Industry Insights

CMS Announces Delay in Termination of Common Working File

March 2014
Author:  Julie Bilyeu

Julie Bilyeu

Managing Director

Consulting

Health Care

910 E. St. Louis Street, Suite 200
P.O. Box 1190
Springfield, MO 65801-1190 (65806)

Springfield
417.865.8701

The Centers for Medicare & Medicaid Services (CMS) has announced it will not be terminating the Common Working File (CWF) in April 2014 as initially planned. The CWF is used by many providers to verify Medicare eligibility information. In April 2013, CMS terminated some eligibility options used as part of the CWF. 

Last year, CMS announced that other inquiries, including the Health Insurance Query Access (HIQA), commonly used by skilled nursing facility (SNF) providers, will be terminated by April 7, 2014. The current delay extends the April 7, 2014, termination date. At this time, CMS has not released a revised termination date; however, CMS did announce it will provide at least 90 days' advance notice to give providers time to prepare. 

The CWF is being transitioned to the Health Insurance Portability and Accountability Act (HIPAA) Eligibility Transaction System (HETS), because the CWF is not in a HIPAA-compliant data format. Most vendors currently providing access to the CWF also can provide access to HETS. Some Medicare Administrative Contractors (MAC) also provide HETS eligibility through their Web portals.

Providers should contact their current CWF vendor or visit their MAC’s webpage to inquire how they can obtain access to HETS. This change will not affect how providers transmit claims or receive files back from their MAC. This change also will not affect how providers access their MAC’s direct data entry (DDE) system to perform claims transactions such as inquiries, corrections and adjustments.

Although this change is delayed until further notice, CMS is strongly encouraging providers to make the transition to HETS now instead of waiting for the CWF to be terminated. For more information on HETS, providers can visit the CMS website.

What You Need to Know:

  • The CWF will be going away, but there is no set termination date.
  • Providers relying on the CWF to obtain eligibility information will need to transition to HETS.
  • Vendors providing CWF access also should be able to provide HETS access.
  • Providers should contact their current vendor to inquire about HETS access.
  • This will not affect how providers currently submit claims to their MAC or view claims in DDE.

If you’d like more information about the CWF issue, contact your BKD advisor.

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