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HETS Attestation

Medicare eligibility runs through HETS, the HIPAA Eligibility Transaction System, which requires an approved trading-partner relationship. A trading-partner attestation requirement took effect May 11, 2026.

What the Requirement Is

HETS access is conditioned on an approved trading-partner relationship and on attesting to the terms of that access. The attestation requirement became effective May 11, 2026.

Because many organizations reach HETS through a vendor rather than directly, there is a widespread assumption that the vendor's posture covers them. That assumption is worth verifying rather than inheriting.

Evidence and MBI Lookup

Provenance Is the Evidence

Attestation is an assertion. What supports it is a record of what was actually accessed, by whom, and under what relationship: the same lineage a well-instrumented routing layer produces as a byproduct of normal operation. This is a case where a compliance obligation asks for evidence that already exists if the plumbing was built correctly, and is unreconstructible if it wasn't.

MBI Lookup Is Adjacent

MBI lookup retrieves a beneficiary's current Medicare Beneficiary Identifier when it is unknown or has changed. It is a related capability with its own access considerations. PNT's specific HETS posture, attestation support, and MBI lookup capability are engagement-specific. Confirm your own posture with current CMS documentation before relying on any vendor statement.

Frequently Asked Questions

What is the HETS trading partner attestation requirement?

CMS requires organizations accessing Medicare eligibility through the HIPAA Eligibility Transaction System to hold an approved trading-partner relationship and attest to the terms of that access. The attestation requirement took effect May 11, 2026.

If we access HETS through a vendor, are we covered?

Verify rather than assume. Many organizations reach HETS through an intermediary and assume the vendor's posture covers them. Confirm your own attestation obligation against current CMS documentation rather than inheriting a vendor's characterization of it, including ours.

What is MBI lookup?

Retrieval of a beneficiary's current Medicare Beneficiary Identifier when it is unknown or has changed. The MBI replaced the SSN-based HICN. It is a capability adjacent to eligibility verification with its own access considerations.

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