This meeting was held on April 8, 2026, as an office hour session focused on Phase 2 of the Medicare Plan Finder (MPF) project. The discussion outlined how RevSpring will support health plans in submitting provider directory data to CMS for Contract Year 2027.

Meeting Overview

The session emphasized the transition to Phase 2, which requires all payers offering individual Medicare Advantage (MA) plans to supply directory data directly to CMS. This initiative aims to help beneficiaries and caregivers better identify providers and plan compatibility.

Qualifications

Provider directory data must be supplied for all individual (not-employer-only) Medicare Advantage (MA) plans, including:

• Local Coordinated Care Plans (CCP): HMO, HMO-POS, and Local PPO. 
• Regional PPO Plans. 
• Medical Savings Account (MSA): Network-based plans only.
• Private Fee-for-Service (PFFS): Network-based plans only.

Technical Implementation Details

Data Submission Approach

RevSpring will use a FHIR-based JSON file approach for data submission:

• Index File Generation: RevSpring will generate individual Index File URLs for each contract ID.
• CMS Integration: CMS will crawl these URLs and index files daily to update the Medicare Plan Finder tool.
• Payer Responsibilities: Payers are responsible for ensuring the accuracy of data sent to RevSpring and managing the annual attestation in the Health Plan Management System (HPMS).

Required Data: The Network Crosswalk File

To facilitate integration, payers must provide a pipe-delimited CSV/text file containing (specs):

1. NetworkCode: Must match existing provider file codes.
2. MedicareContractID: 5-character alphanumeric ID (e.g., H1234).
3. MedicarePlanID: 3-character numeric ID (e.g., 001).
4. MedicareSegmentID: 3-character numeric ID (use "000" if not segmented).
5. PlanYear: Set to 2027.

Key Timeline and Milestones

Clarifications & FAQs

• PCP ID vs. NPI: While Phase 1 required a PCP ID, Phase 2 has moved away from this concept. The National Provider Identifier (NPI) is now the mandatory identifier.
• Testing Readiness: RevSpring noted a slight delay in hitting the initial May 4th testing date due to pending technical guidance from CMS but plans to initiate testing by the end of May.
• Materials Access: Both the presentation slide deck and the session recording will be made available via the RevSpring Zendesk instance shortly after the meeting.

Action Items

1. Identify Contacts: Payers must identify and submit a Primary Technical Contact and a Business Contact to their Customer Success Partner by May 5th.
2. Formal Participation: Formally confirm your organization's intent to participate in Wave 1 by May 5th.