,,ii  #aah? ,,congress  #a/ ,session    
,s4 #cjei  ,,9 ,,! ,,s5ate ,,( ,,!      
,,unit$ ,,/ates  ,octob] #ag1 #bjbc,mr4 
,b5net 7= himself1 ,mr4 ,tillis1 & ,mr4 
,wyd57 introduc$ ! foll[+ bill2 :i* 0   
read twice & ref]r$ to ! ,committee on  
,f9ance  ,a ,,bill  ,to am5d title      
,,xviii ( ! ,social ,security ,act to   
e/abli% provid] directory requirem5ts1 &
 to provide acc\ntability = provid]     
directory accuracy1 "u ,m$ic>e          
,advantage4  #a4 ,%ort title ,?is ,act  
may be cit$ z ! ,requir+ ,enhanc$       
,accurate ,li/s ( ,heal? ,provid]s ,act 
or ! ,,real ,heal? ,provid]s ,act4  #b4 
,provid] directory requirem5ts ,section 
#aheb7;c7 ( ! ,social ,security ,act    
7#db ,u4,s4,c4 #aciew-#bb7;c77 is       
am5d$-- 7#a7 9 p>agraph 7#a77;,c7-- 7,a7
 by /rik+ plan1 & any & ins]t+ plan1    
any2 &  7,b7 by ins]t+ ! foll[+ be=e !  
p]iod3 1 &1 9 ! case ( a network-bas$   
,,ma plan 7z def9$ 9 p>agraph           
7#c77;,c771 = plan ye> #bjbf & subsequ5t
 plan ye>s1 ! in=mation describ$ 9      

p>agraph 7#c77;,b72 &  7#b7 by add+ at !
 end ! foll[+ new p>agraph3  7#c7       
,provid] directory accuracy  7,a7 ,9    
g5]al ,= plan ye> #bjbf & subsequ5t plan
 ye>s1 ea* ,,ma organization (f]+ a     
network-bas$ ,,ma plan %all1 = ea*      
network-bas$ ,,ma plan (f]$ by !        
organization-- 7i7 ma9ta91 on a publicly
 available int]net website1 an accurate 
provid] directory t includes ! in=mation
 describ$ 9 subp>agraph 7,b72  7ii7 n   
less frequ5tly ?an once e #ij days1     
v]ify 9 a mann] specifi$ by ! ,secret>y 
! provid] directory in=mation ( ea*     
provid] li/$ 9 su* directory &1 if      
applicable1 update su* provid] directory
 in=mation2  7iii7 if ! organization is 
unable to v]ify su* in=mation ) respect 
to a provid]1 include 9 su* directory an
 indication t ! in=mation ( su* provid] 
may n be up to date2  7iv7 remove a     
provid] f su* directory )9 #e bus9ess   
days if ! organization det]m9es t !     
provid] is no long] a provid] p>ticipat+
 9 ! network ( su* plan2 &  7v7 meet su*

 o!r requirem5ts z ! ,secret>y may      
specify4  7,b7 ,provid] directory       
in=mation ,! in=mation describ$ 9 ?is   
subp>agraph is in=mation enrollees may  
ne$ to access cov]$ b5efits f a provid] 
) :i* su* plan has an agreem5t = furni%+
 items & s]vices cov]$ "u su* plan su* z
 "n1 specialty1 contact in=mation1      
prim>y (fice or facility address1       
availability1 accommodations = p )      
disabilities1 cultural & l+ui/ic        
capabilities1 & teleheal? capabilities4 
7,c7 ,network-bas$ ,,ma plan def9$ ,9   
?is p>agraph1 ! t]m network-bas$ ,,ma   
plan means an ,,ma plan t has a network 
( provid]s t contract or make           
arrangem5ts ) ! ,,ma organization (f]+ !
 plan to furni% items & s]vices cov]$ "u
 su* plan4  4  #c4 ,acc\ntability =     
provid] directory accuracy  7a7 ,co/    
,%>+ = ,s]vices ,furni%$ ,bas$ on       
,reliance on ,incorrect ,provid]        
,network ,in=mation ,section #aheb7;d7 (
 ! ,social ,security ,act 7#db ,u4,s4,c4
 #aciew-#bb7;d77 is am5d$ by add+ at !  

