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Accurate Provider Directories in Medicare Advantage Plans and Patient Protection

New regulations aim to ensure that provider directories in Medicare Advantage plans are always up-to-date and accurate. This will give citizens confidence that information about available doctors is correct, and if there's an error in the directory, treatment costs will be as if the doctor was in-network.
Key points
Medicare Advantage plans must maintain accurate and publicly available provider directories, updated at least every 90 days.
If a patient receives services from an out-of-network provider mistakenly listed in the directory, they will pay in-network costs.
Insurance organizations will be required to annually analyze and report on the accuracy of their directories, increasing transparency.
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Additional Information
To amend title XVIII of the Social Security Act to require MA organizations offering network-based plans to maintain an accurate provider directory, and for other purposes.
Print number: HR 7708
Sponsor: Rep. Panetta, Jimmy [D-CA-19]
Process start date: 2024-03-15