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.
If this applies to your practice, CMS now requires you to enroll these vendors for
HIPAA Eligibility Transaction System (HETS) access by linking each vendor to your NPI.
Common vendors may include Availity and pharma programs that verify eligibility prior
to physician-administered drugs.
Take these 3 steps now:
Contact your vendor promptly
Obtain their unique vendor ID
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 exists between your NPI and third-party 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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PSCF President