In an effort to boost health care cost transparency and increase positive member health outcomes, the Consolidated Appropriations Act (CAA), was adopted in 2022. A Gag Clause Prohibition is among the act’s provisions and forbids plan sponsors from entering agreements with health care providers, third-party administrators (TPAs) or other service providers that result in restricted access to claims data sharing. To comply, plan sponsors or issuers must annually submit a Gag Clause Prohibition Compliance Attestation (GCPCA) by December 31.
The Department of Labor (DOL), Health and Human Services (HHS), the Treasury, and Office of Personnel Management (OPM) released a joint FAQ to provide clarity and boost understanding of the CAA, including guidance on the attestation process, language and requirements.
The FAQ establishes that plans and issuers must still submit the annual compliance attestation even if they have entered into a noncompliant agreement. In the case that a non-compliant provision cannot be removed from an agreement, plans and issuers must include note of the noncompliant provision in the “additional information” box on Step 3 of the Gag Clause Prohibition compliance attestation (GCPCA) webform system.
The CAA is among the alphabet soup of legislation plan sponsors must adhere to. Is your benefits plan hitting the mark? Bukaty Companies’ scope of compliance knowledge helps plan sponsors identify and meet compliance requirements. Our team is one click away to review and strengthen your current practices.
