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Consolidated Appropriations Act, 2026Section 6220 › Proposal

Unverified entries must be flagged and departed providers removed in five days

Making further consolidated appropriations for the fiscal year ending September 30, 2026, and for other purposes, section 6220, Sec. 6220. Written by .

Unverified entries must be flagged and departed providers removed in five days

The document says “shallWho acts: Medicare Advantage organizationsHow: statuteSec. 6220 in the PDF
What the document says

“remove a provider from such directory within 5 business days if the organization determines that the provider is no longer a provider participating in the network of such plan.”

Making further consolidated appropriations for the fiscal year ending September 30, 2026, and for other purposes, Sec. 6220

The new paragraph also requires the organization, where it cannot verify a provider's information, to mark the entry as possibly out of date, and to remove a provider within five business days of determining that the provider is no longer in the plan's network.

What the document actually says

“remove a provider from such directory within 5 business days if the organization determines that the provider is no longer a provider participating in the network of such plan.”

Making further consolidated appropriations for the fiscal year ending September 30, 2026, and for other purposes, Sec. 6220
That sentence, in plain words

If a doctor leaves the plan's group, the plan must take that doctor off the list. It has five work days to do it.

What this is about

A plan that cannot reach a doctor must say so on the list. That warns the patient. A doctor who has left must come off.

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