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CMS Announces Further Changes to Support Hospice Eligibility Inquiries in HETS

Posted on Wednesday, May 15, 2019 2:43 PM

For the past few years, CMS has been trying to streamline hospice beneficiary eligibility inquiries and to establish the HIPAA Eligibility Transaction System (HETS) as the single source for this data. Their efforts have been delayed due in part to the availability of insufficient information in the HETS system regarding hospice benefit period utilization. In late March of this year, the MCARE system issued a notice indicating that changes had been made to the HETS system and that, beginning in fall of 2019, CMS will terminate access to Common Working File (CWF) for entities that already use HETS for that purpose.

“CMS formally announced instructions designed to address hospice eligibility and face-to-face encounter eligibility data needs in HETS by ensuring that all hospice benefit periods (regardless of age) are submitted to HETS and by populating HETS with separate record of Hospice Election Period data and Hospice Benefit Period data.  These changes are scheduled to become effective on October 1, 2019 (with an implementation date of October 7, 2019).  MCARE has not yet announced a specific date on which CMS will eliminate access to CWF queries for those providers who conduct eligibility queries in HETS.”

Source: NAHC Report


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Corridor is the nation’s preferred partner and trusted business advisor to home health and hospice providers, providing quality services and impactful results for 30 years. Focusing on key operational, regulatory and financial challenges, Corridor delivering industry-unique solutions and deep expertise in coding, clinical documentation review, compliance, billing and collections , consulting and provider staff education . At Corridor, we make the business of caring for people Better! For the most important industry updates and news that impacts home health and hospice, please make sure to sign up for our weekly newsletter to receive the latest up-to-date industry information direct to your inbox!

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