The newspaper investigation found the directory on the Medicare Plan Finder and Medicare.gov website frequently produces inaccurate and conflicting information.
The provider directory tool, which is a resource for seniors shopping for Medicare Advantage plans during open enrollment, produces mixed results, according to an investigation by The Washington Post.
The directory, which is meant to display doctors and hospitals that are in-network for a particular plan, often includes duplicative addresses and contradictory information such as providers showing up as both in-network and out-of-network, the publication reported.
The Center for Medicare & Medicaid Services (CMS) in August told Medicare Advantage organizations in August that it would incorporate the provider directory information into the Plan Finder. The agency asked the organizations to supply provider data by August 29 so its technology partner could display the information in a separate Medicare Advantage directory. Last month, CMS acknowledged in a final rule that ghost networks in the directories are a problem and aims to address it before the 2027 shopping and plan comparison experience.
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The publication said that it raised the most recent issues it found with CMS on Wednesday morning, the day open enrollment began, and officials are addressing the errors. But as of Wednesday night, at 8:30 ET some problems were still appearing on the site. Andrew Nixon, a spokesman for the Department of Health and Human Services, told The Washington Post that the agency is addressing interface and data alignment problems as well as a long-term solution for broader data accuracy issues.
The newspaper noted that CMS said in September that in the event of potential errors during the first year of implementation of the directory if seniors picked a Medicare Advantage plan based on inaccurate information about their preferred providers they would have three months to select a preferred plan. However, consumers don’t necessarily know that information, Diane Omdahl, a Medicare consultant in Wisconsin told the publication.
Meanwhile, Medicare experts also told The Washington Post that the tool is limited to searches for providers within 50 miles. This is not helpful to rural residents who often need to travel further than 50 miles to see their doctors.