MA Plan Finder: Draft Technical Guidance and Timeline Explainer
On November 7, CMS released a memo explaining what data Medicare Advantage carriers need to submit so that their directory information appears
Category: Policy and Regulation
MA Plan Finder: A Dress Rehearsal for National Provider Directory
On September 19, 2025, CMS issued a Final Rule requiring Medicare Advantage (MA) plans to submit provider directory data to CMS in
CMS Health Tech Ecosystem RFI: National Directory Comments
In its recent Request for Information (RFI) on the Health Tech Ecosystem, CMS posed questions about the value and feasibility of a
How will the CMS National Directory affect health plans?
CMS announced on June 3, 2025 plans to build a National Directory of Healthcare (NDH). While the directory’s long-term vision includes both
Notes from the CMS and ASTP/ONC RFI Meeting in Washington, DC
I attended the CMS and ASTP/ONC RFI meeting, which drew 300+ participants from across the healthcare industry. Participants included tech vendors, providers,
VA and CMS: Fixing Provider Directories Together
In the past week, the federal government released two Requests for Information (RFIs): one from CMS seeking input on the Health Technology Ecosystem and
Empowering Patient Choice with Payer and Provider Data
Special thanks to Aneesh Chopra, Chief Strategy Officer at Arcadia; Ryan Howells, Principal at Leavitt Partners; Eric Ellsworth, Director of Health Data
Mental Health Provider Directories: The Rising Risk of Litigation
Last week, a class action lawsuit was filed in the Southern District of New York against Anthem Blue Cross and Blue Shield,
CMS Announces National Directory for Healthcare Pilot in Oklahoma
Yesterday at Health Datapalooza, CMS announced its intent to pilot key components of a National Directory of Healthcare in the state of
HHS report considers the merits of centralized provider directories
In December 2023 the Office of Behavioral Health, Disability, and Aging Policy (within the US Department of Health and Human Services) published
State of Provider Directory APIs 2024
Background and Purpose of Analysis In July 2021, CMS required payers with CMS-regulated health plans to publish Provider Directory APIs. In the 3 years
Provider Directory API’s Supporting Role in the 2024 CMS Interop Rule
Key Takeaways: Re-Cap of the 2024 Rule Our previous post included a summary of the 2024 CMS Interoperability and Prior Authorization Final
A Review of the 2024 CMS Interoperability Rule through the Lens of Directory Use Cases
Yesterday, 13 months after proposing it, CMS finalized its Interoperability and Prior Authorization Rule. As CMS worked towards publishing this rule, payers,
The REAL Health Providers Act
Last week, the Requiring Enhanced and Accurate Lists (REAL) of Health Providers Act was introduced by Senators Wyden D-Ore., Bennet D-Colo., and
Understanding Mental Health ‘Ghost’ Networks
This is the first of a two-part series on mental health ghost networks. In the first post, we will assess the information
Provider Directory APIs: Beyond a Compliance-Only Mindset
State of Payer Compliance on Provider Directory APIs It has been 18 months since the July 2021 effective date of the CMS
Responses to the CMS RFI on National Healthcare Directory
In response to CMS’s RFI on a National Healthcare Directory (responses were due Thurs 12/6/2022), over 600 responses were submitted (around 50%
A Review of the CMS RFI on National Healthcare Directory
Executive Summary: CMS describes a National Healthcare Directory that will streamline provider data collection and promote interoperability. Years of industry engagement have
Payer Compliance: Provider Directory APIs in the first six months since CMS Final Rule enforcement
The CMS Final Rule on Interoperability and Patient Access requires payers to publish provider directory APIs and has been enforceable since July