Bill > S3750

This bill, titled the "Requiring Enhanced and Accurate Lists of Health Providers Act" or "REAL Health Providers Act," aims to improve the accuracy of provider directories for Medicare Advantage plans, which are health plans offered by private companies that provide Medicare benefits. Starting in plan year 2028, Medicare Advantage organizations must maintain publicly accessible, accurate provider directories online, verifying information at least every 90 days and updating it as needed, including removing providers no longer in the network within five business days. These directories must list essential information like provider names, specialties, contact details, addresses, and whether they accept new patients, along with details on accessibility and language capabilities. If a Medicare Advantage plan's directory lists a provider who is not actually in the network when an appointment is made, the plan must ensure the enrollee is only responsible for the lower of the in-network cost-sharing or the otherwise applicable cost-sharing. Furthermore, Medicare Advantage organizations will be required to annually analyze and report on the accuracy of their provider directories, with the Centers for Medicare & Medicaid Services (CMS) publishing these accuracy scores starting in 2029. The bill also allocates $4 million for fiscal year 2026 to support these efforts and mandates a study by the Government Accountability Office (GAO) on the implementation of these new requirements, with a report due by January 15, 2033. Finally, the Secretary of Health and Human Services will convene a public meeting and issue guidance to Medicare Advantage organizations and Part B providers on best practices for maintaining accurate provider directories.

Budget and Finance

https://www.congress.gov/bill/119th-congress/senate-bill/3750/all-info