Medicare Compliance & Reimbursement

As confusion continues to ebb and flow over new Medicare beneficiary numbers, CMS offers more guidance and an open door forum for Medicaid providers and their staffs.

Now: Currently, beneficiaries' Medicare cards contain their Social Security numbers (SSNs) as the primary identifiers. The SSNs also work as the Health Insurance Claim Number (HICN).

Next: However due to a rise in identity theft and the "illegal use of Medicare benefits," MACRA mandated that all cards must be replaced with a new number by 2019. The updated cards will include a brand new number called the Medicare Beneficiary Identifier or MBI, and CMS will start mailing out the new cards in April 2018.

Problem: Many Medicare providers are aware of the change, but do not have systems prepared to address the new number program, which is required by CMS. "Your systems must be ready to accept the new MBI by April 1, 2018," the agency insists. "It's especially important that you're ready for people who are new to Medicare in April 2018 and later because they'll only get a card with the MBI."

Despite the need for a complete overhaul of your billing system to accept the new identifier, there is some good news.

"There will be a transition period when you can use either the HICN or the MBI to exchange data and information with us," notes CMS in its MBI fact sheet. "The transition period will start April 1, 2018, and run through December 31, 2019."

In addition to the fact sheet and other CMS guidance, an open door forum will be offered on Nov. 9 at 2 p.m. EST, targeting "State Medicaid Agencies, Medicaid providers, Managed Care Organizations, Medicaid partners, and other Medicaid stakeholders about the change from Social Security Number-based Health Insurance Claim Numbers to new Medicare Beneficiary Identifiers (MBIs)," CMS said in a release on the event. "A question and answer session follows the presentation."

Resources: To utilize the CMS fact sheet on the new MBIs, visit www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/Downloads/TransitiontoNewMedicareNumbersandCards-909365.pdf.

For a link to the Nov. 9 open door forum, past CMS recordings on the subject, timelines, widgets, and more, visit www.cms.gov/medicare/new-medicare-card/nmc-home.html.