MMSEA Section III NGHP User Guide Update 8.4

On July 13, 2026, the Centers for Medicare & Medicaid Services (CMS) released the MMSEA Section 111 NGHP User Guide to version 8.5. The latest version has been posted to the NGHP User Guide page, which can be found here.  Scroll down to the bottom of the page for each Chapter update.

MMSEA III – July 13, 2026 – NGHP User Guide v 8.5

Summary of Updates

Chapter 1: Introduction and Overview

The updates listed below have been made to the Introduction and Overview Chapter Version 8.5 of the NGHP User Guide. As indicated on prior Section 111 NGHP Town Hall teleconferences, the Centers for Medicare & Medicaid Services (CMS) continue to review reporting requirements and will post any applicable updates in the form of revisions to Alerts and the user guide as necessary.

To eliminate false early and late alerts and emails, to reduce time spent investigating non-issues, and to reduce confusion and incorrect escalations, the Early File Submission and Late File Submission alerts and emails have been discontinued (Chapter 7)

Chapter II: Registration Procedures

The update listed below has been made to the Registration Procedures Chapter Version 8.5 of the NGHP User Guide. As indicated on prior Section 111 NGHP Town Hall teleconferences, the Centers for Medicare & Medicaid Services (CMS) continue to review reporting requirements and will post any applicable updates in the form of revisions to Alerts and the user guide as necessary.

To eliminate false early and late alerts and emails, to reduce time spent investigating non-issues, and to reduce confusion and incorrect escalations, the Early File Submission and Late File Submission alerts and emails have been discontinued (Section 4.3.2 and Chapter 6).

To improve efficiency, files that have been in MSP HOLD (TIN) Error status or Severe Error status will automatically be deleted after 35 days (Chapter 6).

Chapter III: Policy Guidance

The updates listed below have been made to the Policy Guidance Chapter Version 8.5 of the NGHP User Guide. As indicated on prior Section 111 NGHP Town Hall teleconferences, the Centers for Medicare & Medicaid Services (CMS) continue to review reporting requirements and will post any applicable updates in the form of revisions to Alerts and the user guide as necessary.

There are no updates to this chapter.

Chapter IV: Technical Information

The updates listed below have been made to the Technical Information Chapter Version 8.5 of the NGHP User Guide. As indicated on prior Section 111 NGHP Town Hall teleconferences, the Centers for Medicare & Medicaid Services (CMS) continue to review reporting requirements and will post any applicable updates in the form of revisions to Alerts and the user guide, as necessary.

To improve efficiency, files that have been in MSP HOLD (TIN) error status or Severe Error status will automatically be deleted after 35 days (Sections 6.3.3, 7.3.1, and 8.3).

To eliminate false early and late alerts and emails and to reduce time spent investigating nonissues, the Early File Submission and Late File Submission alerts and emails have been discontinued (Chapter 12).

The HEW software version language has been updated (Section 8.1).

Chapter V: Appendices

The updates listed below have been made to the Appendices Chapter Version 8.5 of the NGHP User Guide. As indicated on prior Section 111 NGHP Town Hall teleconferences, the Centers for Medicare & Medicaid Services (CMS) continue to review reporting requirements and will post any applicable updates in the form of revisions to Alerts and the user guide as necessary.

Error code CW08 has been clarified to note that if the Claim Input File Detail Record is provided and does not match the existing WCMSA case, the record will be rejected (Appendix G).

Verbiage has been added to clarify that a member’s most current Medicare ID will be provided when a match is found (Appendix C and Appendix E).

Effective January 2027: New Disposition Code “GL” will result for a Claim Response File when a record is not accepted by the BCRC because it is part of a Global Resolution Settlement (Appendix G).

To reduce errors in address checks, it is no longer advisable to enter all zeros when entering a ZIP code when using the “FC” code (Appendix A, Appendix B, Appendix D, Appendix G).

270/271 Health Care Eligibility Benefit Inquiry and Response Companion Guide for Mandatory Reporting Non-GHP Entities Version 6.0

The email address for contacting an Electronic Data Interchange (EDI) Representative has changed to COBVA@bcrcgdit.com. However, COBVA emails coming from CMS now show the address as COBVA@mail.cms.hhs.gov (Customer Support).

For Additional Information

Medivest will continue to monitor changes occurring at CMS and will keep its readers up to date when such changes are announced. For questions, feel free to reach out to the Medivest representative in your area by clicking here or calling us directly at 877.725.2467.