EBSA Website Update: Gag Clause Prohibition Compliance Attestations

United States Department of Labor sent this bulletin at 02/23/2023 05:53 PM EST

Subject: EBSA Website Update: Gag Clause Prohibition Compliance Attestations

The Centers for Medicare & Medicaid Services (CMS) are now collecting Gag Clause Prohibition Compliance Attestations (GCPCA) on behalf of the Departments of the Treasury, Labor, and Health and Human Services via the portal at https://hios.cms.gov/HIOS-GCPCA-UI.

A GCPCA is an attestation of compliance with Internal Revenue Code (Code) section 9824, Employee Retirement Income Security Act (ERISA) section 724, and Public Health Service (PHS) Act section 2799A-9, as applicable. These provisions generally prohibit plans and issuers from entering into an agreement with a health care provider, network or association of providers, third-party administrator (TPA), or other service provider offering access to a network of providers that would directly or indirectly restrict a plan or issuer from providing, accessing, or sharing certain information related to cost or quality of care or de-identified claims and encounter information.

Instructions for submitting the GCPCA and additional information are available at https://www.cms.gov/cciio/programs-and-initiatives/other-insurance-protections/gag-clause-prohibition-compliance. These materials explain, for example, which entities are required to file an attestation and the technical requirements for completing an attestation in the GCPCA website. Group health plans and health insurance issuers offering group or individual health insurance coverage must annually submit a GCPCA to the Departments. The first GCPCA is due no later than December 31, 2023, and subsequent GCPCAs are due by December 31 of each year thereafter.

Related information posted on the EBSA website: