Stricter regulations to be implemented for Medicare Advantage directories
The Centers for Medicare & Medicaid Services (CMS) has announced that Medicare Advantage plans will be required to improve the timeliness and accuracy of information in their medical provider directories, as part of the Contract Year 2026 Medicare Advantage and Part D final rule.
Starting next year, Medicare Advantage organizations will be responsible for maintaining the accuracy of their provider directories throughout the year. This includes updating their online directories within 30 days of any changes to their provider data.
The Trump administration has made it clear that the changes are aimed at enhancing the overall accuracy of medical provider directories. To ensure compliance, Medicare Advantage plans will have to submit annual attestations affirming the accuracy of the information they provide to CMS.
The Medicare Advantage plans will also need to implement procedures to ensure the timely and accurate updates of their provider directories. Failure to comply with these new requirements could result in potential penalties.
The requirement for improved accuracy and timeliness of provider directory information is part of the Contract Year 2026 Medicare Advantage and Part D final rule. The changes apply specifically to the online directories of Medicare Advantage organizations.
It's important to note that these changes will not affect Medicare Advantage plans outside of the online directory requirement. The changes are aimed at improving the user experience for beneficiaries who rely on accurate and up-to-date information when choosing a healthcare provider.
In a bid to further improve the accuracy of medical provider directories, the Medicare Advantage plan sponsor has been designated as responsible for ensuring the updating and accuracy of information in provider directories. This means that the sponsors will have to take active measures to ensure that the information they provide to CMS is accurate and up-to-date.
Overall, the changes are expected to lead to more accurate and up-to-date information in the provider directories of Medicare Advantage organizations, providing beneficiaries with a better experience when selecting healthcare providers.
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