April 29, 2026 | CMS Medicare Plan Finder Phase II Information Session

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Key Summary

  • Transition to Phase 2: Moves from an optional third-party data exchange (Sunfire Matrix) to a direct data exchange between payers and CMS.

  • Data Format: Payers must provide data via FHIR-based JSON API files. RevSpring will support this by generating necessary plan bundles and hosting index URLs.

  • CMS Integration: CMS will crawl these URLs daily to ingest and validate the data for the Medicare Plan Finder tool.

  • Responsibility: Payers are responsible for the accuracy of provider data and must perform an annual attestation through the HPMS system.

Action Items

1. Identify Contacts & Confirm Participation

  • Deadline: Due by May 5, 2026.

  • Identify primary technical and business contacts.

  • Formally confirm intent to participate in Wave 1.

2. Submit Network Crosswalk File

  • Deadline: Due by May 15, 2026 (for Wave 1).

  • Required Fields: NetworkCode, MedicareContractID, MedicarePlanID, MedicareSegmentID, and PlanYear (2027).

  • Technical Spec: Pipe-delimited .txt format; must match the NetworkCode in your provider file.

  • Delivery: Upload to your existing standard delivery location (AWS S3 or GCP).

3. Data Validation

  • Payers must ensure MedicareContractID and NetworkCode are accurate to avoid validation failures.

  • Verify all required FHIR resources (InsurancePlan, Location, Practitioner, etc.) can be generated in the required format.

4. HPMS Update

  • Update your Health Plan Management System (HPMS) with the Index File URLs generated by RevSpring to allow CMS crawling.


Note: If your organization cannot meet the May 15 deadline, you will be moved to Wave 2, with testing beginning in early Q3 (after June 30).

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