WASHINGTON, DC – Representatives Brian Fitzpatrick (PA-1), Jimmy Panetta (CA-19), Greg Murphy (NC-3), Ann Kuster (NH-2), and Brad Schneider (IL-10) introduced bipartisan legislation to better empower patients with up-to-date information on healthcare providers covered by their insurance plans. The Requiring Enhanced and Accurate Lists (REAL) Health Providers Act would require Medicare Advantage insurance plans to update their provider directories annually starting in 2026.
Patients rely on provider directories from Medicare Advantage insurance plans to find in-network providers. However, many insurers fail to update these directories, creating ghost networks of providers who are listed as options for care despite no longer practicing, no longer accepting patients, or are not part of the plan’s network. The confusion that can arise from ghost networks can result in delays in care, inappropriate treatment, and unnecessary costs for patients unknowingly visiting out-of-network providers.
A recent study looking at the accuracy of provider directories found that 33% of listed providers were inaccurate, non-working numbers. More than 80% of listed, in-network, mental health providers were either unreachable, not accepting new patients, or not in-network. These inaccuracies disproportionately harm seniors, disabled individuals, and Americans living with mental health challenges.
“Seniors covered through Medicare Advantage deserve an accurate listing of in-network health care providers when using the service’s directory,” said Congressman Fitzpatrick. “The bipartisan, bicameral REAL Health Providers Act will ensure the directory has the most updated data, and if incorrect, not penalize seniors with unexpected costs and delayed care for errors beyond their control.”
“Patients need to be able to trust that the health care providers their insurance plans direct them to are real, accessible, and in-network,” said Congressman Panetta. “Our bipartisan legislation is a straightforward solution that would require plans to annually update their provider directories, ensuring patients are not wasting their precious time and money finding the care they need. This is a commonsense step to streamline the health care system and better protect patients.”
“Ensuring seniors and Medicare Advantage beneficiaries have access to accurate and updated provider directories is critical for navigating the complexities of in-network and out-of-network healthcare coverage,” said Congressman Murphy. “I’m proud to support the REAL Health Providers Act which will protect seniors from unforeseen expenses and improve their ability to receive high quality, affordable care.”
“Seniors and folks enrolled in Medicare Advantage deserve to know which doctors are in their network and accepting new patients as they navigate their healthcare coverage. Access to accurate provider directories is essential for receiving timely care. We can and must do more to simplify our health care landscape,” said Congresswoman Kuster. “I am proud to help introduce the REAL Health Providers Act to protect seniors from unexpected health care costs and build a system that is easier to navigate for all.”
“No one should have to find out that their doctor's appointment is out-of-network after the fact,” said Congressman Schneider. “This common-sense, bipartisan bill will create a more navigable health care system and protect seniors from unexpected costs.”
“Ghost networks are false promises by insurers to provide access to care that shift the expense to the patient. They affect private sector health plans purchased by individuals and employers and public sector plans like Medicaid and Medicare Advantage. More than that, they can have negative health consequences for patients who forego or delay treatment because they cannot find a clinician to provide the mental health care they need,” said American Psychiatric Association (APA) CEO and Medical Director Saul Levin, M.D., M.P.A. “APA applauds the introduction of this important legislation to help protect seniors from unexpected health care costs and maintain accurate provider directories.”