Federal Policy
CMS Proposes Rule on MA Directory Accuracy, PBM Transparency
CMS has issued a proposed rule to implement healthcare provisions from a government funding package enacted in February, targeting Medicare Advantage provider directory accuracy and pharmacy benefit manager transparency. The rule would impose new requirements on MA plans to maintain accurate, up-to-date provider directories and require greater disclosure of PBM pricing and business practices. Most provisions would take effect in 2028, giving plans and PBMs a multi-year runway to adjust systems and contracts. The proposal is open for public comment before finalization.
Why it mattersMedicare Advantage plans and PBMs face new compliance and disclosure obligations that will require operational and contractual changes well ahead of the 2028 effective date.