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DATA · MAY 8, 2026

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.

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© 2026 FONTEUM RESEARCH · DATA SNAPSHOT MAY 8, 2026 · BUILT WITH CARE

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Research/REAL Act Compliance

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

First issuance pending — operator triggers the quarterly cron post-merge.

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).

The composite score is an equal-weight average of the four sub-scores. Plans with fewer than 50 matched NPIs are flagged as insufficient-sample and excluded from ranking.

Full methodology →

Cite This Dataset

APA
Fonteum. (2026). REAL Act Medicare Advantage Plan Compliance Scores. Retrieved 2026-05-26, from https://fonteum.com/research/real-act-compliance
Chicago
Fonteum. "REAL Act Medicare Advantage Plan Compliance Scores." Accessed 2026-05-26. https://fonteum.com/research/real-act-compliance.
BibTeX
@misc{fonteum_real_act_2026,
  author       = {Fonteum},
  title        = {REAL Act Medicare Advantage Plan Compliance Scores},
  year         = {2026},
  url          = {https://fonteum.com/research/real-act-compliance},
  note         = {Methodology: real-act/v1. Accessed 2026-05-26.}
}

Limitations:real-act/v1 uses state-level NPI aggregates as an approximation for plan-specific NPI rosters. Full plan-to-NPI mapping from CMS MA crosswalk files is queued for real-act/v2. Scores reflect Fonteum's cross-source analysis and are not an official CMS determination.

Sources: NPPES (CMS), Care Compare (CMS), PECOS (CMS). All data is federal public record. Methodology: real-act/v1.