A bill to amend title XVIII of the Social Security Act to establish provider directory requirements, and to provide accountability for provider director accuracy, under Medicare Advantage.
Requiring Enhanced & Accurate Lists of Health Providers Act or the REAL Health Providers Act
This bill requires Medicare Advantage (MA) organizations to maintain directories of in-network providers and continually ensure their accuracy.
Specifically, MA organizations must publish on their websites an accurate directory of in-network providers and regularly update these directories. The bill additionally specifies that if a provider is listed as in-network in this directory when a beneficiary selects and makes an appointment with the provider, but the provider is not actually in-network, the beneficiary is still only responsible for paying in-network cost-sharing requirements.
MA organizations must annually evaluate and report on the accuracy of their directories; the Centers for Medicare & Medicaid Services and MA organizations must publish this information on their websites. The bill provides funds for these purposes.
The Government Accountability Office must report on the bill's implementation.
Placed on Senate Legislative Calendar under General Orders. Calendar No. 265.
Referred to the Subcommittee on Health.
Introduced in Senate
Read twice and referred to the Committee on Finance.
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