Before December 31, 2023, self-insured plan sponsors are required to file a gag clause attestation with CMS using the HIOS system. For self-insured clients, uploading the attestation is a plan sponsor responsibility under the Consolidated Appropriations Act. However, Diversified Group will submit the attestations to CMS on behalf of our clients in time to meet the December 31, 2023 deadline. Diversified will only submit the attestation form for self-funded medical clients that were active with us during the reporting year(s). The reporting years for the first upload due in 2023 covers groups retroactively from December 27, 2020 through December 2023. Subsequently, this will be an annual filing. We will only submit the attestation for contracts that were facilitated by the client’s active status as a self-insured medical group with Diversified Group (including pharmacy). We will submit the attestation form for any contract outside of the client’s relationship with Diversified Group. Per CMS FAQs, Diversified will be submitting the attestations in bulk and not individually. Fully insured plans should check with their carrier, they may be submitting on your behalf.
A self-funded plan sponsor may contract with a service provider (such as a TPA) who may submit the attestation on the plan sponsor’s behalf. However, the plan sponsor remains legally responsible for compliance. Self-funded plan sponsors who intend to delegate reporting responsibilities to a service provider should ensure the delegation is stated in a written agreement. Over the next few days, Diversified will be sending a data gathering form and written consent form to plan sponsors via Docusign for completion. This form is intended to establish reporting entity contact details and operates as authorization for Diversified to submit the attestation for the plan sponsor. Data or consent not received will not be included in this year’s submission.
If you have any questions, please feel free to contact a member or our compliance team:
Dave Follansbee, dfollansbee@diversifiedgb.com
Laura Williams, lwilliams@diversifiedgb.com
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