46% of Medicare Advantage listings include wrong information: 5 things to know

Written by Laura Dyrda | October 31, 2016 | Print  |

A new investigation from CMS shows nearly half of the physicians listed in the Medicare Advantage directory include inaccurate information, according to an American Journal of Managed Care report.

The survey examined 5,832 providers for 54 Medicare Advantage plans. Here are five quick facts from the study:


1. Inaccurate location for available providers in multi-site practices was the most common error with the data.


2. Nearly 46 percent of physician listings included at least one piece of wrong information.


3. Several listings also included inaccurate phone numbers or addresses. There were 633 who had inaccurate addresses and 521 with wrong phone numbers.


4. In a Health Affairs study of California providers, 30 percent of callers posing as patients found physicians did not practice in the specialties listed in the directory; 10 percent of the physicians weren't accepting new patients.


5. There is a penalty for inaccurate data that could be as much as $25,000 per beneficiary after new 2016 regulations required every Medicare Advantage plan to contact providers in its network every three months to confirm listing information and update as needed.


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