Bills · HR 5281
IN COMMITTEE· 119TH CONGRESS
House BillHR 5281Health
REAL Health Providers Act
INTRO SEP 10· LAST ACTION SEP 10
READING
11MIN
COSPONSORS
8BIPARTISAN
READER REACTIONS0 TOTAL
NO VOTES YET · BE THE FIRST
- Introduced only
LEGISLATIVE PROGRESS
STEP 2 / 8Introduced
In Committee
Reported
Passed House
Passed Senate
Conference
To President
Became Law
WHAT THE BILL DOES
AI-writtenVoters should care about this bill because inaccurate provider directories are a widespread and costly problem for many Americans, particularly seniors enrolled in Medicare Advantage plans. When directories are outdated or incorrect, patients waste time trying to find care, can face delays in treatment, and, most critically, can be hit with unexpected and expensive medical bills if they see a provider who is mistakenly listed as in-network.
If this bill becomes law, it means people using Medicare Advantage plans can trust that the information in their plan's directory is reliable. It provides a real safeguard against "surprise bills" that result from plans providing bad information, shifting the financial burden from the patient back to the insurance company when the directory is wrong. Without this bill, patients often have little recourse and must pay higher out-of-network costs even if their plan's directory was misleading, and plans face less pressure to ensure their public information is correct.
KEY PROVISIONS
4AI-extractedPROVISION 01
Medicare Advantage plans must maintain accurate, publicly available online directories of network providers, starting in 2028.
This makes it easier for patients to find reliable information about which doctors are in their plan's network.
PROVISION 02
Plans must verify provider information at least every 90 days (or annually for hospitals) and remove non-participating providers within 5 business days.
This ensures the directories stay current, reducing the chance of outdated or incorrect listings that can mislead patients.
PROVISION 03
If an enrollee sees an out-of-network provider who was listed as in-network in the directory, the plan must charge only the lower, in-network cost-sharing.
This protects patients from unexpected high bills due to inaccurate information provided by their health plan, shifting the financial risk.
PROVISION 04
Medicare Advantage plans must conduct annual analyses of their directory accuracy, focusing on high inaccuracy areas, and report the findings to the government.
This creates accountability for plans and helps identify areas where directory accuracy needs systematic improvement, particularly for critical services like mental health.
SPONSORSHIP
1 + 8
D· California
YRS IN OFFICE
9
BILLS LED
54
COSPONSOR BREAKDOWNBIPARTISAN · 75%
DEM 5 REP 3 IND 0
ACTION TIMELINE
2 EVENTSSEP 10
Introduced in House
SEP 10
Referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
BILL INFO
TypeHouse Bill
NumberHR 5281
Congress119th
StatusIn Committee
IntroducedSep 10, 2025
Last actionSep 10, 2025
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IN COMMITTEE· 119TH CONGRESS · WAYS AND MEANS COMMITTEE · INTRODUCED SEP 10, 2025
House BillHR 5281Health
REAL Health Providers Act
INTRODUCED SEP 10, 2025· LAST ACTION SEP 10, 2025
PASSAGE CHANCES
—%
READING
11 min
COSPONSORS
8
COMPLEXITY
Moderate
