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.

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.

Cite This Dataset

Fonteum. (2026). REAL Act Medicare Advantage Plan Compliance Scores. Retrieved 2026-05-27, from https://fonteum.com/research/real-act-compliance

Fonteum. "REAL Act Medicare Advantage Plan Compliance Scores." Accessed 2026-05-27. https://fonteum.com/research/real-act-compliance.

@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 2026-05-27.}
}