I've got great news. There is a new standard with which health insurers and group health insurance plans will have to comply. I know that sounds like, to the casual reader, “ not a regular kind of holiday.”
And, normally, I would agree with you. But you know how I love compliance and transparency!
Something important is coming, a very special day, which will be a new national holiday. We have been celebrating it for years, on the same day, with this bullshit placeholder we called New Year's Eve, but this year, out with the old, in with the new disclosures and certifications of compliance with all appropriate regulations as they relate to group health plans! Quoting the National Law review:
Group health plans and health insurance issuers must attest that they are in compliance with the Anti-Gag Clause Provisions by submitting annually a Gag Clause Prohibition Compliance Attestation (GCPCA) to the Departments of Labor, Health and Human Services, and the Treasury. The initial GCPCA must be submitted by December 31, 2023, for the period covering December 27, 2020 through December 31, 2023. Group health plans that are required to attest by submitting a GCPCA include ERISA plans, nonfederal governmental plans, church plans, and grandfathered group health plans. Account-based plans, such as health reimbursement arrangements (HRAs), are not required to submit a GCPCA.
A group health plan may attest on its own behalf, or, for fully-insured plans, the issuer of the insurance coverage under the plan may attest on behalf of the group health plan. Self-funded and partially self-funded plans may enter into a written agreement under which the plan’s service provider attests on the plan’s behalf.
The annual attestation must be satisfied by submitting a GCPCA via the webform at https://hios.cms.gov/HIOS-GCPCA-UI by December 31st of each year.
FAQs about the Anti-Gag Clause Provisions may be found at https://www.cms.gov/files/document/aca-part-57.pdf.
So I'm proposing that we make December 31, instead of that extremely sloppy and off key New Year's Eve nonsense, a day of remembrance. I want to remember gag clauses!
These were the provisions against disclosing pricing in Healthcare. It was held, in dashes of yore, that negotiated rates were Proprietary. And now they're not proprietary anymore.
So, much like the Guilty Remnant in the show the Leftovers, I want to remember all the things we have lost, somberly. In order to prevent it from being Tucson bar, I'm going to manually write a parody poem which I could totally have AI do for me but won’t:
Should auld backroom deals be forgot
And never brought to mind?
Should auld rebates be forgot
And the days of auld lang compliance?
For auld proprietary kickbacks, my dear
For auld profitable agreements
We'll drink a cup of whiskey yet
For the sake of what was a pretty sweet deal
And surely you will buy your with the billions of dollars you put in your pocket over the course of the last 20 years
And surely I'll negotiate a complex arrangement with a safe Harbor law in order to justify the acquisition of mine!
We'll take a attestation of compliance yet
For the sake of good old times
We two have padded each other’ padded each other's wallets
From 1974’s ERISA till just before the combine appropriations act passed in 2021
The regulations between us ebb and flow
Since the days of auld gag clauses
For old disclosures be forgot
And never brought to mind
Should old profits be forgot
For the sake of attestation requirements
For old profits be forgot
And never brought to mind
Should old profits be forgot
In the days of auld gag clauses?
For auld profitable arrangements buried under layers of legalese, my dear
For an extremely profitable arrangement as long as nobody look too closely and we didn’ an extremely profitable arrangement as long as nobody look too closely and we didn't have to disclose, so we got away with it for years
We'll drink a cup of expensive liquor yet yet
For the sake of all that money we used to make.
Every employer and payer has to do this. It's mandatory. Now I get to see how big the kickbacks really are!
Does anyone have a New Year's resolution?
—Owen Scott Muir, M.D.