To amend title XVIII of the Social Security Act to require MA organizations offering network-based plans to maintain an accurate provider directory, and for other purposes.

Summary

This bill requires Medicare Advantage (MA) organizations to maintain directories of in-network providers and continually ensure their accuracy. Specifically, MA organizations must publish on their websites an accurate directory of in-network providers and regularly update these directories. The bill additionally specifies that if a provider is listed as in-network in this directory when a beneficiary selects and makes an appointment with the provider, but the provider is not actually in-network, the beneficiary is still only responsible for paying in-network cost-sharing requirements. MA organizations must annually evaluate and report on the accuracy of their directories; the Centers for Medicare & Medicaid Services and MA organizations must publish this information on their websites. The bill provides funds for these purposes. The Government Accountability Office must report on the bill's implementation.

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Documents

3 official files

• Introduced in House (text)

  Introduced in House · EN · 15 March 2024

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• Introduced in House (PDF)

  Introduced in House · EN · 15 March 2024

  ViewDownloadOpen at official source

• Introduced in House

  summary · EN · 15 March 2024

  Open at official source

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