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 is due by December 31, 2023, and covers 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) will submit the GCPCA on behalf of our fully insured client groups that had Blue Cross NC insurance during the relevant time period of December 27, 2020, to December 31, 2023, 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 unless the balance funded group opts out by submitting the opt out form no later than November 30, 2023.

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 is providing 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 Therapeutics®, Avalon Healthcare Solutions, Community Eye Care, EyeMed® and Health Network Solutions.

For more information, please refer to the CMS webpage.