150 Million Medicare Health Insurance Claim Numbers to be Changed to New Medicare Beneficiary Identifier Numbers in 2018

CMS, Medicare Set-Aside Blog, MSP News on January 18, 2017
Posted by Katharine Rupp, JD

On Tuesday January 17, 2017, CMS held a special open door forum to discuss the changes and impact of the SSNRI on Medicare Secondary Payer (MSP) stakeholders. Starting April 1st, 2018, CMS will be replacing all Social Security Number (SSN) based Health Insurance Claim Numbers (HICN) with Medicare Beneficiary Identifier (MBI) numbers. Over 150 million beneficiaries will be affected; including current Medicare beneficiaries, deceased beneficiaries, archived beneficiaries, and new beneficiaries. By replacing the SSN based HICN numbers with new unique 11 digit MBI numbers, CMS hopes to better protect private healthcare and financial information. In applications, HICN fields will be renamed as Medicare Identifier fields but nothing with respect to file formats will change.

During the transition period of April 1st, 2018 to December 31, 2019 MSP stakeholders may use either the previously issued HICN or the newly issued MBI to exchange data with CMS. However, during the transition period all return correspondence from CMS will include both the same beneficiary identifier submitted with the incoming correspondence/transaction, as well as, the newly assigned MBI number. Once the transition period is over, MSP stakeholders will only be able to use SSN numbers in a few limited situations (i.e. Section 111 queries, web portals, etc.). CMS recommends that all MSP stakeholder’s internal systems and business processes be updated to accept MBI numbers starting April 2018.

There is one organization that will not be converting to MBI numbers. The U.S. Treasury Department and its affiliates will phase out the use of HICN and SSN numbers but rather than transitioning to the beneficiary’s MBI, they will use a recovery case ID number. CMS representatives explained that beneficiaries will be able to be identified by cross-referencing the Conditional Repayment Center (CRC) or Benefits Coordination & Recovery Center (BCRC) case ID. Conditional payment letters will continue to contain the most recent of either the beneficiary’s HICN or MBI number. Affected MSP stakeholders should anticipate the U.S. Treasury Department change by the close of 2017.

A transcript and audio recording of the Open Door Forum will be posted by CMS here.  For additional information or any questions about the impact of the SSNRI, please contact us at info@medval.com.