Compliance Webinar: Gag Clause, Data and Fiduciary Responsibility (3/14/2024)

LVBCH Compliance & BSI Presentation

Date: March 14, 2024
Topic: Gag Clause, Data, and Fiduciary Responsibility

Presenter: Kyle McLemore, SVP of Operations (kmclemore@bsicorporate.com)

Agenda:

• CAA Overview – Understanding the Consolidated Appropriations Act
• Gag Clause Provision – Explanation of direct and indirect gag clauses
• Employer Responsibility – Fiduciary duties and compliance
• Carrier Responsibility – Data-sharing obligations of carriers
• Understanding Your Data – Best practices for using and analyzing health plan data

Key Takeaways:

• Gag Clause Attestations were required by December 31, 2023, and apply to all group health plans, with penalties of up to $100 per day per affected individual.
• Employers are fiduciaries and must ensure transparency and disclosure.
• Carriers must provide requested data to plan sponsors and facilitate third-party data access.
• Best practices include working with a trusted partner to analyze data and ensure compliance.
• Action Item: Employers should verify that their carriers, PBMs, and other health plan partners are complying with gag clause regulations.