An important reminder: Group health plans are required to attest that they are in compliance with the Consolidated Appropriations Act’s gag clause prohibition no later than December 31, 2023.
The 2021 federal law requires that all group health plan sponsors file an attestation (via a federal web portal) declaring and verifying that they have not entered into any agreements with health care or service providers or provider networks which prohibit them from accessing certain claim and health care provider data. This type of contractual provision is known as a “gag clause,” and the prohibition is designed to increase transparency by removing gag clauses on price information from applicable agreements.
Health plan sponsors must attest that their applicable agreements are compliant annually with the first attestation due via the federal web portal by the last day of 2023. Since the prohibitions described in the law have been in place for group health plans since December 27, 2020, this first attestation covers calendar years 2020 – 2023.
Third parties, such as MedBen, can prepare and file the attestation for our group health plan clients, but only with express written authority from the plan sponsor to do so. The federal rules confirm that the plan sponsors can satisfy the attestation requirement with regard to self-insured group health plans by entering into a written agreement with a third-party service provider (such as their TPA) who then agrees to prepare and file the attestation on the health plan’s behalf. This means that a TPA can attest on behalf of its clients – but only with written authorization to do so.
MedBen has reviewed the applicable provider agreements to which MedBen is a party – those accessed by our plan sponsor clients – and none of those agreements contain prohibited language or provisions. MedBen cannot attest to contracts that MedBen hasn’t signed. Attestation regarding such direct agreements between providers and the plan sponsor is the responsibility of the plan sponsor, not MedBen.
MedBen previously emailed a summary and attestation form to clients. If you would like MedBen to prepare and file the attestation on your behalf, please complete the form in its entirety, including an authorized signature, and return it to us as soon as possible. If you have any questions, please contact your Account Management team or the MedBen Compliance Department.