Gag Clause Prohibition Compliance Attestation

July 6, 2023

Gag Clause Prohibition Compliance Attestation

The Consolidated Appropriations Act (CAA), 2021, requires group health plans and health insurance issuers to annually complete a Gag Clause Prohibition Compliance Attestation (GCPCA), and the first attestation is due December 31, 2023.

Group health plans and health insurance issuers may not enter 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 restrict the plan or issuer from providing, accessing, or sharing certain information about provider price and quality and deidentified claims.

As our clients directly contract with other service partners, WebTPA is not in a position to attest to compliance with the rule for our clients. We can confirm that WebTPA’s agreements with our clients do not contain gag clause verbiage, but we cannot attest on behalf of the other vendors.

The Attestation Process

The full attestation process can be completed in approximately 20 minutes and a health plan does not need a registered-HIOS account. The health plan would access the webform at the following link, https://hios.cms.gov/HIOS-GCPCA-UI, and requests a unique code from CMS. Within 10 minutes, CMS emails the code to the user, who can then open the GCPCA webform instructions and the GCPCA module user manual. The instructions explain how the Reporting Entity Excel Template and the attestation are to be completed. You may also view the user manual here prior to accessing the GCPCA website.

Once the attestation is submitted, the user will see “submission successful” on the screen and a link to the submission receipt to be downloaded.

Please contact your WebTPA Account Executive with questions about your plan’s submission.