Sponsors (3)
The bill improves Medicare Advantage directory accuracy and protects beneficiaries from surprise out-of-network costs, but it raises compliance costs, privacy risks, and may burden smaller plans—potentially increasing premiums or reducing plan choice.
Medicare beneficiaries will pay in-network cost sharing when they relied on an MA plan's directory but saw a nonparticipating provider, reducing unexpected out-of-pocket costs.
Medicare beneficiaries gain better access information because MA plans must publish accurate, regularly verified online directories with provider specialties, locations, language and disability accommodations, and telehealth capabilities.
Beneficiaries get clearer transparency about directory reliability because plans must mark unverifiable providers and post plan accuracy scores beginning in 2029.
Some MA plans may pass verification and compliance costs onto enrollees through higher premiums or reduced benefits, increasing costs for Medicare beneficiaries.
Smaller or low-enrollment MA plans could be disproportionately burdened (despite waiver options), risking network reductions or plan exits and reducing beneficiary choice.
MA organizations will face increased administrative and compliance costs to verify directories every 90 days and report accuracy scores, raising plan overhead.
Based on analysis of 2 sections of legislative text.
Requires certain Medicare Advantage plans to keep public online provider directories accurate by verifying listed providers at least every 90 days (with limited exceptions for hospitals/facilities), marking entries that could not be verified, and removing providers within 5 business days after they stop participating. Starts for plan year 2028 and adds protections so enrollees aren’t penalized (cost-sharing consequences) when they rely on incorrect directory information.
Requires certain Medicare Advantage plans to verify and publish accurate online provider directories at least every 90 days, mark unverified entries, remove nonparticipating providers within 5 business days, and add enrollee cost-sharing protections.
Introduced January 29, 2026 by Michael F. Bennet · Last progress January 29, 2026