Are You Prepared for the Transition to New Medicare Beneficiary Identifier?

    To protect the integrity of the Medicare program and the identity of Medicare patients, a provision of the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015 prohibits the display or embedding of social security account numbers (or a derivative thereof) on Medicare issued beneficiary cards. Effective April 2018, the Centers for Medicare and Medicaid Services (CMS) will replace the social security account number-derived Health Insurance Claim Number (HICN) with an 11 character, randomly generated Medicare Beneficiary Identifier (MBI). 

    CMS plans to begin mailings of new Medicare cards in April 2018, in phases and based on geographic location. Further details about the data and information exchange transition period between healthcare providers and Medicare Administrative Contractors can be found on the CMS website. Healthcare providers are expected to fully transition to MBIs by January 1, 2020. 

    Access the fact sheet from the Centers for Medicare & Medicaid Services.

    What does CohnReznick think?

    Healthcare providers must be proactive in educating patients and staff about the change to ensure updated patient information is received.  Providers should test and implement the necessary changes to their practice management systems to ensure the existing fields can accommodate the new MBI, automatically accept the new MBI from the remittance advice, enroll in Medicare Administrative Contractors (MACs) provider portals to access MBI information, notify patients to contact Medicare if they have had a change in address to ensure the new MBI card is received, and work with billing vendors to ensure systems are ready to accept the new MBI by April 1, 2018.  Preparing now for the transition to MBI will prevent future delays in the claiming and receipt of payments.  

    View a listing of MAC provider portals.

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    Peter Epp

    CPA, Partner, Community Health Leader

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    This has been prepared for information purposes and general guidance only and does not constitute legal or professional advice. You should not act upon the information contained in this publication without obtaining specific professional advice. No representation or warranty (express or implied) is made as to the accuracy or completeness of the information contained in this publication, and CohnReznick LLP, its partners, employees and agents accept no liability, and disclaim all responsibility, for the consequences of you or anyone else acting, or refraining to act, in reliance on the information contained in this publication or for any decision based on it.