Medicare plans must stop hiding outdated provider lists from seniors
S. 3750 — REAL Health Providers Act · Filed by Michael Bennet (D-CO) · 2 cosponsors · Introduced Jan 29, 2026 · Referred to committee
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What it does
This bill requires Medicare Advantage plans to maintain accurate, publicly available provider directories and verify provider information at least every 90 days (or annually for hospitals). If an enrollee sees a provider listed in the directory who is not actually in the plan's network, the enrollee pays only the in-network cost-sharing amount rather than the higher out-of-network rate. MA plans must also conduct annual accuracy audits, report scores to CMS, and CMS will publish these scores publicly starting in 2029 so beneficiaries can compare plan network quality.
Why we flagged it
This bill establishes mandatory provider directory accuracy standards, verification requirements, and cost-sharing protections for Medicare Advantage enrollees when they rely on inaccurate provider listings. It is fundamentally a consumer protection and transparency measure within the MA regulatory framework.
What the text implies
- MA plans face significant new administrative and compliance costs to verify provider directories quarterly or annually, which may be passed to enrollees through higher premiums or reduced plan offerings in less profitable markets.
- The requirement to maintain accuracy scores and post them publicly creates competitive pressure on MA plans, potentially disadvantaging smaller or regional plans with less sophisticated data infrastructure.
The full analysis lists 5 implications of this text.
Who stands to gain
health information technology vendors (directory management software); data aggregation and verification service providers; Medicare Advantage plans with robust IT infrastructure