MGMA Stat poll: Split over preparedness for new Medicare beneficiary ID

Since the beginning of the Medicare program in 1966, the Social Security number (SSN)-based Health Insurance Claim number (HICN) was used as the beneficiary identifier for administering the Medicare program. The Centers for Medicare & Medicaid Services (CMS) uses the HICN with multiple parties, such as the Social Security Administration (SSA), the Railroad Retirement Board (RRB), states, Medicare providers, Medicare plans and others.

Use of the HICN on the paper Medicare beneficiary identification (ID) card raised concern in recent years regarding medical identity theft. To address that concern, provisions in the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) requiring removal of the HICN from Medicare beneficiary ID cards and urges the agency to explore using a different identifier for Medicare beneficiaries. MACRA also requires CMS accomplish this change with a cost-effective process that involves the least amount of burden to Medicare beneficiaries and providers.

A Feb. 13 MGMA Stat poll revealed that 46% of respondents say their practice’s software is prepared for the new Medicare Beneficiary Identifier
(MBI), while 9% said they are not and 45% of respondents are unsure if their software is prepared for the new MBI. Many of the “unsure” respondents report that they have not heard of the new identifier or they have yet to confirm their software system’s level of preparedness. 

MGMA’s Government Affairs office developed a new member-benefit resource — New Medicare Card Toolkit for Medical Group Practices —to assist practice leaders in preparation for the new MBI. 
Poll respondents who claimed their software is prepared for the change noted that few adjustments were necessary, including completion of a software upgrade (provided by their EHR vendor), transition to an alphanumeric format field for capture of the MBI and notifying staff and personnel paired with appropriate training. 

MGMA recommends medical practices communicate and share the following CMS resources with their patients to educate them about the new identifier:

• A downloadable poster displayed at the practice
• A downloadable patient flyer
• A downloadable patient tear-off

Your organization may begin receiving cards with the new MBI in April. Ensure that your systems and workflow can accept the 11-digit alphanumeric MBI and can accommodate both the HICN and the MBI throughout the transition period. All beneficiaries should receive cards with updated identifiers by April 2019. Medicare claims containing any beneficiary identifier other than an MBI will be rejected starting January 2020. 

Additional resources:

• In the New Medicare Card Toolkit for Medical Group Practices, MGMA Government Affairs experts outline the MBI characteristics, timeline, practice checklist items and more.
• The CMS MBI website offers additional information on this transition.