KMA NEWS

Consolidated Appropriations Act: Reminder for Providers

As part of the 2021 Consolidated Appropriations Act (CAA), providers will soon be asked to verify their online provider directory information on a regular basis to help ensure patients can locate the most current information for in-network providers and facilities. It is important that you keep your information up to date. Here’s what you can do now:

  • Review your online provider directory information through each health plan’s website on a regular basis to ensure it is correct.
  • Submit updates and corrections to your directory information to the health plan as they occur. Consider these changes:
    • add/change an address location
    • name change
    • tax ID changes
    • provider leaving a group or a single location
    • phone/fax number changes
    • closing a practice location

Consolidated Appropriations Act implementation

The Consolidated Appropriations Act does not preempt state law requirements. This means that the CAA applies in addition to any state law requirements of providers to update their provider directory information.

On August 20, 2021, the Tri-Agencies (Departments of Labor, Health and Human Services and the Treasury) announced that regulations to implement the provider directory requirements would be issued on or after January 1, 2022. Health plans are expected to implement the provider directory requirements based on a good faith, reasonable interpretation of the requirements by January 1, 2022, with a primary focus on ensuring that members who rely on provider directory information that inaccurately depicts a provider’s network status are only liable for in-network cost sharing amounts.