From April 2018 to April 2019, the Centers for Medicare & Medicaid Services (CMS) will mail new Medicare cards to all active Medicare beneficiaries.
The New Medicare Card—formerly known as the Social Security Number Removal Initiative (SSNRI)—is occurring to implement a provision in the Medicare Access and CHIP Reauthorization Act (MACRA) requiring the removal of Social Security numbers from Medicare cards due to concerns about identity theft.
Action must be taken now to avoid disruption
The new cards have a Medicare Beneficiary Identifier (MBI) instead of the Social Security Number-based identifier known as the Health Insurance Claim Number (HICN).
Like HICNs, MBIs will be 11 characters in length and occupy the same field in Medicare transactions. However MBIs will be clearly distinguishable from HICNs and composed of only numbers and uppercase letters (no special characters).
The transition from HICNs to MBIs will significantly impact physician practices’ workflows.
Practices must be prepared to use MBIs starting April 1, 2018, as patients new to the Medicare program beginning in April 2018 will only have cards with MBIs.
From April 1, 2018 to Dec. 31, 2019, CMS will accept both HICNs and MBIs on Medicare transactions (including eligibility requests and claims) for beneficiaries in the Medicare program prior to April 1, 2018 (i.e., those who received a HICN).
Beginning in Jan. 2020, physicians may only use MBIs. (Exceptions may include appeals and retrospective adjustments.)
Listen to the webinar
In February, the AMA arranged for a CMS briefing on the new Medicare card. Listen to the webinar now.
- CPT Assistant newsletter: Prepare your practice for new Medicare cards and identifiers coming April 2018 (PDF)
Communicate now with Medicare patients
Physician practices will play a vital role in educating Medicare patients about their new cards. To prepare patients for this transition, your practice can:
- Use waiting room posters (PDF): Post notices in your office to alert your patients about the new cards. CMS plans to release additional waiting room signs and posters before April 2018.
- Verify patients' addresses: If addresses on file differ from addresses on electronic eligibility transactions, ask patients to contact the Social Security Administration to update their Medicare records.
- Prepare appointment reminders: Starting in April 2018, include prompts in reminders for Medicare patients to bring their new cards to appointments.
Communicate now with health IT vendors
Your systems must be ready for the MBI to avoid delays in reimbursement, but software changes can take months. Prepare now to process MBI claims by testing office systems for the MBI format (PDF). If an upgrade is necessary, ask about the timeline.
Download and give this flyer (PDF) to your technology vendors to ensure they have the necessary information to ensure they are prepared for the transition to the New Medicare Card.
Prepare with CMS’ educational resources & tools
Prepare to use the MBI look-up tool: AMA advocacy resulted in CMS creating tools including a secure look-up tool scheduled for release in June 2018. The tool can be used when patients do not present their Medicare card. Physicians must sign up for the MAC portal to have access to the look-up tool. If you do not have a MAC Portal account, contact your MAC to create an account.
Contact the New Medicare Card Provider Ombudsman with questions: The Provider Ombudsman for the New Medicare Card serves as a CMS resource for the physician community. The Ombudsman, Dr. Eugene Freund, will ensure that CMS hears and understands any implementation problems experienced by clinicians and will collaborate with CMS to develop solutions to any implementation problems that arise. To reach the Ombudsman, contact at [email protected].