Prior to September 2006, CMS allowed clearinghouse or clearinghouse-type organizations to apply for HETS 270/271 access. For the purpose of the HETS 270/271 application, CMS defined clearinghouse/clearinghouse-type submitters as clearinghouses, billing services, software vendors, etc. These various organizations were required to demonstrate they would be submitting transactions on behalf of active Medicare providers/suppliers, and that their organization would meet all HETS 270/271 clearinghouse security and data requirements.
Effective September 2006, CMS restricted application and access to the Medicare HETS 270/271 system to only direct Medicare providers or suppliers. As a result, no applications have been accepted from clearinghouse or clearinghouse-type organizations since September 2006. CMS also recently enacted a moratorium on new Third Party Vendor submitters.
CMS continues to monitor error rates and transaction volume trending very closely. CMS anticipates making a decision to allow or disallow new clearinghouses, clearinghouse type submitters or Third Party Vendors by July 2008.
Please contact the Help Desk if you have any questions or comments.
Medicare Customer Assistance Re: Eligibility (MCARE) Help Desk
1-866-324-7315