2024 Updates to 'No Gag Clause' Attestations

CMS has given us a nice summer treat- updated ‘No Gag Clause’ instructions for the 2024 filing that promise to ‘streamline’’ the process for employer plan sponsors. As a reminder, the ‘No Gag Clause’ first took effect in December, 2020. The law disallows health plans from entering into agreements with providers whereby the plan is restricted from providing cost or quality of care information. Plans are also prohibited from agreeing to contract terms that restrict access to de-identified claims data. Employer attestations as to their compliance with the clause were first required by December 31, 2023, via the CMS portal.

A few highlights of the changes that will be of interest to employers are as follows:

• Step 1 ‘Submitter Contact Information’ expanded employer “plan types” to now include 3 categories of group health plans:

• ERISA group health plan, including a union plan

• Governmental group health plan

• Church plan

• Labels relating to provider types (medical network, PBM, behavioral health network, and ‘other’)

• A much needed ‘definitions’ section in the instruction appendix

The DOL template will also assist employers of self insured plans, who will be completing their own attestations. The updated instructions can be found here. Employers should review these updates with their advisors in advance of the December 31, 2024 filing deadline.

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