New Medicare Cards to Feature New Identifiers

CMS, Medicare Set-Aside Blog, MSP News, Social Security on May 31, 2017 | Posted by Jean S. Goldstein, JD

As reported several months ago, CMS has begun preparation of a new fraud prevention initiative that removes Social Security numbers (SSN) from all Medicare cards.  This initiative is the result of the passage of the Medicare Access and CHIP Reauthorization Act of 2015, which mandated the removal of the SSN-based HICN from Medicare cards.  Known as the Social Security Number Removal Initiative (SSNRI), beginning in April, 2018 Social Security cards will use a unique, randomly-assigned number called a Medicare Beneficiary Identifier (MBI).  The MBI will replace the Health Insurance Claim Number (HICN) that is currently noted on Medicare cards.  Per legislative requirements, new Medicare cards are to be mailed by April 2019.

CMS estimated that over 150 million beneficiaries will be affected by this initiative; including current Medicare beneficiaries, deceased beneficiaries, archived beneficiaries, and new beneficiaries.  The goal of replacing all SSN based HICN numbers with new unique 11 digit MBI numbers is to protect private healthcare and financial information.  In many applications, HICN fields will be renamed as Medicare Identifier fields, but no additional changes with respect to file formats will change.

During the transition period of April 1st, 2018 to December 31, 2019, MSP stakeholders will still be able to still utilize the previously issued HICN or the newly issued MBI to share data with CMS. After December, 2019, HICNs may still be used for the following:

  • Appeals;
  • Reports (Incoming to CMS (quality reporting, Disproportionate Share Hospital data requests, etc. and Outgoing from CMS (Provider Statistical & Reimbursement Report, Accountable Care Organization Reports, etc.));
  • Retroactive enrollment;
  • Span-date claims;
  • Adjustments on a claim (Prescription Drug Event, Risk Adjustment and Encounter data, etc.) Incoming information requests (inquiries, Medicare Secondary Payer information requests, Requests for Medical Documentation, etc.); and
  • Incoming premium payments (Part A premiums, Part B premiums, Part D income related monthly adjustment amounts, etc.).

The MBI number will still be 11 characters in length, just as current HICN numbers, but will be made up of numbers and uppercase letters. New cards will also no longer have the gender or signature line as on current Medicare cards.  By January 2020, HICNs are expected to no longer be exchanged with beneficiaries, providers, plans or other third parties.  However, Responsible Reporting Entities (RREs) will still be able to use the HICN for Medicare Secondary Payer reporting purposes.

More information about the SSNRI can be found on CMS’ website here.  CMS has also indicated that they will plan regular calls to share updates and answer provider questions before and after new cards are mailed beginning in April 2018.