Under the Consolidated Appropriations Act of 2021 (CAA), group health plans and insurers may not enter into agreements with providers, third-party administrators (TPAs), or other vendors that restrict access to cost or quality-of-care information—often referred to as “gag clauses.”
To demonstrate compliance, plans must file an annual attestation with the Centers for Medicare and Medicaid Services (CMS) by December 31, 2025.
For 2025, CMS has not announced any changes to the submission process or requirements.
The rule applies broadly to:
- Fully insured and self-funded plans
- Grandfathered and grandmothered plans
- ERISA and non-ERISA plans
It does not apply to excepted benefits, retiree-only plans, or account-based arrangements such as HRAs or FSAs.
Employer Considerations
- Confirm that your plan documents and agreements do not contain gag clauses.
- Coordinate with your carrier, TPA, or consultant to ensure timely completion of the attestation.