Prepare Your Systems for the Social Security Number Removal Initiative

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The Medicare Access and Children’s Health Insurance Program Reauthorization Act (MACRA) of 2015 requires the Centers for Medicare & Medicaid Services (CMS) to remove Social Security Numbers (SSNs) from all Medicare cards by April 1, 2019. A new Medicare Beneficiary Identifier (MBI) will replace the SSN-based Health Insurance Claim Number (HICN) on new Medicare cards for Medicare transactions such as billing, eligibility status, and claim status. Following are some questions that this author has received about the SSN Removal Initiative (SSNRI).
Q: Why is the SSNRI necessary?
A: The major reason for removal of the SSN-based HICN from Medicare cards is to fight medical identity theft for people with Medicare. By replacing the HICN on all Medicare cards, the CMS can better protect both
Q: How does CMS use the SSN-based HICN?
A: The CMS currently uses the SSN-based HICN to identify people with Medicare and to administer the Medicare program. In addition, the CMS uses the HICN with its business partners:
Q: What will the CMS do to comply with the MACRA requirement?
A: The CMS will do the following for each person enrolled in Medicare:
Note: Spouses or dependents who may have had similar HICNs will each get their own different MBI.
Note: The gender and signature line will be removed from the new Medicare cards.
Q: Will this conversion change Medicare benefits?
A: No, the MBI will not change Medicare benefits. People with Medicare may start using their new Medicare cards and MBIs as soon as they get them.
Q: Will this conversion happen all at once or gradually?
A: Moving to new Medicare numbers and cards requires a lot of change to both the CMS systems and the providers’ systems and to the way providers do business. In achieving this goal the CMS seeks to
The CMS already started this conversion in order to help providers shift to the new MBIs by April 2018. Beginning in April 2018, the CMS will start sending new Medicare cards with the MBIs to all people with Medicare. Per the MACRA requirement, the CMS must mail out all Medicare cards with the new MBI by April 2019.
The CMS plans to have a transition period where providers can use either the HICN or the MBI to exchange data with the CMS. The transition period will begin no earlier than April 1, 2018, and will run through December 31, 2019.
The CMS will tell providers, in the message field on the eligibility transaction responses, when they mailed a new Medicare card to each person with Medicare. Eligibility service providers can also provide this information.
During the transition period, the CMS will return the same beneficiary identifier to providers that the providers submitted on the incoming transaction. Also during this transition period, the CMS will return the MBI on the remittance advice starting October 2018 when providers submit a claim using their patient’s HICN. After the transition period, affected systems interacting with stakeholders will only use the MBI for most information exchanges, with some limited exceptions that are outlined in the next question and answer.
Q: When the transition period is over, will providers be able to use the HICN number to reference past history?
A: Yes, once the transition period is over, providers will still be able to use the HICN for the following:
Q: Will the MBI look the same as the HICN and RRB number?
A: No, the MBI will be clearly different than the HICN and RRB number. It will be 11 characters and include only numbers and uppercase letters (no special characters). The CMS will use numbers 0 to 9 and all letters from A to Z, except for S, L, O, I, B, and Z.
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