When Members Search for Their Doctor, Will Your Plan Show Up?
Provider directory accuracy has always been hard. But for Medicare Advantage plans, CMS-4208-F2 changes the stakes. Under the CMS-4208-F2 final rule, MA organizations must make provider directory data available to CMS/HHS for use in Medicare Plan Finder, update that information within 30 days of known changes, and attest at least annually that the data is […]
CMS-4208-F2 and Medicare Plan Finder: What MA Plans Need to Do Now
The days of static provider directories are numbered. CMS is building a National Provider Directory powered by FHIR-based APIs, and starting October 1, 2026, the Medicare Plan Finder will begin ingesting provider and facility data directly from Medicare Advantage plans’ publicly accessible Plan-Net APIs. If your API isn’t ready, your plan data won’t show up […]
Provider Directories, Interoperability, and What Medicaid & MA Plans Can Learn from Real-World Connectivity: A Conversation with Defacto Health
By Mark Scrimshire, Chief Interoperability Officer, Onyx Accurate, accessible provider directory data sits at the foundation of almost every function in our healthcare system: member access, network adequacy oversight, referral management, prior authorization automation, and CMS-driven transparency initiatives. As CMS pushes toward nationwide standardization — including the forthcoming National Provider Directory — Medicaid and Medicare Advantage plans […]