The Self-Insurance Institute of America (SIIA) recently sent a letter to the Federal Tri-Agencies requesting that action be taken to assist self-insured group health plans and their plan sponsors to appropriately submit Gag Clause attestations, which are currently due on December 31st of this year. SIIA’s letter can be found here.

Specifically, SIIA asked the Federal Departments to delay the December 31st attestation submission date for at least six months while further clarifications and changes are sought before Congress.

SIIA believes that this delay will give group health plans and their plan sponsors more time to work with owners of provider networks to eliminate contractual language that restricts the sharing of quality information and health claims data in all agreements and contracts. These include contracts and agreements between the owner of the provider network and the group health plan, as well as those agreements and contracts between the owner of the provider network and the plan sponsor or a third-party hired to perform plan administration functions.

Such a delay will also provide the Departments with additional time to develop and issue guidance clarifying that restricted “gag clauses” must be removed from all agreements and contracts involving the owner of the provider network and the plan sponsor or a third-party hired to perform plan administration functions, not just the group health plan.

In the absence of a delay, SIIA has asked the Departments to announce a non-enforcement period for at least six months for those plans and their sponsors that believe – in good faith – that prohibited “gag clauses” are still present in the agreements noted above.

SIIA will continue to keep members updated on Congressional and regulatory actions related to the Gag Clause Prohibition and the Gag Clause attestations.  In the meantime, if you have questions or would like to talk further on issues related to the upcoming attestation deadline, please contact Chris Condeluci (ccondeluci@siia.org) or Ryan Work (rwork@siia.org).