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Health & Welfare Plans Newsletter

BULLETIN
May 24, 2024

 

[Official Guidance]

Text of Agencies' Publication Annual Submission Instructions for Gag Clause Prohibition Compliance Attestation (PDF)

27 pages, May 2024. "By submitting a [Gag Clause Prohibition Compliance Attestation (GCPCA)] to the Departments, a plan or issuer is attesting that, for the period of the attestation, it has not entered into any agreement that violates Code that violates Code Section 9824, ERISA Section 724, and PHS Act Section 2799A-9. ... A Responsible Entity is a plan or issuer that is subject to Code Section 9824, ERISA Section 724, and/or PHS Act Section 2799A-9, as applicable, and has directly or indirectly -- generally through a third-party administrator (TPA) or another vendor, such as a Pharmacy Benefit Manager (PBM), Independent Practice Association (IPA), or Behavioral Health Manager (BHM) -- entered into an agreement(s) with health care providers, a network or association of providers, TPAs, or other service providers offering access to a network of providers. The Responsible Entity is responsible for ensuring it annually attests, or that another party (such as its TPA or vendor) attests on its behalf, and that the Responsible Entity complies with the prohibition on gag clauses."  MORE >>

U.S. Department of Health and Human Services [HHS]; U.S. Department of Labor [DOL]; and U.S. Treasury Department

[Official Guidance]

Text of CMS Gag Clause Prohibition Compliance Attestation User Manual (PDF)

63 pages. "This User Manual explains how to use the Gag Clause Prohibition Compliance Attestation (GCPCA) webform.... Plans and issuers must annually submit to the Departments of Labor (DOL), Health and Human Services (HHS), and the Treasury an attestation of compliance with these requirements and should use the GCPCA Webform to do so." [Also available: Responsible Entity Excel Template]  MORE >>

Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS]

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BenefitsLink® Health & Welfare Plans Newsletter, ISSN no. 1536-9595.

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