How a Bounced Email Turns Off Your Eligibility Checks
CMS said on Thursday that a HETS EDI enrollment whose email fails to deliver three months running gets suspended, and every eligibility request submitted for that NPI gets rejected. The first of the three sends went out October 1, seven days before anyone was told, and your clearinghouse is not allowed to fix it. Also in the window: nine transmittals in one day, an ASC update implemented three days before it issued, and 41 fewer four-star Medicare Advantage contracts.
If your eligibility checks go out through a clearinghouse, a practice management system or an EHR, there is an email address on a CMS enrollment record that you have almost certainly never looked at.
As of Thursday it decides whether Medicare answers you at all.
The three strikes nobody announced
The October 8 MLN Connects carries a four-sentence item under the heading "HETS: Verify Email by December 1 to Avoid Rejected Eligibility Requests." The operative sentence: if your HETS email fails to deliver for three consecutive months, on October 1, November 1 and December 1, 2026, "HETS will suspend your HETS EDI enrollment and reject all eligibility requests submitted for your NPI."
What gets switched off is the 270/271 channel itself, for every NPI on that enrollment, until someone corrects the address.
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