REAL Health Providers Act

Key Points

• Medicare Advantage plans would be required to update their online lists of doctors and hospitals at least every 90 days starting in 2028. If a plan cannot confirm a doctor's information, they must clearly label that doctor's listing as potentially out of date so patients are not misled.
• If you visit a doctor who is listed as "in-network" in the directory but has actually left the plan, you will be protected from surprise bills. Under this policy, you would only have to pay the lower, in-network price for that visit, and the insurance company would have to cover the rest.
• Insurance companies would have to remove doctors from their directories within five business days of learning the doctor is no longer in their network. This prevents "ghost networks" where plans look like they have many doctors available when they actually do not.
• Starting in 2029, the government will publish "accuracy scores" for each plan's doctor list. This allows you to see which insurance companies do the best job of keeping their information current before you sign up for a plan during open enrollment.
• The policy specifically targets mental health and substance use disorder providers, which often have the most outdated information. By requiring regular check-ins, the bill aims to make it easier for people to find available mental health care when they need it most.