The Consolidated Appropriations Act (CAA) was signed into law in 2020 to provide relief legislation in response to the coronavirus pandemic. Under one of the provisions in the CAA, Blue Cross and other health plans are required to verify provider directory information every 90 days beginning in 2022. Updated practice information allows us to provide patients with current practice and provider information to assist them with selecting the most appropriate providers for the care they are seeking. 

Provider Responsibilities Under the CAA

Providers have responsibilities under the CAA to comply with these requirements. These include:

• Verify your directory information every 90 days.
• Update your information when it changes. This would include name, address, specialty, phone number and digital contact information. 
• If you are newly enrolled in or leave a network, please update your directory information immediately. 

Confirm Directory Information

Blue Cross uses Council for Affordable Quality Healthcare (CAQH) as a primary source for all provider updates. Make sure your CAQH profile is current to ensure your records remain accurate.

Potential CMS Provider Directory Information Audit Questions

The following questions may be asked during a CMS Provider Directory Information Audit:

1. Does the provider see patients at this location?
    
2. What is the address?
    
3. Does the provider accept a Medicare Advantage Prescription Drug (MA-PD) plan at this location?
    
4. Does the provider accept new patients who have this MA-PD plan? (The provider directory is considered accurate if it correctly indicates the provider is or is not accepting new patients.)
    
5. Is the provider a primary care physician, cardiologist, oncologist or ophthalmologist?
    
6. What is the telephone number for making appointments? (Usually confirmed by dialing the phone number.)
    
7. What is the provider's name?
    
8. What is the practice name?

Use this printable version of the potential questions to prepare your office staff.

If you have questions, email us at Credentialing@bcbsal.org.

For more information, reference the CAA Provider Directory Statute.