REAL Health Providers Act

This bill would set new rules, starting in plan year 2028, for the provider directories that Medicare Advantage plans with provider networks must keep online. Plans would have to check each listed provider's information at least every 90 days, mark entries they cannot verify, and remove providers who leave the network within 5 business days. If an enrollee sees an out-of-network provider who was listed in the plan's directory when the appointment was made, the enrollee would pay no more than the in-network cost share. Plans would also have to study and report the accuracy of their directories each year, and the government would post the accuracy scores online, with $4 million provided to carry this out. The bill also requires a public meeting, federal guidance on keeping directories accurate, and a government study due by 2033.

Full text and official record on Congress.gov

Sponsors

• Michael F. Bennet Democrat sponsor
• 2 cosponsors