CMS Proposes Rule Implementing REAL Act Requirements for Medicare Advantage Plans
What happened
On October 20, 2026, the Centers for Medicare & Medicaid Services published a proposed rule implementing provisions of the Consolidated Appropriations Act, 2026. This rule introduces new requirements for Medicare Advantage plans under the Requiring Enhanced and Accurate Lists of (REAL) Health Providers Act, which mandates verification, reporting, disclosure, and liability rules starting in contract year 2028. CMS is currently accepting comments on various implementation approaches until December 15, 2026.
From natlawreview.com
Why it matters
The REAL Act was introduced to address concerns regarding 'ghost networks' and surprise out-of-network costs within Medicare Advantage. The new rules impose specific verification and consumer protection requirements on Medicare Advantage plans, affecting how they operate and manage costs.
From natlawreview.com
Who's involved
- Mercy HospitalA hospital potentially subject to new verification and reporting costs under the REAL Act.
Who could feel it
Possible knock-on effectsThese are possibilities Brind reasoned out, not predictions, and not advice. Most are not stated in any report.
- Mercy HospitalSpeculative
Mercy Hospital might face increased operational costs due to new verification and reporting requirements imposed by the REAL Act.
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The entities involved
-
Insight
company based in Hokkaido, Japan
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