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What CMS outlined
In a Feb. 18 document, CMS described a three-phase path for its Medicare Advantage provider directory, ending in a beta launch of a broader National Provider Directory later this year.
- Phase one ran during last fall’s open enrollment, using an interim tool built on data collected by a third-party vendor. Lawmakers criticized conflicting and duplicate entries.
- Phase two creates a system for MA organizations to send CMS current information on in-network providers and facilities. Testing runs May through August, with release planned for Oct. 1, ahead of open enrollment for 2027 coverage.
- Phase three covers testing and launch of the national directory. CMS has shared few details so far.
The directory will span all individual MA plan types, including coordinated care plans, local and regional PPOs and network-based private fee-for-service plans. Directory data will be built into Plan Finder so beneficiaries can see whether a doctor or hospital is in network while comparing plans.
The rules behind it
A final rule issued last September requires MA plans to submit directory data for publication on Plan Finder for 2027 open enrollment, update entries within 30 days of learning of a change and attest to accuracy at least once a year. The accuracy problem is long-standing. A 2023 Senate subcommittee secret-shopper review found only about a third of listings accurate, though the sample was small, and a separate 2023 study found inconsistencies in upwards of 80% of listings.
Why hospitals should act
Plans will submit the data, but the information about your physicians, locations and specialties starts with you. Once it appears on a federal comparison tool, errors become a patient access problem and a market share problem. A senior who cannot find your orthopedic group listed, or sees a closed clinic address, may pick a plan or a competitor accordingly.
- Audit current listings. Pull what your major MA plans show for your employed and affiliated clinicians and compare it with credentialing and scheduling records.
- Fix the feed. Assign an owner for provider data changes, such as new hires, departures, moved clinics and closed panels, and set a routine for sending them to every contracted plan.
- Use contracts. In renewals, ask for timely directory updates and a process to correct errors you report.
- Time it to the calendar. Cleanup completed before summer testing has the best chance of showing up correctly on Oct. 1.
Archive entry for Feb 25, 2026, added Nov. 11, 2026.