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Ensuring Provider Directory Compliance with H.R. 133

In December 2020, the Consolidated Appropriations Act of 2021 (H.R. 133) was put into place, requiring group health plans and health insurance insurers to improve the verification and refresh process of their provider directory systems. But most health plans were unprepared to meet the requirements that were due by Jan. 1, 2022, such as verifying and updating directories at least every 90 days, removing providers that can’t be verified, refreshing provider data within two business days of receiving a request for an update from providers and ensuring key provider attributes are verified and up to date. Health plans, insurers, and state agencies who are concerned about compliance should work toward developing a flexible architecture, participate in workgroup meetings, and include the perspectives of stakeholders and departments across the enterprise, as well as external partners.

 

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Post By Ken Shafton (1,696 Posts)