The Centers for Medicare & Medicaid Services (CMS) today issued a proposed rule that would improve the accuracy of provider directories for Medicare Advantage plans, establish transparency and compensation requirements for Pharmacy Benefit Managers (PBMs), and deliver enhanced cost-saving protections for low-income Medicare beneficiaries.
“CMS has been working to improve data connectivity and accuracy in provider directories across the healthcare system,”said CMS Administrator Mehmet Oz. “The actions we are proposing today will give Medicare Advantage and Part D enrollees more reliable information, stronger financial protections, and greater confidence in both programs.”
To ensure beneficiaries have reliable and up-to-date information, CMS is proposing to make improvements to Medicare Advantage provider directories. This proposal establishes a clear framework to significantly improve the accuracy of provider directories for Medicare Advantage plans. Under the proposed rule, plans would be required to verify and update their provider directory information at least every 90 days and report an accuracy score to CMS. These scores would also be prominently displayed on the plans’ public-facing directories, empowering beneficiaries to choose plans with confidence. ARTICLE