May 6, 2026 | CMS Medicare Plan Finder Phase II Information Session

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The video outlines the Medicare Plan Finder (MPF) Phase 2 Info Session, focusing on how Medicare Advantage (MA) plans will share provider directory data with CMS for contract year 2027.

Key Summary
  • Objective: MA plans are required to provide machine-readable directory data (JSON/FHIR-based) to CMS. This allows beneficiaries to see which providers accept specific plans.

  • Data Hosting: RevSpring will host FHIR-based JSON files via URLs that plans must enter into the Health Plan Management System (HPMS). CMS will crawl these URLs daily to validate and update the MPF tool.

  • New CMS Clarifications:

    • Plans must specify if their URL points to standard or FHIR-based JSON.

    • Directories must only include current, in-network providers and must be updated every 30 days.

    • All contracted providers, including supplemental benefits (dental, vision, hearing), must be included. Pharmacy data is handled via a separate process.

  • Implementation Phases:

    • Wave 1: Final commitment was due May 5th; crosswalk files are due by May 15th.

    • Wave 2: Target for submissions starting June 30th.

    • Testing Window: Open from May through the end of August.


Action Items
Immediate (For Wave 1 Plans)
  • Submit Network Crosswalk File (Due May 15th): Plans must provide a pipe-delimited .txt file containing the NetworkCode, MedicareContractID, MedicarePlanID, and MedicareSegmentID.

  • Validation Check: Ensure the NetworkCode in the crosswalk file exactly matches the code used in your existing provider data feeds to ensure data integrity.

Administrative Tasks
  • HPMS Data Entry: MA organizations must enter and maintain the directory URLs provided by RevSpring in the HPMS Basic Contract Management module.

  • Data Scrubbing: Verify that your provider data feeds exclude pharmacy records and provider groups (include individual providers only).

  • Segment Values: If a plan is not segmented, use the value 000 in the segment ID field.

Long-term Compliance
  • Update 2027 Data: While 2026 data can be used for initial testing, plans must be ready to provide contract year 2027 data by late August for the final production release.

  • Address Validation Errors: Monitor HPMS for CMS validation results and collaborate with RevSpring to adjust JSON files if errors are identified.

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