Referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
The REAL Health Providers Act requires Medicare Advantage plans to maintain accurate, publicly available provider directories and hold insurance companies accountable when outdated information misleads enrollees. Starting in 2028, affected plans must verify provider information at least every 90 days, remove providers from directories within 5 business days of leaving the network, and include details like specialty, contact information, disability accommodations, and telehealth capabilities. If an enrollee sees an out-of-network provider listed in the directory and that provider is no longer in the network, the patient will pay only the in-network cost-sharing amount instead of higher out-of-network rates. Beginning in 2029, Medicare Advantage plans must publicly report accuracy scores for their provider directories, and the Government Accountability Office will study the program's effectiveness by 2032. The legislation appropriates $4 million to the Centers for Medicare & Medicaid Services to implement these requirements and directs the Department of Health and Human Services to provide guidance to insurers and providers on best practices for maintaining accurate directories.
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