Almost 49 percent of Medicare Advantage physician directories are riddled with errors regarding provider location, phone number and ability to accept new patients, according to a CMS report.
The report details the results of CMS' third round of reviews of MA online provider directories. The agency split MA organizations into thirds, reviewing a batch each year for the past three years. The latest review examined the accuracy of 108 provider listings in 52 MA directories. The review process evolved over the past three years, so CMS says the results are not comparable, though they do indicate that inaccuracies in provider directories are a widespread problem.
"Inaccurate provider directories can create a barrier to care and raise questions regarding the adequacy and validity of the [MA organization's] network as a whole," the report notes.
Here are nine findings from the latest review:
- 50.14 percent of providers had at least one deficiency in their listing
- 48.74 percent of locations listed had at least one deficiency
- 33.14 percent of locations listed providers who didn't work there or didn't accept that MA plan
- CMS found 1,393 instances in which providers shouldn't have been listed in the directory at all
- 690 phone numbers were wrong or disconnected
- 364 addresses were incorrect
- 221 providers were not accepting new patients, but were listed as accepting
- 41.75 percent of locations listed had a deficiency CMS deemed likely to be a barrier to care
- 85.64 percent of locations with deficiencies had the "most egregious errors"
"Very few organizations performed well," the report says.
In response, CMS plans to conduct another review of 32 MA organizations and has issued warning letters to noncompliant MA organizations.
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