REAL Health Providers Act
The REAL Health Providers Act (Requiring Enhanced and Accurate Lists of Health Providers Act) is a 2026 US law that sets directory accuracy rules for Medicare Advantage plans from plan year 2028: verification at least every 90 days, removal of departed providers within five business days, and a yearly accuracy score that CMS publishes.
Is the REAL Health Providers Act law?
Yes. It was enacted as Section 6220 of the Consolidated Appropriations Act, 2026 (H.R. 7148). It was first introduced on its own as H.R. 5281 and S. 3750.
What does it require?
From plan year 2028, Medicare Advantage organizations must, for each plan covered by the law:
- keep an accurate provider directory on a public website
- verify provider directory information at least every 90 days (hospitals and some other facilities at least every 12 months), and flag any listing they can't verify as possibly out of date
- remove a provider within five business days of finding they no longer participate in the network
- protect members who relied on a wrong listing from out-of-network cost-sharing, and tell members about that protection
- estimate directory accuracy each year from a random sample of providers and report an accuracy score to CMS
When do accuracy scores become public?
From plan year 2029, CMS must post each plan's accuracy score in a machine-readable file on a CMS website.
How does it relate to the No Surprises Act?
The No Surprises Act already sets 90-day verification for group health plans and insurers. The REAL Health Providers Act brings similar rules to Medicare Advantage and adds a yearly, public accuracy score.