REAL Health Providers Act
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Progress
Where this bill stands in the legislative process.
- Introduced
- Passed Senate
- Passed House
- To President
- Became Law
Overview
The REAL Health Providers Act aims to improve the accuracy and accountability of provider directories used by Medicare Advantage plans. It requires these plans to maintain publicly available, up-to-date directories of participating providers, including information about accepting new patients and accommodations for disabilities. The bill also establishes penalties for plans that list providers who aren't actually participating in their networks and mandates regular accuracy analyses by the plans, with reports submitted to the government. Finally, it provides guidance to Medicare Advantage organizations and providers on maintaining accurate directories and offers cost-sharing protections for enrollees who receive care from listed providers who are not actually in the plan’s network.
Key provisions
- Requires Medicare Advantage plans to maintain publicly available, accurate provider directories.
- Establishes a frequency for verifying and updating provider directory information (at least every 90 days).
- Creates penalties for plans that list providers not participating in their networks.
- Mandates annual accuracy analyses of provider directories by Medicare Advantage organizations.
- Requires notification to enrollees about cost-sharing protections when receiving care from listed providers who are not in the network.
- Requires plans to prominently display accuracy scores on their provider directories.
- Directs the GAO to conduct a study on the implementation and effectiveness of the changes.
- Requires the Secretary to hold a stakeholder meeting to gather input on maintaining accurate provider directories.
Bill text
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Sponsors
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3 on record
Primary sponsor
Cosponsors
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