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Date
2019-07-17
Subject
Discontinuing Duplicate Provider Medicare Fee-For-Service (FFS) Beneficiary Health Insurance Eligibility Systems - July 17, 2019
User Community
HETS 270/271

CMS announcement:

Beginning Fall of 2019, we will discontinue clearinghouse and vendor access to the Common Working File beneficiary eligibility data when they already access this same data through the HIPAA Eligibility Transaction System (HETS).  For most providers, this will be transparent because their vendor or clearinghouse will automatically route the eligibility queries to HETS. At this time, providers can continue to submit individual provider queries using the Direct Data Entry real-time Fiscal Intermediary Shared System (FISS) application if they don’t use a vendor or clearinghouse. 

From: CMS MCARE
Sent: Wednesday, March 27, 2019 12:01 PM
Subject: Discontinuing Duplicate Provider Medicare Fee-For-Service (FFS) Beneficiary Health Insurance Eligibility Systems - Updated

The previously published notice has been updated to reflect a new timeline.  The original announcement is included below for your convenience.

Updated statement:

In December 2012, CMS announced plans to discontinue the Common Working File (CWF) beneficiary health insurance eligibility transactions (MLN Matters® Special Edition Article SE1249).  In that same article, CMS also announced the HIPAA Eligibility Transaction System (HETS) would be the single source for this data. CMS subsequently delayed this effort based on feedback about the differences in data returned between the two systems and the one-year limit to HETS historical search capability. CMS resolved these issues and is moving forward to phase-out the CWF beneficiary health insurance eligibility transactions. This will address inefficiencies of maintaining two different systems returning the same data.

Beginning in the fall of 2019, CMS plans to terminate access to CWF eligibility queries for those who already utilize HETS. If you currently use both CWF and HETS to get Medicare beneficiary health insurance eligibility information, you should immediately begin to use HETS exclusively.  

From: CMS MCARE
Sent: Friday, December 07, 2018 2:38 PM
Subject: Discontinuing Duplicate Provider Medicare Fee-For-Service (FFS) Beneficiary Health Insurance Eligibility Systems

In December 2012, CMS announced plans to discontinue the Common Working File (CWF) beneficiary health insurance eligibility transactions (MLN Matters® Special Edition Article SE1249).  In that same article, CMS also announced the HIPAA Eligibility Transaction System (HETS) would be the single source for this data. CMS subsequently delayed this effort based on feedback about the differences in data returned between the two systems and the one-year limit to HETS historical search capability. CMS resolved these issues and is moving forward to phase-out the CWF beneficiary health insurance eligibility transactions. This will address inefficiencies of maintaining two different systems returning the same data.

Beginning in the summer of 2019, CMS plans to terminate access to CWF eligibility queries for those who already utilize HETS. If you currently use both CWF and HETS to get Medicare beneficiary health insurance eligibility information, you should immediately begin to use HETS exclusively.