Gag Clause Prohibition Compliance Attestation

Sentara Health Plans is gathering information to meet the timelines for the required Gag Clause Prohibition Compliance Attestation (GCPCA), due no later than December 31, 2025.

The Gag Clause provision prohibits group health plans and health insurance issuers from entering into agreements with providers that prevent enrollees, plan sponsors, or referring providers from seeing provider-specific cost and quality data.

Plans and issuers must annually attest to CMS that they are in compliance with all requirements. As a courtesy, Sentara Health Plans will attest on behalf of fully insured and self-funded groups. The requirements for these groups are the following:

• Fully-insured groups – no action is required
• Self-funded and BusinessEDGE^®groups– required to submit a form with group information to Sentara Health Plans

Self-funded and BussinessEDGE groups will receive an email with a link to complete an electronic form to collect the required data points. The form must be submitted by October 15, 2025. Once received, we will process the information and submit the attestation to CMS by December 31, 2025.

Gag Clause Attestation Form

For information on how to complete form visit Gag Clause Form frequently asked questions. More details on the regulations and requirements can be found on the CMS website our frequently asked questions on our website.

Please contact your Sentara Health Plans representative if you have questions.