Medicare Compliance & Reimbursement

Last month, CMS started sending out new Medicare cards to its beneficiaries. As with any new federal healthcare rollout, questions and concerns arise - and sometimes these issues impede the delivery of patients' benefits and providers' pay.

Reminder: MACRA mandated that CMS institute a card renovation because of identity-theft issues related to Social Security numbers (SSNs) on the old cards. In place of the SSNs, which previously worked as the Health Insurance Claim Numbers (HICNs), CMS started distributing cards via mail on April 1 with an entirely new 11-digit number called the Medicare Beneficiary Identifier (MBI). The new cards will continue to be disbursed in waves through June 2018, according to the CMS mailing strategy.

See the Medicare card distribution timeline at www.cms.gov/Medicare/New-Medicare-Card/NMC-Mailing-Strategy.pdf.

Important: The Railroad Retirement Board (RRB) will not start mailing its beneficiaries their new MBI-laden cards until June 1, 2018. "The new RRB card will still have the RRB logo in the upper left corner and "Railroad Retirement Board" at the bottom," explains an MLN Connects release on the subject. "But, you cannot tell from looking at the MBIs if these patients are eligible for Medicare because they are railroad retirees."

The agency also added a Frequently Asked Questions document to its guidance that hits on seven MBI-question areas: general; provider; appeals; research; testing; plans, and other.

"CMS published an updated version of their Frequently Asked Questions regarding the New Medicare Card rollout and the MBI that is replacing the Social Security Number-based HICN," notes an NGS Medicare release. "The questions pertain to all Medicare providers and discusses crossover, claim submission, eligibility checks and much more."

Review the FAQ at www.cms.gov/Medicare/New-Medicare-Card/NMC-FAQs-5-18.pdf.

Tools and tips: Also, the MAC MBI look-up tool is confusing to some, MLN Connects suggests. It "will only return an MBI if the new Medicare card has been mailed," CMS clarifies. "This avoids potential confusion if the MBI is used before the beneficiary receives their new Medicare card/MBI."

Providers should also check their Remittance Advice (RA) starting in October through the transition period, recommends the agency.

Read the MLN Connects guidance at >www.cms.gov/Outreach-and-Education/Outreach/FFSProvPartProg/Provider-Partnership-Email-Archive-Items/2018-05-17-eNews.html?DLPage=1&DLEntries=10&DLSort=0&DLSortDir=descending#_Toc514225692.