To amend title XVIII of the Social Security Act to require MA organizations offering network-based plans to maintain an accurate provider directory, and for other purposes.
Impact
The passage of HB 7708 is expected to have significant implications for state and federal healthcare policies. By enforcing rigor in the maintenance of provider directories, beneficiaries will benefit from reduced instances of mistakenly relying on outdated information to access services. Enhanced provider directory accuracy supports compliance with existing Medicare regulations while pushing towards greater accountability in the Medicare Advantage sector. This bill serves to ensure that beneficiaries can make informed decisions based on accurate data regarding their healthcare options, thereby enhancing overall healthcare delivery within the system.
Summary
House Bill 7708 aims to enhance the accuracy of provider directories for Medicare Advantage (MA) organizations that offer network-based plans. This legislation mandates that MA organizations maintain publicly accessible and periodically updated provider directories, ensuring that beneficiaries have access to accurate information regarding healthcare providers. The requirement includes maintaining an updated list at least every 90 days, as well as removing providers from the directory within five business days if they are no longer part of the network. The bill seeks to improve the provision of reliable healthcare services under Medicare by minimizing the inaccuracies that beneficiaries face when accessing their plans.
Contention
Notably, there may be contention surrounding the administrative burden this legislation places on MA organizations, as they will need to implement robust protocols to consistently verify and update their directories. Some stakeholders may argue that the operational costs and labor-intensive requirements could divert resources away from patient care improvements. However, supporters contend that such measures are necessary to protect Medicare beneficiaries from unexpected costs due to inaccuracies in provider listings, particularly in critical areas such as mental health or substance disorder treatment, where accurate provider access is vital.
To amend title XVIII of the Social Security Act to provide for enforcement of standards for reasonable and relevant contract terms and conditions and essential retail pharmacy protections under the Medicare program.
To amend title XVIII of the Social Security Act to ensure fair assessment of pharmacy performance and quality under Medicare part D, and for other purposes.
A bill to amend title XVIII of the Social Security Act to provide for payment for services of radiologist assistants under the Medicare program, and for other purposes.
Health benefit plan directories; directing plans to publish certain information in a publicly accessible manner; requiring reporting to Insurance Commissioner. Effective date.