As part of the Consolidated Appropriations Act of 2021 (CAA), employer-sponsored group health plans (both fully insured and self-funded) must submit an annual Gag Clause Prohibition Compliance Attestation (GCPCA) to the Centers for Medicare & Medicaid Services (CMS).<\/p>\n\n\n\n
The purpose of the attestation is to certify that neither Blue Cross and Blue Shield of Kansas City (Blue KC) nor group health plans use \u201cgag clauses\u201d in their agreements. Gag clauses are contractual terms that restrict the sharing of information about healthcare costs and quality of care, or limit access to de-identified claims information pursuant to section 264(c) of the Health Insurance Portability and Accountability Act of 1996 (HIPAA), the Genetic Information Nondiscrimination Act of 2008 (GINA), and the Americans with Disabilities Act of 1990 (ADA).<\/p>\n\n\n\n
The 2025 attestation is due December 31, 2025. Subsequent attestations are due by December 31 each year thereafter.<\/p>\n\n\n\n
Fully insured and level funded ASO<\/strong> Self-funded: Large Group ASO and JAA<\/strong>
Blue KC will submit the attestation on behalf of fully insured groups, including Cost Plus. New in 2025, Blue KC also will submit for all level funded ASO groups. No additional action is required of these Blue KC groups.<\/p>\n\n\n\n
Blue KC will not submit the attestation on behalf of self-funded groups, including large group ASO and JAA groups. To assist these groups with submission of their own GCPCA, Blue KC is providing its\u00a0Confirmation of Compliance\u00a0<\/a>with the CAA prohibition on Gag Clauses. This Gag Clause Confirmation applies to all Blue KC provider contracts and vendors.<\/p>\n\n\n\nAdditional information<\/strong><\/h2>\n\n\n\n