Gag Clause Attestation

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The U.S. Department of Labor (DOL) recently issued resources to help health plans and insurers submit their annual compliance attestation for the Consolidated Appropriation Act’s (CAA) gag clause prohibition. The resources can be used to submit the next gag clause attestation, which is due by December 31, 2024.



Effective in 2020, the CAA bars health plans and issuers from including gag clauses in contracts with providers, third-party administrators (TPAs), or service providers. Plans and issuers must annually attest to compliance with this rule by December 31st each year.


2024 Resources

The DOL has published the following resources to assist with the next annual attestation:

The Centers for Medicare & Medicaid Services had provided instructions and a user manual for previous attestation submissions.


Action Steps

Employers should review their contracts to ensure that they comply with gag clause requirements. Insured plans may not need to provide attestations if the issuer does so. Self-insured employers can arrange for TPAs to provide attestations, but the legal responsibility lies with the health plan. Some TPAs may not be willing to submit attestations. Employers needing to submit attestations should refer to the latest instructions and user manual. Download the bulletin for more details.


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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.

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Steve Smith

Steve Smith

Steve Smith, Employee Benefits Consultant for National Insurance Services, has his energy level permanently set at “high.” His maxim is “work hard, play hard.” Steve’s an expert in getting groups of people working together for a higher cause. Minnesota schools, cities, and counties rely on Steve’s unique and creative ideas of engaging employees in their own health and wellness to lower utilization trends. He has 20+ years in the health insurance field doing compliance, cost mitigation, utilization, analytics, wellness plans, and strategic planning. Steve is a licensed insurance agent and holds the designations for Managed Healthcare Professional (The Health Insurance Association of America), Certified Patient Protection and Affordable Care Act Professional (National Association of Health Underwriters), and Group Benefits Disability Specialist (Hartford School of Insurance). He specializes in Employee Benefits Consulting for Minnesota schools, cities, and counties including fully insured, self-insured, and stop-loss plans.