Discontinuation of Common Working File (CWF) Eligibility Access for New Direct Data Entry (DDE) ID Requests

In December 2012, the Centers for Medicare & Medicaid Services (CMS) announced plans to discontinue the Common Working File (CWF) Beneficiary health insurance eligibility transactions. In that same article, CMS also announced that the HIPAA Eligibility Transaction System (HETS) would be the single source for this data.

As part of the transition effort to HETS, beginning in early August 2019, all Part A Medicare Administrative Contractors (MACs) will not provide any new direct access to the CWF eligibility transactions (HIQA, HIQH, ELGA, and ELGH) when new Direct Data Entry (DDE) Online Remote Terminal Access is requested. This includes when current users allow his/her access to expire and would need to request new access. Current users will continue to have access to CWF until CMS provides advanced notice of access termination, as described in SE1249.

This change 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 Contractor’s Interactive Voice Response (IVR) units and/or Internet portals.

Medicare beneficiary eligibility data may be accessed via:

• The eServices Portal (Palmetto GBA’s free Internet-based, provider self-service portal)
• Direct access to HETS
• IVR system (855-696-0705 (PDF))

Resource: MLN Matters® Number: SE1249 (PDF)