Gag Clause Attestation: Deadline Approaching
Section 201 of the 2021 CAA contained a clause prohibiting health plans and providers from contractually restricting the ability of the plan to provide information to another party. The Departments issued guidance in the Spring of 2023 to assist plan sponsors in understanding their responsibility under the rule. In summary, Health plans cannot enter into contracts that restrict the plan from disclosing provider-specific cost information to providers, the plan sponsor, or participants, from accessing de-identified claims information, and from sharing this type of information with a TPA or business associate.
Annually on December 31 2023, plans will need to make an attestation stating that they are in compliance with this rule. Fully insured employers can rely on their carriers to complete this on their behalf.
Self insured employers, and those with level funded arrangements will need to log in to the CMS HIOS portal and complete the attestation themselves following these simple steps:
The individual completing the attestation for the employer/plan will need to create an HIOS account, using their work related email address here
Once the account is activated, log in to the system using the code sent via email
From there, follow the steps to complete the attestation
If you offer a self funded or level funded health plan, complete the attestation following the steps above no later than December 31, and annually thereafter.