Compliance you can prove with data.

Navigating the Future of Healthcare Compliance with Precision and Expertise

• Unraveling the Complexities of the Consolidated Appropriations Act (CAA) of 2021 - Ramifications and new Client Obligations
• Facilitating Access to and Interpretation of Payer Machine-Readable Data as Mandated by the CAA2021
• Guidance Through the Gag Clause Prohibition Compliance Attestation (GCPCA)
• Addressing Increased ERISA Scrutiny Arising from the Availability of Machine-Readable Files
• Insulating your firm from Increasing Department of Labor Audits with Strategic Compliance Strategies
• Mitigating Risks Associated with the Attestation Clause and Ensuring Factual Reporting
• Empowering Clients with Data Analytics Tools to Manage and Understand Their Own Healthcare Data

Your Ally in Ensuring Compliance and Driving Healthcare Transparency

The Gag Clause Prohibition Compliance Attestation

In the evolving landscape of healthcare compliance, the significance of the Consolidated Appropriations Act (CAA) of 2021 and its accompanying legislation is a critical consideration. Central to these changes is the requirement for a Gag Clause Prohibition Compliance Attestation (GCPCA). This attestation affirms adherence to the provisions set forth in Internal Revenue Code (Code) section 9824, Employee Retirement Income Security Act (ERISA) section 724, and Public Health Service (PHS) Act section 2799A-9. These sections, introduced by section 201 of Title II (Transparency) of Division BB of the CAA, are fundamental in ensuring transparency and accountability in healthcare transactions and management.

Our expertise and services are more crucial now than ever in helping organizations like yours navigate these complex legislative requirements. The GCPCA is not just a formality; it is a declaration of your organization's commitment to ethical healthcare practices as mandated by these laws. Compliance with these statutes involves intricate understanding and application, areas where our team's proficiency in payer networks, medical provider billing, and ERISA law becomes invaluable.

Machine-readable data and ERISA

Moreover, the CAA of 2021 mandates the use of machine-readable healthcare data, introducing a new dimension to compliance. This data, while rich in potential, presents challenges due to its vast size and complexity. Our role goes beyond simply providing access to this information. We specialize in interpreting and aligning this data not only with the compliance requirements of the Gag Clause Prohibition Compliance Attestation (GCPCA) but also in assessing managed plan compliance with ERISA, based on the negotiated arrangements as managed by the plan's Third-Party Administrators (TPAs). This comprehensive approach ensures that your organization maintains compliance not just in theory, but in practice, armed with concrete data to substantiate your compliance status across multiple regulatory requirements.