REAL Act MA Plan Compliance Leaderboard
Medicare Advantage plans are required by the Reducing Barriers to Medicare Beneficiary Access Act (ACA §1002 / 42 CFR §422.111) to maintain accurate provider directories. CMS enforces compliance via quarterly audits — plans with inaccurate directories face civil monetary penalties.
Fonteum computes these scores from cross-source NPI agreement data (NPPES vs CMS Care Compare vs PECOS) — the same engine that powers the Provider Directory Accuracy Index. All underlying data is public record.
Plan Rankings
Methodology
Scores are computed from Fonteum's cross-source NPI agreement engine. Each MA contract is scored on four dimensions:
- Completeness: Fraction of plan NPIs found in Fonteum's cross-source data.
- Currency: Fraction of plan NPIs with an NPPES update within 90 days.
- Accuracy: Field-level agreement rate (NPPES vs Care Compare vs PECOS) from the PDAI engine.
- Ghost-network risk: Inverse fraction of plan NPIs absent from CMS Care Compare (higher score = lower risk).
Compliance posture
We don’t sell ranking and don’t accept payment to move a provider up the list. For final hire decisions, verify licensing, insurance, and references directly with the applicable licensing or credentialing body.
No bulk-licensing source family is currently ingested for this vertical. Hire-time checking still routes through the body named above.