Gag Clause Prohibition Compliance Attestation (GCPCA)

What is the Gag Clause Prohibition Compliance Attestation?

The Gag Clause Prohibition Compliance Attestation (GCPCA) is an attestation of compliance with Internal Revenue Code (Code) section 9824, Employee Retirement Income Security Act (ERISA) section 724, and Public Health Service (PHS) Act section 2799A-9, as added by section 201 of Title II (Transparency) of Division BB of the CAA, as applicable.

This provision prohibits group health plans and health insurance issuers from entering into agreements with health care providers, networks, third-party administrators (TPA), or other service providers that would directly or indirectly restrict a health plan or issuer from sharing:

  • Provider-specific cost or quality of care information
  • Electronically accessing de-identified claims and encounter information or data
  • Financial information, such as the allowed amount or any other claims-related financial obligations
  • Service codes
  • And more

What do employer groups need to know about GCPCA?

Sana will file your annual GCPCA on your group's behalf — no employer actions are required!

  • We will submit an attestation of compliance to the Departments of Labor, Health and Human Services, and the Treasury (collectively, the Departments). The Centers for Medicare & Medicaid Services is collecting GCPCAs on behalf of the Departments. 
  • The first GCPCA is due by December 31, 2023. Subsequent attestations are due by December 31 of each year after. 
  • Sana will handle all reporting requirements for active periods each year on your behalf.

What proof will be provided once this is complete?

CMS doesn't have a way to track submissions on a group level, but you can feel free to contact our Customer Success Team if you have any doubt your report was submitted on time. We are committed to maintaining compliance for all of our groups.

 

Have questions? We've got you covered.