Compliance Update: Gag Clause Prohibition Compliance Attestation (GCPCA)
Under the Consolidated Appropriations Act (CAA) of 2021, group health plans and health insurance issuers are required to comply with the Gag Clause ProhibitionCompliance Attestation (GCPCA).
TheCAA prohibits "gag clauses" in agreements between group health plans/issuers and service providers (e.g., TPAs and PBMs) that restrict accessto cost and quality-of-care data. Plans and issuers must annually attest that they are not entering into contracts with these restrictions.
Upcoming Deadline:
The deadline for submitting the GCPCA is December 31, 2024.
Penalty for Non-Compliance:
Failure to comply with the attestation requirement may result in enforcement actions, including potential civil monetary penalties under the EmployeeRetirement Income Security Act (ERISA) and the Internal Revenue Code.
ActionRequired:
- Review agreements with service providers to ensure compliance.
- Submit the GCPCA through the designated CMS portal.
For further assistance or questions on meeting this requirement, please contact your Genesys Health compliance team or reach out to us at results@genesys.health.