end ! foll[+ new p>agraph3  7#g7 ,co/   
%>+ = s]vices furni%$ bas$ on reliance  
on incorrect provid] network in=mation  
7,a7 ,9 g5]al ,= plan ye> #bjbf &       
subsequ5t plan ye>s1 if an enrollee is  
furni%$ an item or s]vice by a provid] t
 is n p>ticipat+ 9 ! network ( a        
network-bas$ ,,ma plan 7z def9$ 9       
subsection 7c77#c77;,c77 b is li/$ 9 !  
provid] directory ( su* plan 7z requir$ 
to be provid$ to an enrollee pursuant to
 subsection 7c77#a77;,c77 on ! date on  
:i* ! appo9tm5t is made1 ! ,,ma         
organization (f]+ su* plan %all ensure t
 ! enrollee is only responsible = !     
am\nt ( co/ %>+ t w\ld apply if su*     
provid] _h be5 p>ticipat+ 9 ! network ( 
su* plan4  7,b7 ,notification requirem5t
 ,= plan ye> #bjbf & subsequ5t plan     
ye>s1 ea* ,,ma organization t (f]s a    
network-bas$ ,,ma plan %all-- 7i7 notify
 enrollees ( _! co/-%>+ protections "u  
?is p>agraph & make su* notifications1  
to ! ext5t practicable1 by n lat] ?an ! 
fir/ day ( an annual1 coord9at$ election

 p]iod "u section #ahea7;e77#c7 )       
respect to a ye>2  7ii7 include         
in=mation reg>d+ su* co/-%>+ protections
 9 ! provid] directory ( ea*            
network-bas$ ,,ma plan (f]$ by ! ,,ma   
organization2 &  7iii7 notify enrollees 
( _! co/-%>+ protections "u ?is p>agraph
 9 an explanation ( b5efits4  4  7b7    
,requir$ provid] directory accuracy     
analysis & reports  7#a7 ,9 g5]al       
,section #aheg7;e7 ( ! ,social ,security
 ,act 7#db ,u4,s4,c4 #aciew-#bg7;e77 is 
am5d$ by add+ at ! end ! foll[+ new     
p>agraph3  7#f7 ,provid] directory      
accuracy analysis & reports  7,a7 ,9    
g5]al ,beg9n+ ) plan ye>s beg9n+ on or  
aft] ,janu>y #a1 #bjbf1 subject to      
subp>agraph 7,c71 a contract "u ?is     
section ) an ,,ma organization %all     
require ! organization1 = ea*           
network-bas$ ,,ma plan 7z def9$ 9       
section #aheb7;c77#c77;,c77 (f]$ by !   
organization1 to annually-- 7i7 conduct 
an analysis ( ! accuracy ( ! provid]    
directory ( su* plan 7includ+ provid]   

types ) high inaccuracy rates1 su* z    
provid]s specializ+ 9 m5tal heal? &     
sub/ance use disord] treatm5t1 z det]m9$
 by ! ,secret>y72 &  7ii7 submit a      
report to ! ,secret>y conta9+ ! results 
( su* analysis & o!r in=mation requir$  
by ! ,secret>y4  7,b7 ,consid]ations ,9 
e/abli%+ requirem5ts ) respect to       
analysis & report+ "u ?is p>agraph1 !   
,secret>y %all take into acc\nt-- 7i7   
data s\rces ma9ta9$ by ( ,,ma           
organizations2  7ii7 publicly available 
data sets2 &  7iii7 ! adm9i/rative burd5
 ( ma9ta9+ provid] directories on plans 
& provid]s4  7,c7 ,exception ,!         
,secret>y may waive ! requirem5ts ( ?is 
p>agraph 9 ! case ( a network-bas$ ,,ma 
plan ) l[ enrollm5t 7z def9$ by !       
,secret>y74  7,d7 ,transp>5cy ,!        
,secret>y %all po/ accuracy scores 7z   
report$ "u subp>agraph 7,a771 9 a ma*9e 
readable file1 on ! int]net website ( ! 
,c5t]s = ,m$ic>e  ,m$icaid ,s]vices4    
7,e7 ,implem5tation ,! ,secret>y %all   
implem5t ?is p>agraph ?r\gh notice &    

