Ensuring Access to Essential Providers Act of 2025 requires Medicare Advantage plans to cover services from essential community providers.
The Ensuring Access to Essential Providers Act of 2025 amends title XVIII of the Social Security Act to mandate that Medicare Advantage plans cover items and services from essential community providers. These providers include Federally qualified health centers, hospitals, mental health facilities, and others serving low-income and underserved populations. Plans must include a sufficient number of these providers in their networks. If a plan does not meet the standard, the offering organization must explain why and justify how it will improve.
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