Medicare Finalizes Provider Directory Updates for Plan Finder
Published Date: 9/19/2025
Rule
Summary
Starting in 2026, Medicare Advantage plans must update how they share provider directory info, making it easier for you to find doctors and services. This change helps people using Medicare Advantage, Medicare drug plans, and PACE programs get clearer, more accurate info without extra costs. Plans need to follow these new rules on time to keep everything running smoothly and keep you informed.
Analyzed Economic Effects
1 provisions identified: 1 benefits, 0 costs, 0 mixed.
New Medicare Provider Directory Format
Starting in 2026, if you have a Medicare Advantage plan, a Medicare prescription drug plan (Part D), or are in a PACE program, your plan must use a new format to share provider directory information for the Medicare Plan Finder. You should be able to find doctors and services more easily because the information will be clearer and more accurate, and the summary states this will occur without extra costs to you. Plans must follow the new rules on time so directory information stays current.
Your PRIA Score
Personalized for You
How does this regulation affect your finances?
Sign up for a PRIA Policy Scan to see your personalized alignment score for this federal register document and every other regulation we track. We analyze your financial profile against policy provisions to show you exactly what matters to your wallet.
Key Dates
Department and Agencies
Related Federal Register Documents
2026-04797 — Medicare and Medicaid Programs; CY 2026 Payment Policies Under the Physician Fee Schedule and Other Changes to Part B Payment and Coverage Policies; Medicare Shared Savings Program Requirements; and Medicare Prescription Drug Inflation Rebate Program; Correction
This document fixes some typos and technical mistakes in the Medicare and Medicaid payment rules for 2026. It affects doctors, healthcare providers, and anyone using Medicare Part B by clarifying payment policies and program requirements starting January 1, 2026. These corrections help make sure payments and coverage rules are clear and accurate, so everyone gets paid right and on time.
2026-04467 — Patient Protection and Affordable Care Act, HHS Notice of Benefit and Payment Parameters for 2027; and Basic Health Program; Correction
This correction fixes some missing labels in important tables from the 2027 health insurance rules under the Affordable Care Act. It mainly affects insurance companies and people using marketplace plans by clarifying how risk and payments are calculated. These fixes take effect right away on March 6, 2026, ensuring everyone has clear info before the 2027 plan year starts.
2025-23081 — Medicare Program; Inpatient Rehabilitation Facility Prospective Payment System for Federal Fiscal Year 2026 and Updates to the IRF Quality Reporting Program; Correction
This correction fixes some math and typo mistakes in the Medicare payment rules for inpatient rehab facilities starting October 1, 2025. It mainly affects rehab centers by updating their payment rates and quality reporting details to be fair and accurate. These changes ensure providers get the right money and info for the 2026 fiscal year.
2025-22543 — Medicare Program; Alternative Payment Model Updates and the Increasing Organ Transplant Access (IOTA) Model
Medicare is updating its payment plans to help more people get organ transplants through the Increasing Organ Transplant Access (IOTA) Model starting in Performance Year 2. These changes affect hospitals and doctors who work with Medicare patients needing transplants, aiming to improve care and save lives. Comments on the proposed rule are open until February 9, 2026, so stakeholders can share their thoughts before it’s finalized.
2025-21767 — Medicare and Medicaid Programs; Calendar Year 2026 Home Health Prospective Payment System (HH PPS) Rate Update; Requirements for the HH Quality Reporting Program and the HH Value-Based Purchasing Expanded Model; Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program Updates; DMEPOS Accreditation Requirements; Provider Enrollment; and Other Medicare and Medicaid Policies
Starting in 2026, Medicare is updating how it pays for home health care and durable medical equipment, making sure payments match patient needs better. Home health providers will see new rules for quality reporting and value-based programs, while suppliers must meet updated accreditation and enrollment standards. These changes affect patients, providers, and suppliers, with payment updates and new deadlines kicking in early next year.
2025-21458 — Medicare and Medicaid Programs; CY 2026 Payment Policies Under the Physician Fee Schedule and Other Changes to Part B Payment and Coverage Policies; Medicare Shared Savings Program Requirements; and Medicare Prescription Drug Inflation Rebate Program; Correction
This document fixes some technical mistakes in the Medicare payment rules for 2026, especially about payments for skin substitutes. It affects doctors, Medicare patients, and providers by clarifying how certain payments work starting November 28, 2025. No big changes in money, just important corrections to keep things running smoothly.
Previous / Next Documents
Previous: 2025-18228 — Form PF; Reporting Requirements for All Filers and Large Hedge Fund Advisers; Further Extension of Compliance Date
If you’re a big hedge fund or private fund adviser, the deadline to follow new Form PF rules just got pushed back a whole year—from October 1, 2025, to October 1, 2026. This gives you more time to get your reports in order without rushing. No new fees, just a friendly extension to keep things smooth and clear!
Next: 2025-18237 — Commission's Rules of Practice
The Securities and Exchange Commission is updating how it reviews certain staff decisions about when registration and offering statements become effective. These changes affect companies filing under Regulation A and aim to make the process clearer and quicker. The updates could speed up approvals, helping businesses get to market faster without extra costs.
Take It Personal
Get Your Personalized Policy View
Start a Free Government Policy Watch to see how policy affects your household, then upgrade to PRIA Full Coverage for year-round monitoring.
Already have an account? Sign in