The Consolidated Appropriations Act (CAA) requires an annual “gag clause prohibition compliance attestation” (GCPCA) be submitted by Dec. 31, 2023, and annually hereafter. Importantly, carriers/administrators/payers have largely removed any references to gag clauses and prohibitions of sharing pricing and quality data, which was prohibited by the CAA. It is now the responsibility of carriers, administrators, and employers to confirm compliance with the gag clause prohibition by way of an annual, online attestation.
It might come as a surprise that such gag clauses have heretofore existed, but in many instances, they did. Specifically, certain agreements between health insurance plans/issuers and healthcare providers/networks would prevent the disclosure of both cost and quality of care data to stakeholders. Healthcare providers/networks are still allowed to place “reasonable restrictions” on the public disclosure of such information.
The compliance burden associated with the GCPCA consists of 2 separate aspects:
Employers are encouraged to check with their health plan issuers, administrators, brokers, consultants, etc. to verify if number 1 and/or 2 above is being handled by their plan issuer/administrator.
For more guidance and information on the annual Gag Clause Prohibition Compliance Attestation (GCPCA) compliance requirement, see – https://www.cms.gov/marketplace/about/oversight/other-insurance-protections/gag-clause-prohibition-compliance-attestation
And to actually make your filing, here is the link – https://hios.cms.gov/HIOS-GCPCA-UI
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