CMS Pub. 100-16, ch. 4, § 110.2.2

MAOs are expected to update directory information any time they become aware of

changes. All updates to the online provider directories are expected to be completed

within 30 days of receiving information. Updates to hardcopy provider directories must

be completed within 30 days, however, hardcopy directories that include separate

updates via addenda are considered up-to-date.

MAOs should contact their network/contracted providers on a quarterly basis to update

the following information in provider directories:

• Ability to accept new patients;

• Street address;

• Phone number; and

• Any other changes that affect availability to patients.

MAOs should contact providers using a method that is likely to achieve the highest

response rate. It is not sufficient to determine that a group practice is accepting new

patients. Outreach does not apply to entities such as hospitals.

All providers listed in hard copy or online directories must have current contracts to

participate in the MA plan network. Directories provided during the AEP for the

upcoming plan year are expected to fairly represent the network for the upcoming plan

year.

Note: Employer/Union-only Group Waiver Plans (EGWP) may direct enrollees to their

employer for information on the available providers. Employer/Union-only Group

Waiver Plans (EGWP) must comply with the same requirements that are applicable to all

MA and PDP plans regarding the provision of hard copy and online directories.