# Provider Directory Overview

CMS has introduced new requirements requiring Medicare Advantage (MA) plans supply provider and facility directory data for display on Medicare.gov’s Plan Finder beginning October 1, 2026 (Contract Year 2027). These changes ensure beneficiaries can see which doctors and facilities are in-network when comparing plans.

Health plans must meet the following requirements:

* Submit provider directory data through a public FHIR API or machine-readable JSON file.
* Update data within 30 days of any change.
* Complete an annual CEO/CFO/COO attestation.


1upHealth can create and maintain the public FHIR API and assist with validating the FHIR resources against CMS guidelines to ensure compliance.

If the provider directory data provided for a MA payer does not clearly trace which providers and facilities are in network for each of their plans, the payer may be out of compliance. Payers that fail this validation may have their plans removed from the Plan Finder during the open enrollment period.

## Validating your provider directory data

1upHealth works with customers during implementation to validate their FHIR resources and answer the following questions:

* Are the required resources present?
* Are the required fields for each resource present and in the correct format?
* Do relevant references successfully resolve?
* Do the shared references between the FHIR resources successfully resolve so CMS can trace health plans through their organization to in network providers and facilities?


## Providing the public FHIR API

1upHealth already provides FHIR Provider Directory APIs based on CMS 9115-F requirements. The new requirements for Medicare Advantage plans necessitate additional validation of the relevant FHIR resources. 1upHealth assists customers with ensuring their FHIR data complies with Provider Directory API requirements during implementation.