Group health plans are now required to submit an annual attestation confirming that the agreements the plan enters into with its service providers do not contain “gag clauses,” which are limitations regarding the plan’s ability to access de-identified claims data or disclose provider-specific information to third parties, including plan participants.
The first attestation is due by December 31, 2023, and will cover the period of December 27, 2020 through December 31, 2023. The attestation must be submitted through a CMS portal.
An attestation will be due by the 31st of December each following year. Self-funded plans can contract with their third-party administrators to submit the attestation on their behalf, however ultimate responsibility for filing remains with the plan. For fully insured plans, the insurance carrier may make the required attestation on behalf of itself and its client plans.
Notably, insurance carriers who also act as a third-party administrator for self-funded plans are permitted to submit a single attestation on behalf of all of their fully insured and self-funded group health plan clients.
Agency guidance regarding gag clauses and the annual attestation requirement can be found here.
