gag clause

A provision that may be incorporated in a physician’s contract with managed care organizations, which prevents him from being open with his patients about the terms of the patient’s coverage and therapeutic options

gag clause

Any item in a contract that restricts free speech or personal expression.
References in periodicals archive ?
Something else we've done in Congress is trying to address something called the gag clause. The gag clause is one of those things that was just behind the scenes that no one knew, but the pharmacists knew because if you came in with your insurance card to pick up your prescription the pharmacist knew the actual cost that you would pay if you paid in cash.
"The gag clause compels the pharmacists to be complicit in the scheme.
Removal of the contracts gag clause would allow pharmacists to inform their patients of money-saving options, without fear of retaliation from PBMs.
Belafonte wants a gag clause on ever being discussed by Mel publicly.
The customer refused, and KlearGear invoked the gag clause in its Terms of Service, sending the significant fine to a collections agency and damaging the consumer's credit rating.
The so-called gag clause has been cited by some as a technique used by managed care companies to limit access to care.
Nelson praised the bill's provisions on grievance and appeals procedures, direct access to specialists, HMO liability, gag clause prohibitions, and continuity of care for patients with chronic conditions if their physician is dropped from an HMO's provider panel.
In testimony before the House Energy and Commerce Subcommittee on Health, National Community Pharmacists Association board member Hugh Chancy urged support for a gag clause prohibition.
Exhibit A in our case that PBMs deliberately seek to conceal the costs of pharmaceuticals is the "gag clause." This is the language in PBMs' contracts with pharmacists that prohibits them from notifying customers, for example, that a particular generic drug might be cheaper than the patient's insurance copayment.
The FTC alleged that these gag clause provisions, and the defendants related warnings, threats, and lawsuits, harm consumers by unfairly barring purchasers from sharing truthful, negative comments about the defendants and their products.
In seeking ways to help reduce patients' out-of-pocket drug costs--including direct and indirect remuneration (DIR) fee reform--the National Association of Chain Drug Stores is building on the 2018 law that bans "gag clauses." Those clauses had prevented pharmacists from advising patients when they could save money by paying cash for prescriptions rather than using insurance.
And as we have previously said, CVS Health does not engage in gag clauses and we support efforts to ban them.