If you use a vendor to check patients’ Medicare eligibility,
action is required by
May 11, 2026
Many practices use third-party vendors to check Medicare beneficiary eligibility.
CMS now requires practices to enroll these vendors for HIPAA Eligibility Transaction
System (HETS) access by linking each vendor to your NPI.
Common vendors may include Availity and pharmaceutical programs that verify eligibility
prior to physician-administered drugs.
Take These 3 Steps Now:
1.
Contact your vendor promptly
2.
Obtain their unique vendor ID
3.
Complete enrollment linking the vendor to your NPI
Complete enrollment by May 11 to avoid interruption. Practices that do not enroll may receive AAA error code “41,” indicating no valid relationship between your NPI and the vendor.
CMS announced this requirement in its April 23 newsletter, allowing little lead time. After 5/11/26, vendors may be blocked from performing eligibility checks unless the required attestation has been submitted.
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