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Annual Gag Clause Prohibition Compliance Attestation

September 12, 2024
 

The Consolidated Appropriations Act (CAA) of 2021 prohibits group health plans and health insurance issuers from entering into certain agreements with service providers. Specifically, agreements that would directly or indirectly restrict a group health plan or an insurer from providing provider-specific cost or quality of care information or data; electronically accessing de-identified claims and encounter information or data for each enrollee; or sharing that information or data with a business associate.

The CAA requires group health plans and issuers to report compliance with the Gag Clause Prohibition provision annually to the Department of Health and Human Services (HHS). The next Gag Clause Prohibition Compliance Attestation (GCPCA) is due December 31, 2024,

Premera Blue Cross and Premera Blue Cross HMO will submit the attestation to HHS as required on behalf of our fully insured groups. For self-funded and Optiflex customers, Premera will provide a statement of compliance to support the customer’s responsibility to complete their own attestation. The statement of compliance will be available on our website by the end of October 2024.

Additional resources, including instruction manuals for GCPCA submission, are available on the CMS website at Gag Clause Prohibition Compliance Attestation | CMS.