Gag clause attestation

As part of the Consolidated Appropriations Act of 2021 (CAA), all employers offering group health insurance and group health plan sponsors offering balance funded or self-funded coverage must submit an annual Gag Clause Prohibition Compliance Attestation (GCPCA) to the Centers for Medicare & Medicaid Services (CMS). The first attestation was due December 31, 2023, and covered the time period of December 27, 2020, to December 31, 2023. Subsequent attestations are due by December 31 of each year and cover the preceding year. 

Blue Cross and Blue Shield of North Carolina (Blue Cross NC) successfully submitted the first annual Gag Clause Prohibition Compliance Attestation (GCPCA) to the Centers for Medicare & Medicaid Services (CMS) on December 15, 2023. Blue Cross NC submitted the GCPCA on behalf of our fully insured client groups and balance funded client groups (unless an opt-out request was made) and provided supporting documentation to assist our self-funded (ASO) groups in their submission.    

Blue Cross and Blue Shield of North Carolina (Blue Cross NC) will continue to submit the GCPCA on behalf of our fully insured client groups to the CMS Portal by the regulatory deadline. No additional action is required by Blue Cross NC fully insured client groups.  

Blue Cross NC will also submit the GCPCA on behalf of our balance-funded client groups to the CMS Portal by the regulatory deadline if an opt-in request is made. (Previous submission included balance funded groups unless an opt-out request was made) The opt-in process is under development.  

Blue Cross NC will not submit the GCPCA on behalf of self-funded (ASO) groups. To assist Blue Cross NC and BlueTPA℠ ASO groups with their submission of their own GCPCA, Blue Cross NC provides the following linked attestation of Blue Cross NC compliance with the CAA prohibition on Gag Clauses. This gag clause attestation (PDF) applies to all Blue Cross NC provider contracts and vendors, including Prime, Avalon, Community Eye Care, EyeMed and Health Network Solutions.

For more information, please refer to the CMS webpage.