Compliance with federal Consolidated Appropriations Act (CAA) Gag Clause provision

As you are aware, the federal Consolidated Appropriations Act (CAA) of 2021 contains several provisions applicable to health plans and their providers. One of the provisions is commonly referred to as a Gag Clause provision; specifically, Section 201: Increasing Transparency by Removing Gag Clauses on Price and Quality Information. The Gag Clause provision prohibits provider agreements from containing certain restrictions that would impact a health plans’ ability to provide provider‑specific cost or quality of care information or data to referring providers, health plan sponsors, members, or individuals eligible to become members.

In compliance with the Gag Clause provision, Anthem Blue Cross and Blue Shield (Anthem) will no longer be able to allow suppression of price and quality data upon provider request.

If provider participates in a Georgia Commercial health benefit plan through any Anthem affiliate, such agreement shall comply with the Gag Clause provision of the CAA.

In addition, Commercial health plans are required to attest annually that their provider agreements are in compliance with the Gag Clause provision. Should your provider agreement with Anthem have language inconsistent with the Gag Clause provision, it is hereby deemed null and void by Anthem.  

Thank you for the care you provide our members — your patients.