Medicare Eligibility Checks at Risk? HETS Email Deadline Is December 1, 2026

CMS is asking Medicare providers and suppliers to verify their HETS enrollment email address by December 1, 2026. Failed delivery of the monthly transaction reports on October 1, November 1 and December 1 can lead to suspension, with eligibility requests rejected for the affected NPI until the email issue is corrected.

For practices using HETS, the first step is to confirm who receives the monthly transaction report and whether it is arriving. CMS explains the deadline in its October 8, 2026 MLN Connects newsletter.

What your practice should check now

• Find the report: Confirm that the HETS monthly transaction report reaches a monitored mailbox.

• Check for warnings: Investigate missing reports or delivery-failure notices promptly.

• Assign an owner: Identify who at the practice will coordinate any enrollment correction with the Medicare Administrative Contractor (MAC).

• Confirm resolution: Retain the correction confirmation and verify that eligibility responses are working.

How do you know whether your practice uses HETS?

The HIPAA Eligibility Transaction System (HETS) supports real-time Medicare eligibility checks. Your practice may use it through an EHR, practice-management system, billing service or clearinghouse without seeing the HETS name on screen.

Ask your vendor: “Do our Medicare eligibility checks use HETS, and which enrolled NPI or NPIs do we submit?”

Use the answer to identify the relevant enrollment records. If your organization checks eligibility under multiple NPIs, verify each affected record rather than assuming one working connection covers all of them.

Who can correct the enrollment email?

The practice must work through its MAC to correct the enrollment email. A billing company, EHR vendor or clearinghouse cannot change it on the practice’s behalf. CMS’s HETS enrollment guidance explains the enrollment process.

Missing reports or a delivery-failure notice warrant prompt follow-up. Billing support can help identify the issue and coordinate the response, while a designated practice owner completes the required enrollment step and retains confirmation.

What if Medicare eligibility requests start failing?

Record the error message, submitted NPI and time of the request, then ask your vendor or clearinghouse to investigate.

Not every eligibility error is an enrollment-email problem. Distinguish an enrollment issue from a connection problem or an error in the transaction itself before deciding what to correct.

If an email-related suspension is confirmed, work with the MAC to correct the record and test for successful eligibility responses afterward. An eligibility-system error is not proof that a patient has lost Medicare coverage.

Make the monthly report part of routine oversight

CMS instructs providers to review their reports and keep enrollment information current. A practical next step is to assign a regular reviewer and a backup, then confirm that the report does not depend on an unmonitored mailbox or a former employee’s address.

Document who owns the check and how unresolved errors are escalated. This gives front-desk and billing staff a clear next step when eligibility responses fail.

How Horizon Can Help With Medicare Eligibility Issues

Recurring eligibility errors can leave your office spending time on the same problems. We can help investigate those errors, coordinate with your clearinghouse, and clarify any enrollment steps your practice needs to complete.

Call (408) 444-8845 for a complimentary billing review to identify where eligibility problems are slowing down your workflow.