April 9-13 Policy Watch: CMS Tells Providers to Prepare for New Medicare Cards

April 5, 2018 4:58 pm

Providers have three ways to look up Medicare enrollees’ new numbers.

April 6—Providers will start to see new identification cards presented this month by Medicare enrollees, and that may require action steps.

The Centers for Medicare & Medicaid Services (CMS) has begun mailing newly designed Medicare cards to its 55 million beneficiaries, replacing Social Security numbers (SSNs) with a Medicare beneficiary identifier (MBI), or Medicare number. The new number replaces SSN-based health insurance claim numbers (HICNs).

New Medicare enrollees will be among the first to get the new cards, and existing Medicare beneficiaries will get their new cards on a rolling basis from April 2018 to April 2019.

Providers will have three ways to find Medicare enrollees’ new MBIs:

  • Reading the patient-provided card at time of service
  • Receiving it through the remittance advice
  • Obtaining it through the secure web portal with their Medicare administrative contractor

Stakeholders may submit either the old number or the HICN during the transition period, which runs through Dec. 31, 2019. During the transition period, CMS will process all claims with either the MBI or the old identifier, even when both are used in the same batch of claims, CMS noted on its provider page.

All claims submitted starting Jan. 1, 2020, will need to use the new patient identifier, no matter when the service was performed.

Providers can use either the old or new patient identifier for claims appeals and related forms until 2020.

Among the steps CMS has urged providers to take to prepare for the rollout of the cards are implementing changes and testing them within practice management systems and business processes. Proper preparations may require coordinating with the provider organization’s billing and office staff.

Providers that use vendors to bill Medicare should contact them to find out about their MBI-related practice management system changes. 

Early preparation is key because Medicare enrollees who join in April or later will receive only the new Medicare card.

The new numbers will have the same number of characters as the current HICN (11) but will be visibly distinguishable from the HICN because the new identifiers will include only uppercase letters.

Providers can check whether a patient has been mailed a card with the new identifier by using the CMS HIPAA Eligibility Transaction System.

CMS already has provided state Medicaid agencies and supplemental insurers with the new identifiers for Medicaid-eligible people who also have Medicare coverage.

CMS is developing a secure look-up tool for providers to access a beneficiary’s identifier at the point of service. That tool—expected to launch in June—will allow providers to look up the new numbers of beneficiaries who do not have a card.

CMS urged providers to remind Medicare enrollees that Medicare officials will never contact them to request personal information. Medicare beneficiaries should protect their new Medicare number like a credit card and share it only with trusted providers.

In the letter providing beneficiaries with new cards, CMS will urge beneficiaries to destroy their old Medicare cards.

Monday, April 9

Webinar by Manatt Health Strategies and the Commonwealth Fund to review emerging best practices for integrating sustainable social support investments into Medicaid managed care. Learn more.

Tuesday, April 10

Workshop in Rockville, Md., for users of the Agency for Healthcare Research and Quality’s Medical Expenditure Panel Survey (MEPS). Learn more.

Wednesday, April 11

Senate Health, Education, Labor and Pensions Committee hearing on bipartisan draft legislation to address the opioid crisis. Learn more.

House Energy and Commerce Committee’s Health Subcommittee hearing to address the opioid epidemic (final of three such hearings). Learn more.

Senate Judiciary Committee’s Crime and Terrorism Subcommittee hearing titled “Defeating Fentanyl: Addressing the Deadliest Drugs Fueling the Opioid Crisis.” Learn more.

House Oversight and Government Reform Committee’s Subcommittee on Healthcare, Benefits, and Administrative Rules hearing titled “Local Responses and Resources to Curtail the Opioid Epidemic.” Learn more.

CMS’s Qualified Health Plan Issuer Conference (through April 13). Learn more.

Deadline for fourth-quarter 2017 Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) Patients’ Perspectives of Care survey data (extended from April 4). Learn more.

Thursday, April 12

HFMA’s Virtual Conference: a deep dive into consumerism, including impact, expectations, and success stories. Learn more.

CMS webinar hosted with PCPI on How to Use the Registry of Patient Registries (RoPR). Learn more.

Annual Health Law Conference (through April 13). Learn more.


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