In a July 16 letter to state health officials, the Centers for Medicare and Medicaid Services (CMS) provides guidance on provider directory requirements and expectations outlined in the Consolidated Appropriations Act, 2023 (CAA, 2023).
The CAA, 2023 requires fee-for-service (FFS) and managed care programs to update their network provider directories quarterly and specifies which provider types must be in the directory. The directory must include each provider’s name, address, phone number, and specialty.
The CAA, 2023 also adds and updates minimum required information in the directory to include:
- Facility accommodations for individuals with physical disabilities
- The provider’s website
- Whether the provider offers covered services via telehealth
- Whether the provider is accepting new Medicaid or Children’s Health Insurance Program (CHIP) patients.
- Whether American Sign Language is offered, and other cultural and linguistic capabilities
The CAA, 2023 also requires state Medicaid and CHIP agencies that provide FFS services to add the above information to their provider directories.
CMS reiterates that enhanced federal financial participation is available for design; development, and implementation; and operations and maintenance of state Medicaid information technology systems for FFS provider directories.
CMS also reviews corrective action plan requirements for noncompliance and procedures to return to compliance.
These changes are effective July 1, 2025.
Contact Director of Policy Rob Nelb, MPH, at rnelb@essentialhospitals.org or 202.585.0127 with questions.