Mark April 1, 2018, on your calendars – that’s when change will be coming for more than 60 million active Medicare beneficiaries, their healthcare providers and payers who work with Medicare patients. Medicare cards with new Medicare Beneficiary Identifiers (MBI) numbers could start arriving in beneficiary mailboxes and be presented beginning on that date. It will take a year for the Centers for Medicare & Medicaid Services (CMS) to mail out all of the cards, but the industry needs to ramp up now. ABILITY is currently reviewing its processes and applications to prepare to support its providers, payers and Strategic Partners during the transition and beyond.
With identity theft rampant, Congress mandated that Medicare halt the use of Social Security numbers as patient identifiers under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). The New Medicare Card project (formerly known as the Social Security Number Removal Initiative) was born. An additional incentive for the program is to reduce fraudulent billing to Medicare. All providers, payers and other entities who service Medicare beneficiaries will need to take action to comply with the program.
Providers can prepare in the following ways:
- Double-check addresses. A good first step is to make sure beneficiary addresses in your files are up to date. If addresses aren’t current, staff members should encourage patients to contact Social Security with their new address right away. An incorrect address could result in the new card being sent to the wrong place.
- Educate staff. As it stands now, the primary mechanism for the changeover lies with patients presenting their new cards to provider offices and facilities. Beneficiaries may arrive for appointments with the new card, the wrong card or no card at all. CMS has promised providers a secure look-up tool for accessing the new identifiers, but ideally the information will come right from the patient’s new card. Having all staff on the same page will be crucial.
- Be ready on Day 1. CMS will not release information about how, when and where cards will be mailed out over the 12-month transition. For example, CMS won’t reveal whether cards are being mailed according to a geographic plan, in alphabetical order or in numeric order. The intent is to discourage fraud, but the long-term transition may create confusion for providers, payers and beneficiaries. It’s essential to be ready on the first day, but to expect a year-long implementation of the new cards.
- Spread the word. The American Medical Association has expressed concern that some beneficiaries won’t be expecting these cards and may throw them away. Once again, with a window of 12 months in which cards may arrive, the odds of beneficiaries overlooking them increases. CMS will supply educational posters for providers to use and also plans communications with caregivers. Starting conversations with beneficiaries will help.
- Be in the know. Providers and payers can visit a CMS website dedicated to this initiative and sign up for a newsletter that will keep them informed. CMS is offering quarterly dial-in phone sessions as a means to update stakeholders and answer questions. Some key facts:
- The change applies to both traditional Medicare and Medicare Advantage.
- The new 11-digit numbers are randomly generated and are called Medicare Beneficiary Identifiers (MBI). They will replace the Health Insurance Claim Number (HICN) currently in use. The MBI card will be easy to read and will be readily distinguishable from the HICN card. The new cards will not have a signature or gender line.
- The transition period in which either the HICN or the MBI can be used is April 2018 to December 2019, but CMS is strongly encouraging stakeholders to start using the MBI as soon as possible.
- After the December 2019 cutoff, the HICN will still be eligible for use on appeals, reports, span-date claims and in certain other instances. The CMS website has details on the exceptions.
As the leading connectivity channel for Medicare, ABILITY Network regularly monitors regulatory changes and industry trends to help providers, payers and Strategic Partners stay on track with industry issues. A CMS-approved Network Service Vendor (NSV), ABILITY offers nationwide access to all Medicare Enterprise Data Centers and Medicare Administrative Contractors (MACs), and is also a Health Information Handler (HIH).
ABILITY is working with internal experts and industry resources to support Strategic Partner, payer and provider readiness for the New Medicare Card project in all relevant applications and processes.
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