As part of a recent MLN Matters article, MLN Matters SE1249 Revised, the Centers for Medicare & Medicaid Services (CMS) announced that its intended April 1, 2014, termination of access to Common Working File (CWF) eligibility queries in the Fiscal Intermediary Standard System (FISS) Direct Data Entry (DDE), often referred to as the HIQA, HIQH, ELGA and ELGH screens and HUQA, will be further delayed.
CMS is continuing to make modifications to the HIPAA Eligibility Transaction System (HETS) so that, among other things, it returns hospice benefit period information in the same format as is currently available in the CWF. No future termination date has been set but the article indicates that CMS will provide at least 90 days advance notice of the new termination date.
Providers should be preparing to make the transition to HETS for eligibility inquiries. Discontinued access for CWF eligibility queries will not affect the use of DDE to submit claims or to correct claims and will not impact access to beneficiary eligibility information from Medicare Contractors’ Interactive Voice Response (IVR) units and/or Internet portals.
RECENT CMS HETS FAQ
Q. Does CMS plan to modify the HETS 271 response to display either the benefit period number or the last three election periods regardless of date of activity?
A. HETS 270/271 only returns 27 months’ worth of history. However, The HETS 270/271 application is being modified to return the total number of Hospice occurrences on a 271 response whenever STC 45 is requested on the 270. This new data element will not be available on the 271 response until the HETS R2014Q100 release. Once available, the total number of Hospice occurrences will be returned in a separate 2110C Loop on the 271 response.
Please see the current HETS 270/271 Companion Guide Section 7.16 for additional information.
CMS HETS Help web page can be found here.
HETS 270/271 Companion Guide can be found here.