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Coming Soon: New Medicare Cards

The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) requires the removal of Social Security Numbers (SSNs) from all Medicare cards by April 2019. The Centers for Medicare and Medicaid Services (CMS) has begun the process of replacing and distributing new Medicare cards. New Medicare Beneficiary Identifier (MBI) cards are intended to help reduce identity theft for people with Medicare. The new cards will use randomly selected MBI numbers to replace the current Social Security-based Health Insurance Claim Numbers (HICN) for Medicare transactions like billing, eligibility status, and claim status. MBIs will be 11 characters in length, made up of numbers and uppercase letters, and clearly different from HICN.

Distribution of new MBI cards will begin in April 2018 to all Medicare beneficiaries in phases based on geographic location. All MBI cards will be replaced by April 2019. New Medicare cards will be effective as soon as they arrive. Additionally, there will be a 21-month transition period allowing usage of both the MBI and HICN cards. The transition period will conclude on Dec. 31, 2019. While there is a transition period with both cards being accepted, Medicare beneficiaries are being instructed to destroy their old Medicare cards when they receive their new cards. Beginning Jan. 1, 2020, only MBIs will be accepted, with a few exceptions. MBI cards will not change Medicare benefits. CMS will be able to accept MBI cards as soon as they begin distributing them on April 1, 2018.

Providers that handle Medicare transactions are also required to change their systems to be able to accept MBI by the April 1, 2018 start date. MBI or HICN submissions by providers will be accepted during the 21-month transition period. CMS is working to create a system for providers to securely access a beneficiary’s MBI through a lookup tool at the point of service. The point of service lookup tool is expected to be available to providers by June 2018. Further advice for providers includes verifying the addresses you have on file with the addresses you get from electronic eligibility transaction responses. If they are different, encourage patients to correct their addresses using ssa.gov/myaccount. Providers should also remind patients that Medicare will never request personal information such as SSN or MBI numbers.

Providers should look at their management systems and business processes and determine what changes are needed to use the new MBI. These changes should be made and tested by April 2018, before CMS mails out new Medicare cards. Providers who use vendors to bill Medicare should contact them to find out about their MBI practice management system changes.

Beginning in October 2018, through the transition period, when providers submit a claim using a patient's/resident's valid and active HICN, CMS will return both the HICN and the MBI on every remittance advice. The MBI will be in the same place where the "changed HICN" is currently: 835 Loop 2100, Segment NM1 (Corrected Patient/Insured Name), Field NM109 (Identification Code). For claims submitted using a recipient's MBI, this field will be blank.

CMS recently asked their Medicare Administrative Contractors (MACs) to mail letters to all Medicare Fee-For-Service providers. The letter will describe the new Medicare card project and how to use the MAC's secure portal so that in June 2018, providers will be able to look up MBIs for Medicare recipients who don't have new cards when they come for care.

A fact sheet on the project is posted here. Additional information regarding new Medicare cards is available here, and recent CMS Open Door Forum slides are available here.

Contact: Ken Allison, kallison@leadingageny.org, 518-867-8820