Here's what's proposed, how it affects you, and what to do now.
What is CMS proposing?
On October 16, 2026, CMS proposed a rule to fix "ghost networks": doctor listings in Medicare Advantage directories that are wrong or out of date. Under the proposal, plans would have to:
- Check their directories at least every 90 days and fix errors
- Confirm accuracy more often than once a year
- Publish an accuracy score for the public to see
- Charge in-network prices if a patient goes out of network because the directory was wrong
How this affects your practice
More requests from plans to confirm your address, phone number, specialties and whether you take new patients.
Wrong listings will cost plans money, so they will push practices harder to keep data current.
Patients will trust directories more, so an accurate listing will bring in more patients.
What to do now: 5 simple steps
How to turn this into an opportunity
Free marketing.
A correct listing that says "accepting new patients" sends patients to your door.
Fewer surprise denials.
Correct data means fewer claims rejected because provider details don't match.
Be the easy practice.
Plans will value practices that keep their data clean.
Key dates
| Date | What happens |
|---|---|
| October 16, 2026 | CMS proposed the rule |
| 2028 (if finalized) | 90-day directory checks begin |
| 2029 (if finalized) | Plans publish accuracy scores |
The bottom line
This is still a proposal, but cleaning up your listings now costs little and brings in patients. Check every plan's directory this month.
Frequently asked questions
What is a ghost network?
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A ghost network is a list of doctors in an insurance directory who can't actually be seen: they've moved, retired, left the plan, or aren't taking new patients.
Is the directory rule final?
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No. It is a proposed rule. If CMS finalizes it, most requirements would start in 2028.
What are NPPES and CAQH?
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NPPES is the national system that holds your NPI record. CAQH is the database many insurers use for your practice and credentialing information. Keeping both current keeps directories accurate.
How often should I check my listings?
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At least every 90 days, and any time a provider, address, phone number or specialty changes.
Feeling overwhelmed? HealthRescue Partners can help
Keeping listings right across every plan takes time. HealthRescue Partners can help. We can:
- Explain the proposed rule in plain terms
- Give you a simple directory checklist
- Help you keep CAQH, NPPES and plan listings up to date
Sources
- CMS proposes reforms to strengthen transparency and affordability in Medicare Advantage and Part DCMS press release, Oct 16, 2026
- CMS proposes rule to clean up MA provider directoriesHealthcare Dive, Oct 19, 2026
- CMS proposes MA ghost network requirementsFierce Healthcare
This article is general information, not legal or billing advice.