Requiring Enhanced and Accurate Lists of Health Providers Act; REAL Health Providers Act
Summary
The "REAL Health Providers Act" aims to improve the accuracy of provider directories under Medicare Advantage plans. It mandates that MA organizations maintain accurate, up-to-date directories and provide cost-sharing protections for enrollees who rely on incorrect information. The bill also requires annual accuracy analysis and reporting, with the results made publicly available, and allocates $4 million for implementation.
Expected Effects
This bill will likely lead to more accurate provider directories for Medicare Advantage plans. Enrollees will have better information when choosing a plan and accessing care. It will also hold MA organizations accountable for directory accuracy.
Potential Benefits
- Improved accuracy of Medicare Advantage provider directories.
- Cost-sharing protections for enrollees relying on inaccurate directories.
- Increased transparency through public reporting of accuracy scores.
- Better access to care for Medicare beneficiaries.
- Reduced administrative burden through data standardization.
Most Benefited Areas:
Potential Disadvantages
- Increased administrative costs for Medicare Advantage organizations.
- Potential burden on providers to verify directory information.
- Possible need for additional funding beyond the initial appropriation.
- Complexity in determining accuracy scores and verification methods.
- Potential for confusion among enrollees regarding cost-sharing protections.
Constitutional Alignment
The bill aligns with the Constitution's general welfare clause (Preamble). Congress has the power to legislate in areas that promote the health and well-being of citizens. The bill's focus on improving healthcare access and transparency falls within this purview.
Impact Assessment: Things You Care About ⓘ
This action has been evaluated across 19 key areas that matter to you. Scores range from 1 (highly disadvantageous) to 5 (highly beneficial).