CMS Proposes Crackdown On Inaccurate Medicare Advantage Provider Directories

CMS Proposes Crackdown On Inaccurate Medicare Advantage Provider Directories Come 2028, insurance companies would have to verify the accuracy of their provider directories every 90 days, Modern Healthcare reported. If a member visits an out-of-network provider that the insurer’s directory improperly listed as in-network, the insurer would have to cap members’ cost-sharing to the in-network level. ​The proposed rule also calls for transparency from pharmacy benefit managers. https://kffhealthnews.org/morning-breakout/medicare-and-medicaid-101926/