The REAL Health Providers Act requires Medicare Advantage plans to maintain accurate, publicly available provider directories and hold plans accountable for inaccuracies. Starting in plan year 2028, Medicare Advantage organizations must verify provider information at least every 90 days, remove providers from directories within five business days when they leave the network, and flag outdated information they cannot verify. The bill protects enrollees by limiting their out-of-pocket costs to in-network rates when they see a provider listed in the plan's directory, even if that provider has since left the network. Medicare Advantage plans must also annually report accuracy scores for their provider directories to the Centers for Medicare & Medicaid Services, with scores posted publicly beginning in 2029 so beneficiaries can compare plans. The legislation includes $4 million in funding for fiscal year 2026 to implement these requirements and directs the Government Accountability Office to study the law's effectiveness by January 2033, with particular attention to mental health and substance use disorder providers, which have historically had higher directory inaccuracy rates.
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