Issued by: Centers for Medicare & Medicaid Services (CMS)

Issue Date: May 22, 2020

On November 1, 2019, CMS notified submitters via notification on the MCARE website and message on CWF screens that CMS would begin revoking direct access to Common Working File (CWF) eligibility transactions HIQA, HIQH, ELGA and ELGH effective February 1, 2020.

CMS completed removing the direct access to the CWF transactions for many of the large vendors and clearinghouses.  For most users, this was transparent because your vendor or clearinghouse automatically routed the eligibility queries to the HIPAA Eligibility Transaction System (HETS).

Beginning January 2021, Medicare Administrative Contractors (MACs) will contact submitters who have direct access to CWF queries and access to HETS, as notice, CMS will discontinue direct access to the CWF transactions upon notification by the MAC.  If you do not have access to HETS, the MACs will contact you to discuss an alternative way to access beneficiary eligibility.  CMS will not discontinue your access until there is a viable solution and transition.

If you currently use the Fiscal Intermediary Shared System (FISS) - Direct Data Entry (DDE), you can continue; CMS is not discontinuing that access.  CMS expects to remove all direct access to the CWF transactions by December 2021.  For additional questions, please contact your MAC.

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DISCLAIMER: The contents of this database lack the force and effect of law, except as authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically incorporated into a contract. The Department may not cite, use, or rely on any guidance that is not posted on the guidance repository, except to establish historical facts.