CMS to launch Medicare Advantage directory of hospitals, physicians

 CMS said in a Feb. 18 document it plans to “beta launch” a national directory of Medicare Advantage providers, including hospitals and physicians. 

MA organizations are only required to supply current in-network providers and facilities to CMS, according to the agency’s document. For years, healthcare industry stakeholders have called for a centralized, federal directory to combat inaccurate lists from insurers, also known as “ghost” networks and physicians. 

Over the last few years, a growing number of health systems and hospitals have gone out of network with MA plans, despite the “sunk-cost” of their yearslong prior investment in MA. 

“Incorporating provider directory data into [CMS’ Medicare Plan Finder] will enable people with Medicare and their caregivers to determine whether specific providers and facilities are in-network when shopping and comparing plans,” the document said. “This provision directly supports the administration’s priority and focus on transparency, informed beneficiary choice and efficiency.”

Former administrations have proposed creating a national directory of healthcare providers and services, but the idea has not come to fruition. CMS said its beta launch will occur “later this year.”

The directory will include data on all individual Medicare Advantage plans, including local coordinated care plans, local and regional preferred provider organizations, medical savings account network-based plans and private fee-for-service network-based plans. 

Becker’s has reached out to CMS and will update this article should more information become available. 

https://www.beckershospitalreview.com/legal-regulatory-issues/cms-to-launch-federal-directory-of-hospitals-physicians/