Medicare AdvantageAdministrativeHigh impact
MAPAP203 - Access to Care Guidelines - Added CMS access to care & appointment wait times monitoring requirements and corrective action if not able to comply.
Blue Cross of Idaho·ID·Medical Policy
Effective date
Nov 1, 2025
We identified it
Jun 19, 2026
Summary
Blue Cross of Idaho updated their Access to Care Guidelines policy to include new CMS monitoring requirements for Medicare Advantage plans. Providers must now comply with specific appointment wait time standards (30 business days for routine care, 7 days for urgent non-emergency care) or face mandatory training and potential removal from the provider directory.
Action Required
Immediately: All providers must ensure compliance with appointment scheduling timeframes - 30 business days for routine/preventative care, 7 business days for urgent non-emergency services, immediate access for emergencies, and less than 45 minutes office wait time for scheduled appointments. If notified of non-compliance, complete the mandatory Access to Care Guidelines training module and attestation on the Blue Cross of Idaho provider portal within 30 days to avoid removal from provider directory.