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Medicare HETS 270/271 Eligibility - Information Bulletin - Upcoming System Release Update - June 24, 2016
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HETS 270/271

Medicare HETS 270/271 Submitters:

CMS has published updated HETS R2016Q300 release documents.  Please review the Revision History in the linked documents below for additional information regarding these changes.

Companion Guide: /Research-Statistics-Data-and-Systems/CMS-Information-Technology/HETSHelp/Downloads/HETS270271CompanionGuideUpcoming.pdf (PDF) (version 10-1)

Release Summary: /Research-Statistics-Data-and-Systems/CMS-Information-Technology/HETSHelp/Downloads/R2016Q300HETS270271ReleaseSummary.pdf (PDF)  (version 1.04)

CMS has also updated the HETS R2016Q300 271 Transaction Example to reflect the removal of the 2100A PER loop from the 271 response.  The updated sample document is linked below.

271 Transaction Example: /Research-Statistics-Data-and-Systems/CMS-Information-Technology/HETSHelp/Downloads/5010271ResponseExampleUpcoming.pdf (PDF) (Date of Last Revision 6/10/2016)

CMS reminds HETS 270/271 Submitters that they may need to take action to ensure that their 270 requests do not contain any of the following data elements:

  • A Social Security Number in the 270 2100C REF segment
  • A Medicare Beneficiary’s Middle Name or Middle Initial in the 270 2100C NM105 element
  • A Gender Code in the 270 2100C DMG03 element
  • A dependent loop in the 270 request
  • Any expired HCPCS codes in the 270 request

Effective with the R2016Q300 Release, HETS will reject all 270 requests that contain any of these data elements with a 999 Implementation Acknowledgement.  HETS 270/271 Submitters may make these changes immediately without any negative impact to their HETS response rates.

Please contact the MCARE Help Desk if you have any questions or comments.