CMS begins issuing new Medicare ID cards to all beneficiaries CMS begins issuing new Medicare ID cards to all beneficiaries

CMS begins issuing new Medicare ID cards to all beneficiaries

Grant Huang, CPC, CPMA
Director of Content

You’ve probably begun seeing patients who present your front desk with shiny new Medicare ID cards that no longer use Social Security Numbers (SSNs). CMS will begin mailing the new ID cards on April 1. The new cards will have unique Medicare beneficiary identifiers (MBIs) instead of SSNs in an effort by the federal government to increase security and protect patient privacy.

Removing the SSN from the cards will help fight medical identity theft, CMS says on its website for the new card. The new MBI should still be kept confidential, the agency says, because it will grant Medicare benefits. Because it only affects Medicare, it is a much less useful prize to would-be identity thieves, unlike the SSN, which can be used to abuse all federal benefits and programs.

From a practice standpoint, you will see most and eventually all patients using the new ID cards, with the MBIs generated from scratch by CMS. Unlike SSNs, which are 9 digits and limited to numbers, the MBIs are 11 characters long and can include letters as well as numbers. Since 1965, the SSN has been part of the Health Insurance Claim Number (HICN) which is used on all patient claim forms to identify patients. The HICN is simply the SSN with an alphabetical prefix or suffix that specifies the beneficiary type (“A” for a retired or disabled worker being the most common). CMS has posted a PDF guide to the new MBI in case you need to make any formatting changes to your systems.

The new MBI will replace the SSN-derived HICN on all claim forms and you should update your systems with patients’ MBIs starting on April 1. However, there’s no need to panic in the coming week – CMS has allotted a 21-month transition period that begins April 1 and ends Dec. 31, 2019.

MBIs become mandatory on all claims Jan. 1, 2020

CMS is making the transition to the MBI under a provision in the Medicare Access and CHIP Reauthorization Act (MACRA). It is required to remove SSNs from Medicare ID cards by April 2019 under the law. The agency has responded by implementing a transition period that will run from April 1, 2018 until Dec. 31, 2019.

The next day, Jan. 1, 2020, marks the date on which all Medicare claims must use the MBI on the new cards. This gives practices plenty of time to adjust while their software vendors build in functionality for the MBI, says Stanley Nachimson, a former CMS senior technical advisor for health IT. During this period, CMS will accept either the HICN or the MBI, and it’s a good idea to ask your vendor how they’ll handle to transition and when you can expect to test-submit some claims with MBIs instead of HICNs, Nachimson says.

CMS is also including multiple exceptions for situations in which it will accept either the HICN or the MBI, as follows:

  • Medicare appeals and all related forms;
  • Adjustments to records, including drug data processing, risk adjustment processing, and encounter data;
  • Medicare claim status queries (for all dates of service before Jan. 1, 2020, after which the queries must use MBI); and,
  • Incoming premium remittances (Part A and B premiums, Part D income-related monthly adjustments).

CMS will also allow the HICN to be used on reports to CMS, such as for quality reporting, and will use the HICN on reports it generates, including reports for Accountable Care Organizations (ACOs). This will be “until further notice” and likely reflects the time the agency needs to adjust its own systems to use MBIs.

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