Medicare Advantage plans must stop hiding outdated doctor lists

What it does

This bill requires Medicare Advantage plans to maintain accurate, publicly available provider directories and update them at least every 90 days (or annually for hospitals). Starting in 2028, if a patient sees a doctor listed in the plan's directory who turns out not to be in the network, the patient pays the in-network cost-sharing amount instead of the higher out-of-network rate. Plans must also conduct annual accuracy audits and report scores to Medicare, which will be published publicly by 2029.

Why we flagged it

The bill's core function is to protect Medicare Advantage enrollees from financial harm caused by inaccurate provider directories through cost-sharing caps and transparency requirements. It is fundamentally a consumer-protection and information-disclosure measure, not a subsidy or deregulation.

What the text implies

• Plans may respond by reducing network size or negotiating stricter data-sharing agreements with providers, potentially narrowing patient choice in some markets.
• The 90-day update requirement and accuracy audits create ongoing operational costs for MA plans, which may be passed to enrollees through higher premiums or reduced benefits in non-protected areas.
• Mental health and substance-use-disorder providers are explicitly called out for accuracy audits, potentially signaling higher historical inaccuracy in those specialties and creating reputational pressure on plans.
• The GAO study (due 2032) may reveal that administrative burden on providers is substantial, potentially triggering future legislative pushback or exemptions.

Who it affects

Medicare Advantage enrollees gain concrete protections: they avoid surprise out-of-network bills when relying on inaccurate directories, and they gain transparency through published accuracy scores to compare plans. Providers and plans bear compliance costs, but the public benefit—reducing patient financial harm and information asymmetry—outweighs those costs.

Who stands to gain

• Medicare Advantage enrollees (through cost-sharing protections)
• Health IT vendors (data standardization and verification tools)
• Patient advocacy organizations (transparency and leverage)

Named in the bill

Centers for Medicare & Medicaid Services (CMS), Medicare Advantage organizations, Health care providers, Secretary of Health and Human Services, Comptroller General (GAO), National Plan and Provider Enumeration System (NPPES), Office of the National Coordinator for Health Information Technology

Where it stands

8 cosponsors: 5 Democrats, 3 Republicans.

• Sep 10, 2025 — Introduced · Congress.gov: “Introduced in House”
• Sep 10, 2025 — Referred to House Committee on Energy and Commerce and House Committee on Ways and Means · Congress.gov: “Referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a…”

Dates and quoted wording are Congress.gov's action record; the timeline shows status changes, not every procedural step.

Money around this bill

3 lobbying clients named this bill on 4 disclosure filings across 3 quarters, Dec 2025 to Jun 2026. Those filings disclosed $5,692,500 in lobbying spend. A filing names 56 bills on average, so that figure is what each filing reported, not a share belonging to this bill.

More lobbying clients named this bill than 61% of bills with at least one filing.

Jimmy Panetta, the sponsor, reported $1,676,556 in PAC receipts in the 2026 cycle.

• American Medical Association — $5,643,000 on 2 filings
• Shatterproof — $30,000 on 1 filing
• Mental Health America — $19,500 on 1 filing

Lobbying Disclosure Act filings through Jul 20, 2026. A filing shows who paid to lobby on a bill it names, not what changed.