11/14/2017
New Medicare cards!
This is from the CMS web site:
New Medicare cards
(Known before as the Social Security Number Removal Initiative (SSNRI))
The Medicare Access and CHIP Reauthorization Act (MACRA) of 2015, requires us to remove Social Security Numbers (SSNs) from all Medicare cards by April 2019. A new Medicare Beneficiary Identifier (MBI) will replace the SSN-based Health Insurance Claim Number (HICN) on the new Medicare cards for Medicare transactions like billing, eligibility status, and claim status. You can find more details in our 5/30/17 press release and latest Open Door Forum slides (6/8/17). Also, you can see the new card on our new Medicare card homepage.
We currently use an SSN-based HICN to identify people with Medicare and administer the program. We’ve used the HICN with our business partners:
The Social Security Administration (SSA)
The United States Railroad Retirement Board (RRB)
State Medicaid Agencies
Health care providers
Health plans
Under the new system, for each person enrolled in Medicare, we’ll:
Assign a new MBI.
Mail a new Medicare card.
The MBI is confidential like the SSN and should be protected as Personally Identifiable Information.
Why are the new Medicare cards important?
The biggest reason we're taking the SSN off of Medicare cards is to fight medical identity theft for people with Medicare.
By replacing the SSN-based HICN on all Medicare cards, we can better protect:
Private health care and financial information.
Federal health care benefit and service payments.
We've often heard from Congress, the General Accountability Office, people with Medicare, and advocacy groups that they want the SSN taken off Medicare cards.
What’s the timeline for the new Medicare cards & what does it mean for me?
Getting started
Moving to new Medicare Numbers and cards requires a lot of changes to our systems and how we do business. The same is true for you -- our business partners.
We’ve already started this work and want to help you shift to the new MBIs by April 2018. Beginning in April 2018, we’ll start mailing the new Medicare cards with the MBI to all people with Medicare in phases by geographic location *Updated*. The change to MBIs won’t change how we find non-active Medicare beneficiaries. The MBI and the HICN don’t tell us which beneficiaries are non-active, so we’ll keep using the data that does give us that information.
Learn, in English or Spanish, what you need to do now and see a timeline of what’s next.
Systems testing
Will there be testing for systems that use the MBI?
We’re planning to test systems that’ll use the MBI, including enhanced integration testing (EIT) for new or high risk systems. We’re not offering end-to-end testing with Medicare fee-for-service claims processing systems because you’ll be able to use either HICNs or MBIs to submit claims during the transition period.
You can use the transition period as a live test and make adjustments as necessary, yet still have claims submitted and processed with HICNs until the transition period ends.
Transition period
We plan to have a transition period where you can use either the HICN or the MBI to exchange data with us. The transition period will begin no earlier than April 1, 2018 and run through December 31, 2019.
During the transition period, we’ll monitor the use of HICNs and MBIs to see how many of you are ready to use only MBIs by January 2020. We’ll also actively monitor the transition and adjustment to the new MBIs to make sure of their wide-spread adoption so Medicare operations aren’t interrupted.
After the transition period ends on January 1, 2020, you'll need to use MBIs on your claims with a few exceptions when you can use either the HICN or MBI.
Medicare plan exceptions:
Appeals - You can use either the HICN or the MBI for claims appeals and related forms.
Adjustments - You can use the HICN indefinitely for some systems (Drug Data Processing, Risk Adjustment Processing, and Encounter Data) and for all records, not just adjustments.
Reports - We’ll use the HICN on these reports until further notice:
Incoming to us (quality reporting, Disproportionate Share Hospital data requests, etc.)
Outgoing from us (Provider Statistical & Reimbursement Report, Accountable Care Organization reports, etc.)
Fee-for-Service claim exceptions:
Appeals - You can use either the HICN or the MBI for claims appeals and related forms.
Claim status query - You can use either the HICN or MBI to check the status of a claim (276 transactions) if the earliest date of service on the claim is before January 1, 2020. If you're checking the status of a claim with a date of service on or after January 1, 2020, you have to use the MBI.
Span-date claims - You can use the HICN for 11X-Inpatient Hospital, 32X-Home Health (home health claims & Request for Anticipated Payments (RAPs)), and 41X-Religious Non-Medical Health Care Institution claims if the “From Date” is before the end of the transition period (12/31/2019). You can submit claims received between April 1, 2018 and December 31, 2019 using the HICN or the MBI. If a patient starts getting services in an inpatient hospital, home health, or religious non-medical health care institution before December 31, 2019, but stops getting those services after December 31, 2019, you may submit a claim using either the HICN or the MBI, even if you submit it after December 31, 2019.
Incoming premium payments - People with Medicare who don't get SSA or RRB benefits and submit premium payments should use the MBI on incoming premium remittances. But, we'll accept the HICN on incoming premium remittances after the transition period. (Part A premiums, Part B premiums, Part D income related monthly adjustment amounts, etc.)
How will the MBI look?
The MBI will be:
Clearly different than the HICN and RRB number
11-characters in length
Made up only of numbers and uppercase letters (no special characters)
Learn about and use our MBI format specifications to make changes to your systems.
Will the MBI's characters have any meaning?
Each MBI is unique, randomly generated, and the characters are "non-intelligent," which means they don't have any hidden or special meaning.
What do the new Medicare cards mean for people with Medicare?
The MBI won’t change Medicare benefits. People with Medicare may start using their new Medicare cards and MBIs as soon as they get them.
The effective date of the new cards, like the old cards, is the date each beneficiary was or is eligible for Medicare.
Once beneficiaries get their new Medicare cards with an MBI, they can use their new cards to enroll in a Medicare health (Medicare Advantage) or drug plan. Those Medicare beneficiaries who do choose to enroll in Medicare health and/or drug plans will still also get an insurance card from their health and/or drug plans. As always, while beneficiaries are enrolled in health and/or drug plans, they should use the cards from those plans when they get health care and/or prescriptions.
See our new Medicare card Partners & employers page for resources you can use when you talk to people with Medicare about the new Medicare cards.
Where can I get more information about the new Medicare cards?
Get our Open Door Forum materials and check this webpage often for updates.
