REAL Health Providers Act

The REAL Health Providers Act would establish new requirements for Medicare Advantage plans to improve the accuracy of their provider directories, which seniors use to find doctors and specialists in their networks. Currently, many directories contain outdated or incorrect information, creating so-called ghost networks where listed providers are no longer in the network, not accepting patients, or unreachable. This bill would require plans to verify provider information at least every 90 days, remove providers from directories within five business days when they leave the network, and include detailed information such as whether doctors accept new patients or offer telehealth services.

If enacted, the bill would also protect patients financially by ensuring that if they reasonably rely on an inaccurate directory listing, they would only pay in-network cost-sharing amounts rather than higher out-of-network costs. Medicare Advantage organizations would be required to conduct annual analyses of their directory accuracy using random sampling methods and report these results to the government. Starting in 2029, these accuracy scores would be made publicly available so beneficiaries can see which plans maintain more reliable directories. The bill allocates $4 million for fiscal year 2026 to support these efforts and requires the Government Accountability Office to study implementation and report findings by January 2033.