Plans must score their own directory accuracy each year from 2028
What the document says“Conduct an analysis estimating the accuracy of the provider directory information of such plan using a random sample of providers included in such provider directory as follows:”
Section 6220 adds a new paragraph (6) to section 1857(e) of the Social Security Act. For plan years beginning on or after January 1, 2028, a contract with a Medicare Advantage organization must require an annual analysis of directory accuracy using a random sample of listed providers, and a report to the Secretary with an accuracy score. The sample must include a random sample of each specialty with a high inaccuracy rate relative to others, as the Secretary determines, and one such specialty may be providers specializing in mental health or substance use disorder treatment.
What the document actually says“Conduct an analysis estimating the accuracy of the provider directory information of such plan using a random sample of providers included in such provider directory as follows:”
The plan must check how right its doctor list is. It does that by picking names from the list at random.
A score puts a number on how right the list is. Fields where the list is often wrong get looked at more. Mental health may be one of them.
No action is recorded against this proposal. That is not evidence that none has been taken, and nobody has yet read it against the record. See what the tracker does not yet cover.