New Medicare identification cards for New Jersey Medicare beneficiaries have been mailed by the Centers for Medicare & Medicaid Services (CMS) beginning in August, 2018. The purpose of this update is to provide:
- Overview of this initiative
- How health care providers can continue to get ready
- Key points to communicate with patients
Overview
The New Medicare Card Project was established in the Medicare Access and CHIP Reauthorization Act of 2015; commonly referred to as MACRA. This act required the removal of social security numbers from all Medicare cards by April, 2019. The new cards will feature a Medicare Beneficiary Identifier (MBI) that will replace the Health Insurance Claim Number (HIC) which is social security number based. CMS is issuing new cards to fight medical identity theft for people with Medicare.
CMS has a three step plan to implement the New Medicare Card Project
1. Generate MBIs for all Medicare beneficiaries. This includes 60 million active and 90 million deceased, or archived beneficiaries.
2. Educate stakeholders and issue new redesigned Medicare cards to new and existing beneficiaries. This will occur in geographic waves of successive mailings. The 50 states are broken down into 7 groups and the new cards will be mailed beginning April 2018. As of July, 2018, Wave 1 is completed and beneficiaries in DE, DC, MD, PA, VA and WV have received their new cards.
3. Offer a number of ways for providers and patients to access the MBI. This includes:
- Through the patient at the time of service
- Provider receives through the electronic remittance advice 835 transaction set after submitting/billing the claim with the HIC number
- Provider receives through a secure web portal obtained through the Medicare Administrative Contractor (MAC). (Tool became available June 2018). Provider must know the patients first and last name, date of birth and Social Security Number.
The new MBI will look clearly different than the HIC number. The characteristics will be as follows:
- 11 characters in length
- Made up of only numbers and capitalized letters. Capitalized letters will only include S,L,O,I,B,Z.
- The MBIs 2nd, 5th, 8th and 9th characters will always be a letter
- The MBIs 1st, 4th, 7th, 10th and 11th will always be a number
- The MBIs 3rd and 6th characters will be a letter or a number
- The MBI will be unique to each Medicare beneficiary. Spouses or dependents who may have had similar HIC numbers, will now have their own different MBI.
CMS’s timeline encompasses two years. The key dates are as follows:
1. January 2018 CMS activated the MBIs and created translation services
2.In April 2018 Medicare began issuing the new Medicare cards geographically. This phase will be completed April, 2019 and all Medicare beneficiaries will have received new cards.
3.CMS established the transition period between April 2018 and December 2019 whereby both the HIC or the MBI number will be accepted from healthcare providers. Providers should not submit both numbers on the same transaction.
4.In January 2020, HIC numbers will no longer be accepted except for the following transactions:
- Claim appeals
- Claims status queries for dates of service prior to 12/31/19
- Claims with dates spanning 2019 and 2020.
How Can Providers Continue To Get Ready
New Jersey practices and providers may have seen some new MBIs from other states earlier this year, but beginning late summer, the influx of new MBIs will begin for NJ Medicare beneficiaries. Providers can minimize disconnects during this transition by the following:
1. Visit the CMS provider website cms.gov/Medicare/New-Medicare-card. Also, sign up for the Medicare Learning Network (MLN) Connects newsletter to receive regular updates.
2. Participate in CMS quarterly calls to obtain additional New Medicare Card Project information. CMS will advise providers of scheduled calls through MLN Connects.
3. Sign up for the MAC provider portal if you currently do not have access.
4. Educate your patients through continued outreach. Consider flyers, posters and other educational materials to raise awareness of the change.
5. Ensure billing and practice management systems can accept the 11 character alphanumeric MBI. Work collaboratively with your billing and system vendors to confirm they are ready for this change.
6. Automatically accept the new MBI from the electronic remittance advice (835) transaction. Beginning in October, 2018 through the transition period, CMS will include the patients MBI on every electronic remittance advice even when the claim was billed with a HIC number.
7. Beginning October 2018, CMS will give free MREP software so you can see and print and access remittance advice information that will include the MBI.
8. Populate your systems with the new MBI from the electronic remittance advice (835). This will ensure your systems have the new MBI and will minimize potential issues in the future.
9. Properly identify patients who qualify for Medicare under the Railroad Retirement Board (RRB). The RRB logo will appear in the upper left hand corner of the Medicare card. Program your system to identify RRB patients based on the image on the card so you know to send those claims to the Specialty Medicare Administrative Contractor (SMAC)
10. Mid 2019, run a query in your provider systems to determine how many MBIs you have not received for your current Medicare population. This will allow you time to identify additional outreach opportunities.
Key Points To Communicate With Patients
1. This is a huge initiative for CMS and it make take some time to receive the new card. As mentioned, CMS is issuing cards in waves and cards may arrive at different times than other family members and neighbors.
2. Encourage patients to make sure their mailing address is correct. If they are receiving correspondence from Medicare it is likely current. If a patient feels they need to correct their address they can do so by contacting Social Security at 800-772-1213 or ssa.gov/myaccount
3. Patients who have elected a Medicare Advantage (MA) plan should not discard their Medicare Advantage identification card. Encourage patients to carry both their MA plan card and their new Medicare Card. This is important for care they may receive at a hospital to have both identification cards for certain types of hospital providers.
4. Remind your patients that Medicare will never call them to confirm their social security number or ask for money in order to receive their new Medicare card. Unfortunately, scammers have come up with ways to take advantage of this change. If a Medicare beneficiary receives a call like this, they should hang up and report it to Medicare at 800-633-4427.
Although the CMS timetable will provide time for providers to prepare, it is still a very significant change for providers and Medicare beneficiaries. Be sure you use the remainder of 2018 and 2019 to ensure you have the new MBI for your entire Medicare population.
Author:Kathryn Ruggieri, Principal | [email protected]
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