The gag clause prohibition compliance attestation (GCPCA) under the Consolidated Appropriations Act (CAA), 2021, prohibits certain types of contracts of a health plan from restricting the provision and sharing of certain provider-specific cost and quality information with groups, brokers, members, and prospective members. It also requires health plan issuers to annually submit an attestation to the Centers for Medicare and Medicaid Services (CMS).
Gag Clause Prohibition Compliance Attestation Frequently Asked Questions (FAQs)
The Consolidated Appropriations Act, 2021 (H.R. 133)
The gag clause prohibition compliance attestation (GCPCA) under the Consolidated Appropriations Act (CAA), 2021, prohibits provider, network, and other contracts of a health plan from restricting the provision and sharing of certain provider-specific cost and quality information with groups, brokers (and other business associates of groups), referring providers, members, and prospective members. It also requires health plan issuers to annually submit a compliance attestation to the Centers for Medicare and Medicaid Services (CMS).
Overview
Kaiser Permanente’s approach and implementation
1The following entities are severally and collectively referred to here as Kaiser Permanente: Kaiser Foundation Health Plan, Inc. (for its Northern California, Southern California and Hawaii regions), Kaiser Foundation Health Plan of Colorado, Kaiser Foundation Health of Georgia, Inc., Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc. Kaiser Foundation Health Plan of the Northwest, Kaiser Foundation Health Plan of Washington, and Kaiser Foundation Health Plan of Washington Options, Inc.
2See note 1.