The Consolidated Appropriations Act (CAA) prohibits health plans from entering into contracts that would restrict the plan from:
The contract cannot prevent this data from being shared or directing that the data be shared with a plan’s business associates. However, a network may place reasonable restrictions on public disclosure of the information.
Plans must submit an annual attestation to the government that they are in compliance with this rule.
It is unclear when this rule will apply to any given plan. By its terms, it seems to govern only prospective contracts; not existing ones. The question of what happens when an existing agreement is renewed or modified remains to be answered.
However, plans currently negotiating new network agreements or contemplating doing so, will likely need to take account of these requirements.
There appears to be tension between making the information available to plan participants and others, and the ability of a network to place reasonable restrictions on public disclosure.
