CMS outlined next steps for its Medicare Advantage provider directory and shared plans to “beta launch” a broader National Provider Directory later this year, according to a Feb. 18 document.
The agency has structured the initiative in three phases. The first phase, launched in fall 2025, displayed Medicare Advantage provider data during open enrollment in an interim tool. Lawmakers raised concerns about conflicting and duplicative information in that data, which was collected by a third-party vendor.
Phase two establishes a system for MA organizations to directly provide CMS with current information on in-network providers and facilities, according to the document. For this directory, testing will be underway between May and August, with plans to release it Oct. 1.
From there, the third and final phase will focus on testing and launching a National Provider Directory.
Details on the national directory are sparse, but CMS’ document said it will “serve as connective tissue between healthcare providers, payers, data networks, and their respective interoperability frameworks.”
The MA directory will be included in the National Provider Directory, according to the document.
For years, healthcare industry stakeholders have called for a centralized federal directory to combat inaccurate insurer lists, also known as “ghost” networks.
“Incorporating provider directory data into [CMS’ Medicare Plan Finder] will enable people with Medicare and their caregivers to determine whether specific providers and facilities are in network when shopping and comparing plans,” the document said. “This provision directly supports the administration’s priority and focus on transparency, informed beneficiary choice and efficiency.”
Former administrations have proposed creating a national directory of healthcare providers and services, but the idea has not come to fruition.
CMS said the directory will include data on all individual MA plans, including local coordinated care plans, local and regional preferred provider organizations, medical savings account network-based plans and private fee-for-service network-based plans.
Becker’s has reached out to CMS and will update this article should more information become available.
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