9.09.26 Medicare Plan Finder Information Session

1. Medicare Plan Finder Phase 2 Overview

Final rule basis: CMS's rule requires all Medicare Advantage (MA) plans to supply provider directory data to CMS, beginning in Contract Year 2027, to populate the Medicare Plan Finder tool used by Medicare beneficiaries.
How RevSpring supports it: RevSpring provides data to CMS via FHIR-based JSON files. Clients make their data available to RevSpring, RevSpring generates a URL, the client populates that URL in HPMS, and CMS crawls the URL daily to validate results and update Medicare Plan Finder.
Division of responsibility: RevSpring owns the technical work to generate the URLs, but health plans remain responsible for the accuracy of the underlying data, the submission of the URLs, and the annual attestation to CMS.

Testing window extended: Now runs through September 18 (previously September 1), giving plans additional time to work through validation feedback ahead of the production cutover. This does not change anything for clients already live on production.
Attestation deadline moved: Now due September 18 (previously September 1), to align with the extended testing window. Clients who already attested before September 1 do not need to do so again.
Go-live date unchanged: Target production release remains October 1, ahead of open enrollment.
Milestone summary: September 18 for attestation and production-ready data, and October 1 for the public go live.

Now available: Launched yesterday, ten days ahead of schedule.
What it does: Lets plans search by contract, plan, segment ID, ZIP code, or NPI to verify how provider and facility directory data will actually display on Medicare Plan Finder before it goes live publicly.
If something looks off: First check how your data file is being assembled on your end. If everything looks correct from there, CMS has a survey link for submitting feedback directly to them.

Hard cap introduced: No more than 10,000 entries in the provider URL array per contract number and contract year, and the file itself must stay under 300 MB.
New fatal error code: Files that exceed the cap will be rejected in full under new error code C4019.
Current status: RevSpring has already checked every current production index file against this limit, and all clients are below the threshold with today's data. RevSpring will continue to monitor this going forward.
Revision log added: CMS added a revision log to the technical guide, right after the title page, making it easier to track what changed between versions without manually comparing documents.

Resolved
- Broken reference/content links: A caching issue on RevSpring's content delivery network was causing these errors. Fixed as of September 4. Should be clearing from validation reports.
- Accepting new patients errors: This was a CMS-side issue; CMS has confirmed it is fixed and it should be dropping off validation reports.
In progress
- Address mapping: A fix is live; RevSpring is verifying it is fully reflected everywhere before considering it closed.
- Provider specialty mapping: A fix is rolling out, but some records list a program name instead of the actual clinical specialty, which can't map cleanly to a standard code. RevSpring is working through the right way to handle this subset.
- Geocoding failures: A small number of addresses are failing CMS's geocoding check even though the underlying data looks correct on RevSpring's end. RevSpring has gone back to CMS to understand why and will share an update soon.

Finalized 2027 data: Send this as soon as possible if you haven't already, or if anything has changed since you did. RevSpring uses this to generate your production URLs.
Production URL: Once RevSpring generates and shares it back with you, enter it on the provider directory URL page in HPMS.
Attestation: Complete in HPMS by September 18, signed off by your CEO, CFO, or COO.
Validation reports: Continue sharing whatever CMS sends back with your Customer Success partner or Data Operations lead. This is the fastest way to catch and resolve issues.
Flagged errors: Resolve any errors RevSpring has identified as yours to fix ahead of go live. Reach out if you get stuck on anything.
Preview tool: Use it to spot-check your directory data in HPMS before launch.

More info sessions through October 8: Next week is a customer roundtable focused on MPF, followed by another info session the week after. Registration details will be shared separately.
CMS drop-in office hours: CMS is running its own office hours with their technical team. No registration required. Plans can just drop in, and there are a few more sessions this month.
Next info session preview: Will cover any new changes since this session and begin looking ahead at what post-go-live support will look like.

Submit finalized 2027 data: As soon as possible, if not already sent.
Enter your production URL in HPMS: Once RevSpring provides it.
Complete attestation by September 18: Signed off by your CEO, CFO, or COO.
Keep sharing validation reports: Send to your Customer Success partner or Data Operations lead.
Resolve any flagged errors: Ahead of the October 1 go live.
Use the benefits preview tool: Spot-check your directory data before it goes live publicly.
Join next week's roundtable: Focused on MPF, registration details to follow.
Consider CMS's drop-in office hours: No registration needed; several sessions remain this month.