The Medicare Access and CHIP Reauthorization Act (MACRA) of 2015, requires the Centers for Medicare and Medicaid Services to remove Social Security Numbers (SSNs) from all Medicare cards by April 2019. A new Medicare Beneficiary Identifier (MBI) will replace the SSN-based Health Insurance Claim Number (HICN) on the new Medicare cards for Medicare transactions like billing, eligibility status, and claim status.
he solution for SSNRI must provide the following capabilities:
1. Generate MBIs for all beneficiaries: Includes existing (currently active and deceased or archived) and new beneficiaries
2. Issue new, redesigned Medicare cards: New cards containing the MBI to existing and new beneficiaries
3. Modify systems and business processes: Required updates to accommodate receipt, transmission, display, and processing of the MBI CMS will use a MBI generator to:
• Assign 150 million MBIs in the initial enumeration (60 million active and 90 million deceased/archived) and generate a unique MBI for each new Medicare beneficiary
• Generate a new unique MBI for a Medicare beneficiary whose identity has been compromised
The Medicare Beneficiary Identifier will have the following characteristics:
• The same number of characters as the current HICN (11), but will be visibly distinguishable from the HICN
• Contain uppercase alphabetic and numeric characters throughout the 11 digit identifier • Occupy the same field as the HICN on transactions
• Be unique to each beneficiary (e.g. husband and wife will have their own MBI) • Be easy to read and limit the possibility of letters being interpreted as numbers (e.g. Alphabetic characters are upper case only and will exclude S, L, O, I, B, Z)
• Not contain any embedded intelligence or special characters
• Not contain inappropriate combinations of numbers or strings that may be offensive CMS anticipates that the MBI will not be changed for an individual unless the MBI is compromised or other limited circumstances still undergoing review.
How will the MBI look on the new card?
The MBI will contain letters and numbers.
Here’s an example: 1EG4-TE5-MK73
• The MBI’s 2nd, 5th, 8th, and 9th characters will always be a letter.
• Characters 1, 4, 7, 10, and 11 will always be a number.
• The 3rd and 6th characters will be a letter or a number.
• The dashes aren’t used as part of the MBI. They won’t be entered into computer systems or used in file formats.
MBI Format Pos. 1 2 3 4 5 6 7 8 9 10 11
Type C A AN N A AN N A A N N
Where will the MBI’s characters go?
C – Numeric 1 thru 9 N – Numeric 0 thru 9 AN – Either A or N A – Alphabetic Character (A...Z); Excluding (S, L, O, I, B, Z)
Position 1 – numeric values 1 thru 9 Position 2 – alphabetic values A thru Z (minus S, L, O, I, B, Z) Position 3 – alpha-numeric values 0 thru 9 and A thru Z (minus S, L, O, I, B, Z) Position 4 – numeric values 0 thru 9 Position 5 – alphabetic values A thru Z (minus S, L, O, I, B, Z) Position 6 – alpha-numeric values 0 thru 9 and A thru Z (minus S, L, O, I, B, Z) Position 7 – numeric values 0 thru 9 Position 8 – alphabetic values A thru Z (minus S, L, O, I, B, Z) Position 9 – alphabetic values A thru Z (minus S, L, O, I, B, Z) Position 10 – numeric values 0 thru 9 Position 11 – numeric values 0
CMS’ will complete its system and process updates to be ready to accept and return the MBI on April 1, 2018
• All stakeholders who submit or receive transactions containing the HICN must modify their processes and systems to be ready to submit or exchange the MBI by April 1, 2018. Stakeholders may submit either the MBI or HICN during the transition period
• CMS will accept, use for processing and return to stakeholders either the MBI or HICN, whichever is submitted, during the transition period.
• In addition, beginning October 2018 through the end of the transition period, when a HICN is submitted on Medicare fee-for-service claims both the HICN and the MBI will be returned on the remittance advice
• The transition period will run from April 2018 through December 31, 2019
CMS will begin issuing new Medicare cards for existing beneficiaries after the initial enumeration of MBIs; roughly 60 million beneficiaries
• The gender and signature line will be removed from the new Medicare cards
CMS will provide outreach and education to:
− Approximately 60 million beneficiaries, their agents, advocacy groups and caregivers − Health Plans − The provider community (1.5M providers) − States and Territories − Key stakeholders, vendors & other partners.