comm5t rulemak+4  4  7#b7 ,provision (  
in=mation to b5efici>ies ,section       
#ahea7;d77#d7 ( ! ,social ,security ,act
 7#db ,u4,s4,c4 #aciew-#ba7;d77#d77 is  
am5d$ by add+ at ! end ! foll[+ new     
subp>agraph3  7,f7 ,provid] ,directory  
,in=mation reg>d+ ! accuracy ( ! plan's 
provid] directory 7z report$ "u section 
#aheg7;e77#f77 on ! plan's provid]      
directory4  4  7#c7 ,fund+ ,9 addition  
to am\nts o!rwise available1 !re is     
appropriat$ to ! ,c5t]s = ,m$ic>e       
,m$icaid ,s]vices ,program ,managem5t   
,acc\nt1 out ( any money 9 ! ,treasury n
 o!rwise appropriat$1 #a1jjj1jjj =      
fiscal ye> #bjbf1 to rema9 available    
until exp5d$1 to c>ry out ! am5dm5ts    
made by ?is subsection4  7c7 ,,gao /udy 
& report  7#a7 ,analysis ,! ,comptroll] 
,g5]al ( ! ,unit$ ,/ates 79 ?is         
subsection ref]r$ to z ! ,comptroll]    
,g5]al7 %all conduct /udy ( !           
implem5tation ( ! am5dm5ts made by      
subsections 7a7 & 7b74 ,su* /udy %all   
include an analysis (-- 7,a7 ! use (    

protections requir$ "u section          
#aheb7;d77#g7 ( ! ,social ,security     
,act1 z add$ by subsection 7a72  7,b7 ! 
provid] directory accuracy scores tr5ds 
"u section #aheg7;e77#f7 ( ! ,social    
,security ,act 7z add$ by subsection    
7b77#a771 bo? ov]all & among provid]s   
specializ+ 9 m5tal heal? & sub/ance     
disord] treatm5t2 &  7,c7 o!r items     
det]m9$ appropriate by ! ,comptroll]    
,g5]al4  7#b7 ,report ,n lat] ?an       
,janu>y #a1 #bjca1 ! ,comptroll] ,g5]al 
%all submit to ,congress1 ! ,commission]
 ( ,social ,security1 & ! ,secret>y (   
,heal? & ,human ,s]vices a report       
conta9+ ! results ( ! /udy conduct$ "u  
p>agraph 7#a71 toge!r ) recomm5dations =
 su* legislation & adm9i/rative action z
 ! ,comptroll] ,g5]al det]m9es          
appropriate4  #d4 ,guidance on be/      
practices = ma9ta9+ accurate provid]    
directories ,n lat] ?an #ab mon?s aft] !
 date ( enactm5t ( ?is ,act1 ! ,secret>y
 ( ,heal? & ,human ,s]vices %all issue  
guidance to ,m$ic>e ,advantage          

organizations (f]+ ,m$ic>e ,advantage   
plans "u "p ,c ( title ,,xviii ( !      
,social ,security ,act 7#db ,u4,s4,c4   
#aciew-#ba et seq47 on ma9ta9+ accurate 
provid] directories = su* plans4 ,su*   
guidance may include ! foll[+1 z det]m9$
 appropriate by ! ,secret>y3 7#a7 ,be/  
practices = ,m$ic>e ,advantage plans on 
h[ to "w ) provid]s to ma9ta9 ! accuracy
 ( provid] directories ( su* plans &    
r$uce provid] & ,m$ic>e ,advantage plan 
burd54  7#b7 ,in=mation on data sets &  
data s\rces ) in=mation t c\ld be us$ by
 su* plans to ma9ta9 accurate provid]   
directories4  7#c7 ,approa*es = utiliz+ 
exi/+ in=mation assets ( plans &        
publicly available data sets & data     
s\rces to ma9ta9 accurate provid]       
directories4  7#d7 ,in=mation t may be  
useful = b5efici>ies to assess plan     
networks :5 select+ a plan & access+    
provid]s p>ticipat+ 9 plan networks dur+
 ! plan ye>4