Does your TPA ASO Agreement include limited audit rights? If so your plan may be non-compliant with the new No Gag Rule for group health plans.
As a plan participant, have your asked for an unredacted copy of your plan’s ASO Agreement but your request was denied? If so your plan may be non-compliant with the new No Gag Rule.
Failure to comply with the no gag clause rule could result in a tax under the Internal Revenue Code.
On February 23, 2023 the Departments of Labor, Health and Human Services, and Treasury (“Departments”) issued guidance on the “no gag clause” rule that was added as part of the Consolidated Appropriations Act, 2021 (“CAA”).
Health plans cannot enter into agreements that directly or indirectly restrict the plan from disclosing provider-specific cost or quality of care information to providers, the plan sponsor, and participants…..