As a provider I am trying to get the word out to the public on these changes. I will be speaking on it at the Malibu Rotary Club on October 11, 2017 (see maliburotary.org).
he solution for SSNRI must provide the following capabilities:
1. Generate MBIs for all beneficiaries: Includes existing (currently active and deceased or archived) and new beneficiaries
2. Issue new, redesigned Medicare cards: New cards containing the MBI to existing and new beneficiaries
3. Modify systems and business processes: Required updates to accommodate receipt, transmission, display, and processing of the MBI CMS will use a MBI generator to:
• Assign 150 million MBIs in the initial enumeration (60 million active and 90 million deceased/archived) and generate a unique MBI for each new Medicare beneficiary
• Generate a new unique MBI for a Medicare beneficiary whose identity has been compromised
The Medicare Beneficiary Identifier will have the following characteristics:
• The same number of characters as the current HICN (11), but will be visibly distinguishable from the HICN
• Contain uppercase alphabetic and numeric characters throughout the 11 digit identifier • Occupy the same field as the HICN on transactions
• Be unique to each beneficiary (e.g. husband and wife will have their own MBI) • Be easy to read and limit the possibility of letters being interpreted as numbers (e.g. Alphabetic characters are upper case only and will exclude S, L, O, I, B, Z)
• Not contain any embedded intelligence or special characters
• Not contain inappropriate combinations of numbers or strings that may be offensive CMS anticipates that the MBI will not be changed for an individual unless the MBI is compromised or other limited circumstances still undergoing review.
How will the MBI look on the new card?
The MBI will contain letters and numbers.
Here’s an example: 1EG4-TE5-MK73
• The MBI’s 2nd, 5th, 8th, and 9th characters will always be a letter.
• Characters 1, 4, 7, 10, and 11 will always be a number.
• The 3rd and 6th characters will be a letter or a number.
• The dashes aren’t used as part of the MBI. They won’t be entered into computer systems or used in file formats.
MBI Format Pos. 1 2 3 4 5 6 7 8 9 10 11
Type C A AN N A AN N A A N N
Where will the MBI’s characters go?
C – Numeric 1 thru 9 N – Numeric 0 thru 9 AN – Either A or N A – Alphabetic Character (A...Z); Excluding (S, L, O, I, B, Z)
Position 1 – numeric values 1 thru 9 Position 2 – alphabetic values A thru Z (minus S, L, O, I, B, Z) Position 3 – alpha-numeric values 0 thru 9 and A thru Z (minus S, L, O, I, B, Z) Position 4 – numeric values 0 thru 9 Position 5 – alphabetic values A thru Z (minus S, L, O, I, B, Z) Position 6 – alpha-numeric values 0 thru 9 and A thru Z (minus S, L, O, I, B, Z) Position 7 – numeric values 0 thru 9 Position 8 – alphabetic values A thru Z (minus S, L, O, I, B, Z) Position 9 – alphabetic values A thru Z (minus S, L, O, I, B, Z) Position 10 – numeric values 0 thru 9 Position 11 – numeric values 0
CMS’ will complete its system and process updates to be ready to accept and return the MBI on April 1, 2018
• All stakeholders who submit or receive transactions containing the HICN must modify their processes and systems to be ready to submit or exchange the MBI by April 1, 2018. Stakeholders may submit either the MBI or HICN during the transition period
• CMS will accept, use for processing and return to stakeholders either the MBI or HICN, whichever is submitted, during the transition period.
• In addition, beginning October 2018 through the end of the transition period, when a HICN is submitted on Medicare fee-for-service claims both the HICN and the MBI will be returned on the remittance advice
• The transition period will run from April 2018 through December 31, 2019
CMS will begin issuing new Medicare cards for existing beneficiaries after the initial enumeration of MBIs; roughly 60 million beneficiaries
• The gender and signature line will be removed from the new Medicare cards
CMS will provide outreach and education to:
− Approximately 60 million beneficiaries, their agents, advocacy groups and caregivers − Health Plans − The provider community (1.5M providers) − States and Territories − Key stakeholders, vendors & other partners.
As a provider I am trying to get the word out to the public on these changes. I will be speaking on it at the Malibu Rotary Club on October 11, 2017 (see maliburotary.org).
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