| All group medical plans | Plans and carriers may not enter into an agreement with a provider, network, TPA or other service provider offering access to a network of providers that restricts the plan from; providing provider-specific cost or quality of care data, electronically access de-identified claim and encounter data for each participant or beneficiary and sharing such information, consistent with applicable privacy regulations. An attestation of compliance must be filed electronically with CMS each year to attest for the previous plan year.
Employers should coordinate in writing with their Carrier, TPAs or other service providers to verify who will be submitting the attestation and will be meeting with the requirement. Employers are ultimately responsible in completing this task. |
No official guidance on penalties have been released as of the creation of this document. |
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