The deadline for 2024 CAA gag clause attestations of compliance is December 31, 2024.

To review, the CAA prohibits group health plans and insurers from directly or indirectly entering contracts offering access to provider networks that contain certain types of “gag clauses.” In the healthcare context, gag clauses are contract terms that restrict information, including provider network rates and deidentified claims data, that plans or insurers can make available to another party, such as a business associate. An example is a provision in a TPA contract that prohibits the plan’s access to network rates because the TPA considers the information to be proprietary.

The CAA requires plans and insurers to annually attest to compliance with its gag clause prohibition for contracts entered since the first attestation made in 2023 via a CMS webform. With a fully insured plan, an insurer can agree to submit the required attestation on behalf of the plan. A self-insured or partially self-insured plan may satisfy the attestation requirement by entering into a written agreement under which the plan’s service provider(s), such as a TPA, submits the attestation for the plan; however, the plan remains responsible for compliance.

In October, we issued several reminders regarding the upcoming gag clause attestation deadline. However, if employers have not yet coordinated with their applicable carriers or plan service providers to ensure the attestations have been timely submitted, they should do so as soon as possible.

For further information on the gag clause prohibition and attestation requirements, please review the available resources on the designated CMS Gag Clause Prohibition Compliance Attestation website and download a copy of the PPI publication CAA Gag Clause Prohibition and Attestation: A Guide for Employers.