Bulletin No. 2025-03: Participation in the OID/CMS Provider Directory Pilot Program

Page 1 of 1 BULLETIN NO. 2025-03 TO: All Health Insurance Companies, HMOs, and Other Interested Parties RE: Participation in the OID/CMS Provider Directory Pilot Program FROM: Glen Mulready, Insurance Commissioner DATE: May 19, 2025 The Oklahoma Insurance Department (OID) and the Centers for Medicare and Medicaid Services (CMS) announced a new partnership in September 2024 to launch a first-of-its-kind provider directory pilot program for those participating in a Qualified Health Plan (QHP). The pilot will establish and implement an automated, one-stop shop, statewide centralized directory that allows QHPs and providers to submit and access pre-populated provider data to improve accuracy and reduce burden. As part of its ongoing work to improve access to care, reduce clinician burden, and support interoperability throughout the health sector, CMS is partnering with the state of Oklahoma to help inform the design and feasibility of any future efforts toward a National Directory of Healthcare (NDH). The QHP Directory Pilot will ideally serve as proof-of-concept that a centralized directory for QHPs can serve as a single point of entry for providers to regularly update or confirm their directory information. Over the past several months, CMS has worked closely with stakeholders in Oklahoma to gain valuable feedback from providers before the launch of user testing later this month. This testing phase will help CMS identify any bugs that need repair and ensure the final product functions as expected before the portal is opened to all available users in Oklahoma this summer. With the issuance of this bulletin, the Oklahoma Department of Insurance (OID) is requiring all QHP issuers to participate in the pilot program. Federal and state guidelines require providers and facilities to update their information. The pilot program is separate and distinct from the provider directory requirements set forth in Section 6971 of Title 36 of Oklahoma Statutes and discussed in OID Bulletin No. 13-2023. Participation in this pilot program does not replace or modify any responsibilities QHPs may have to comply with Section 6971. You can learn more about the pilot by reading the Fact Sheet and Frequently Asked Questions. Please direct any questions or concerns to QHPDirectoryPilot@cms.hhs.gov. Regulated entities can direct inquiries regarding this bulletin to Brian Downs (brian.downs@oid.ok.gov) or Ashley Scott (ashley.scott@oid.ok.gov).