In 2025, more than half of all Medicare beneficiaries were enrolled in a Medicare Advantage (Medicare Part C) plan. These are private plans that provide an alternative to traditional Medicare. Every county has its own Advantage plans offered within that county, and every plan has its own directory of health care providers in its network.
Unfortunately, numerous studies have revealed a persistent problem: provider directories are not consistently reliable. In 2025, Medicarerights.org examined directories and found many listed physicians who were no longer practicing; had left the network; were not accepting new patients; or were listed with the wrong specialties or incorrect contact information. These “ghost” entries were especially prevalent for behavioral health providers.
In 2024, the American Medical Association sent a letter to Congress explaining the negative impact of inaccurate lists on patients, urging Congress to fix the problem. The letter states: Incorrect directory information can be financially devastating to patients and shifts the responsibility onto patients, placing the burden on them to invest significant time in finding an in-network provider or facing the expense of out-of-network care. Additionally, the resulting delays in care can negatively impact patients’ health outcomes. Moreover, in the long run, continuing to allow inaccuracies makes it easier for plans to fail to build networks that are adequate and responsive to patients’ needs.
You can read the AMA’s letter here.
New Law To Improve Accuracy of Listings
Congress has now taken action. On February 3, 2026, the Requiring Enhanced and Accurate Lists of (REAL) Health Providers Act was signed into law. It tackles the longstanding problem of inaccurate provider directories by imposing several new requirements on Medicare Advantage plans. The requirements will be phased in over time. Key requirements include:
- Starting in 2028 Medicare Advantage plans must review their directory listings for accuracy every 90 days.
- If a provider is no longer in network or active, the listing must be removed from the directory within five days.
- Any entries that have not been verified must be flagged accordingly.
- Beginning in 2029, the results of the accuracy audits must be submitted to the Centers for Medicare and Medicaid Services, which will make the scores available to the public.
If you see a doctor in a provider directory of your Advantage plan that you are considering using, you are well-advised to contact the office to make sure he/she is in the network.
For an explanation of Medicare Advantage plans and a comparison of these plans with traditional Medicare, check out the National Council on Aging.
