ASR Supports Clients with Gag-Clause Attestations
The Consolidated Appropriations Act, 2021 (CAA) prohibits gag clauses in contracts between a group health plan and certain service providers. Plans must attest to the Departments of Labor, Treasury, and HHS every year that they have no such clauses in their contracts. The attestation for calendar year 2024 is due December 31.
ASR will submit the required attestation for our clients before the December 31, 2024 deadline*. ASR and our vendor partners (including your PBM partner) have reviewed all relevant contracts and can confirm they contain no prohibited gag clauses, with respect to the time period between January 1, 2024 and December 31, 2024 that ASR administered your group health plan.
Note: The submission instructions provided by the federal government, as currently written, state that the “point-of-contact” within the submission must be a person who works for the reporting entity (the plan sponsor). ASR will enter your daily contact person we have on file as the point-of-contact. In the unlikely event questions from the government arise, we understand that this person will be unable to answer them, so we ask that your contact either (1) direct the inquisitor to ASR or (2) ask us for the information necessary to respond.
Background
A gag clause is a contractual term that directly or indirectly restricts specific data and information that a plan can make available to another party. Under this CAA provision, a health plan is prohibited from entering into an agreement with a provider, network or association of providers, third-party administrator, or other service provider offering access to a network of providers that would directly or indirectly restrict the plan from the following:
- Making available provider-specific cost and quality of care information to referring providers, the Plan sponsor, members, or an individual eligible to become a member
- Accessing de-identified claims and encounter information electronically for each member
- Sharing such information (consistent with Privacy laws)
Provider contracts may, however, prohibit plans from publicly disclosing this information.
Please let us know if you have any questions.
*ASR cannot submit an attestation involving contracts we are either not a party to or have not facilitated in any way. Therefore, ASR will not submit the attestation on behalf of any health plans for which ASR administration terminated on or before 1 December 2024. We can, however, confirm that the plan’s contracts during ASR’s tenure contained no prohibited gag clauses. Plan Sponsors of such plans should contact their current administrator for details on the attestation.