Commonwealth Care Alliance

Commonwealth Care Alliance

Providers > Provider Resources > CMS Provider Directory Requirements

CMS Provider Directory Requirements

The Centers for Medicare and Medicaid Services (CMS) issued refined regulations in 2016 requiring Medicare Advantage health plan to have more comprehensive and up to date provider directories. Inaccurate provider directories have a severe impact on members’ ability to access in network providers, correct service locations and have access to important facts about providers’ practices.

CCA is committed to adhering to the new CMS requirements. To ensure success, CCA has partnered with LexisNexis to perform the provider outreach on its behalf. Providers will be contacted by LexisNexis to provide updated demographics.

You can learn more about the CMS Provider Directory regulations by reviewing the following documents:

Guidance to Verify that Networks are Adequate and Provider Directories are Current

Provider Directory Requirements – Update

If you have any questions, please contact Provider Relations at: ProviderRelations@commonwealthcare.org.

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Last Updated 01/03/2017