New Medicare Beneficiary Identifier (MBI), April 2018 – Update, 03.09.2018

Last updated on March 22nd, 2018 at 01:27 pm CT

[March 9, 2018]
As we prepare for the upcoming changes in the Medicare Beneficiary Identifier we wanted to share some additional information.

If an HICN is sent in the 270, and the HICN is returned in the 271, and the Medicare Beneficiary’s new ID card has been mailed, then CMS will return in the 271 message segment, “CMS mailed a Medicare card with a new Medicare Beneficiary Identifier (MBI) to this beneficiary.  Medicare providers, please get the new MBI from your patient and save it in your system(s).”

This response will only be returned if :

  • The beneficiaries is enrolled in traditional Medicare. Beneficiary’s ENROLLED IN A MEDICARE ADVANTAGE PLAN will not have this message as they will receive all identification information from the Medicare Advantage plan’s ID cards.
  • The beneficiary does not have a date of death on file.

As a reminder the MBI will be included in the 835.

Experian Health is working with CMS on some modifications to help you with these changes and will share details in the next 5-10 business days.

[January, 26, 2018]
We wanted to provide a brief update on the changes that Medicare will be making in April as it relates to the new Medicare Beneficiary Identification (MBI). Experian Health is working closely with Medicare on this change and how electronic data exchange, 270/271 will work. Our Clearinghouse and products will be ready to support both the existing HICN and new MBI by the April 1 2018 go live date.  Important items to know:

  • CMS has stated that there will be no testing of the new MBI format.
  • For 18 months you will be able to send either HICN or MBI. Whichever number you send we will pass to Medicare. Medicare will only respond with the number that was sent. Medicare will not respond with both numbers.

We will continue to provide additional status updates.

[August 17, 2017]
Coming in April 2018: New Medicare Card – New Number

Medicare is taking steps to remove Social Security numbers from Medicare cards. In April 2018, people with Medicare will begin receiving new Medicare cards, replacing all cards by April 2019. These cards will have a Medicare Beneficiary Identifier (MBI) number that is randomly generated with “non-intelligent” characters. Once this change is effective, scheduled for April 2018, we will modify search criteria to support the new MBI. The transition period where both MBI’s and HICN numbers will both be available is now schedule to be for a 21-month period

New Information:
Beginning April 2018, and throughout the 21-month transition period Experian will be supporting both the current HICN and the new MBI formats. Search options will allow for both ID’s. CMS advised us that if you use the HICN number the HICN number will be returned. If you use the MBI the MBI will be returned. They will not be returning both numbers in one transaction/response.

Railroad Retirement Board (RRB) Medicare claims to the RRB Specialty Medicare Administrative Contractor, Palmetto GBA, will notice a change with the new cards:

  • Providers will no longer be able to distinguish people with Railroad Medicare by the number on the card.
  • The RRB will continue to send cards with the RRB logo to people with Railroad Medicare.
  • CMS will return a message on the eligibility transaction response for a Railroad Medicare patient. The message will say, “Railroad Retirement Medicare Beneficiary” in  271 Loop 2110C, Segment MSG.

[May 31, 2017]
Below is an announcement that CMS released today. In order to provide you the most current information on the MBI change we will continue to update this post as we receive more information from CMS. Once this change if effective, scheduled for April 2018, we will modify search criteria to support the new MBI. The transition period where both MBI’s and HICN numbers will both be available is now schedule to be for a 21 month period.

New Medicare cards offer greater protection to more than 57.7 million Americans
New cards will no longer contain Social Security numbers, to combat fraud and illegal use  

The Centers for Medicare & Medicaid Services (CMS) is readying a fraud prevention initiative that removes Social Security numbers from Medicare cards to help combat identity theft, and safeguard taxpayer dollars. The new cards will use a unique, randomly-assigned number called a Medicare Beneficiary Identifier (MBI), to replace the Social Security-based Health Insurance Claim Number (HICN) currently used on the Medicare card. CMS will begin mailing new cards in April 2018 and will meet the congressional deadline for replacing all Medicare cards by April 2019. Today, CMS kicks-off a multi-faceted outreach campaign to help providers get ready for the new MBI.

“We’re taking this step to protect our seniors from fraudulent use of Social Security numbers which can lead to identity theft and illegal use of Medicare benefits,” said CMS Administrator Seema Verma. “We want to be sure that Medicare beneficiaries and healthcare providers know about these changes well in advance and have the information they need to make a seamless transition.”

Providers and beneficiaries will both be able to use secure look up tools that will support quick access to MBIs when they need them. There will also be a 21-month transition period where providers will be able to use either the MBI or the HICN further easing the transition

CMS testified on Tuesday, May 23rd before the U.S. House Committee on Ways & Means Subcommittee on Social Security and U.S. House Committee on Oversight & Government Reform Subcommittee on Information Technology, addressing CMS’s comprehensive plan for the removal of Social Security numbers and transition to MBIs.

Personal identity theft affects a large and growing number of seniors. People age 65 or older are increasingly the victims of this type of crime. Incidents among seniors increased to 2.6 million from 2.1 million between 2012 and 2014, according to the most current statistics from the Department of Justice. Identity theft can take not only an emotional toll on those who experience it, but also a financial one: two-thirds of all identity theft victims reported a direct financial loss. It can also disrupt lives, damage credit ratings and result in inaccuracies in medical records and costly false claims.

Work on this important initiative began many years ago, and was accelerated following passage of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). CMS will assign all Medicare beneficiaries a new, unique MBI number which will contain a combination of numbers and uppercase letters. Beneficiaries will be instructed to safely and securely destroy their current Medicare cards and keep the new MBI confidential. Issuance of the new MBI will not change the benefits a Medicare beneficiary receives.

CMS is committed to a successful transition to the MBI for people with Medicare and for the health care provider community. CMS has a website dedicated to the Social Security Removal Initiative (SSNRI) where providers can find the latest information and sign-up for newsletters. CMS is also planning regular calls as a way to share updates and answer provider questions before and after new cards are mailed beginning in April 2018.