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The Departments of Labor, Health and Human Services, and the Treasury issued an FAQ on the prohibition of gag clauses under the transparency provisions of the Consolidated Appropriations Act, 2021 (CAA). Health plans and health insurance issuers must submit their first attestation of compliance with the CAA’s prohibition of gag clauses by December 31, 2023.
The gag clause prohibits health plans and issuers from entering contracts that restricts them from providing, accessing, or sharing certain information about provider price and quality of deidentified claims.
The first attestation is due by December 31, 2023, covering the period beginning December 27, 2020, through the date of attestation. Subsequent attestations, covering the period since the last attestation, are due by December 31 of each following year.
Employers should ensure that their contracts do not violate the CAA’s prohibition of gag clauses. If the issuer provides the attestation for the employer’s fully insured health plan, the plan doesn’t need to provide one. Self-insured employers’ third-party administrators can provide the attestation, but the legal responsibility remains with the health plan. Enforcement action can be taken if attestations are not submitted timely.
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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.
