CMS orders Medicare Advantage plans to disclose provider networks

Modern Healthcare – Thursday, September 18, 2025
By Bridget Early

Medicare Advantage insurers will be required to submit provider directories to the Centers for Medicare and Medicaid Services next year under a final rule issued Thursday.

CMS intends to incorporate provider network information into the Medicare Plan Finder portal. This policy builds on a plan the agency announced last month to assemble provider lists it will add to the plan finder for the upcoming annual enrollment period. Insurer participation in that initiative is voluntary. CMS eventually aims to create a national provider directory.

“CMS is finalizing a new requirement that will increase beneficiaries’ access to provider data while comparing plans in the CMS Medicare Plan Finder tool, which will contribute to the beneficiaries’ ability to make more informed decisions about their healthcare,” the regulation says.

Under the final rule, Medicare Advantage plans will have to submit their network lists by Jan. 1 and then once a year, plus updates every 30 days to reflect changes in provider participation. Insurers will not have to attest that they meet network adequacy standards.

CMS did not specify when the information will be added to the Medicare Plan Finder.

The regulation amends a final rule published in April, which postponed determinations about some policies proposed last November during President Joe Biden’s term.

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