Blog Post

New Medicare Beneficiary Identifier (MBI)

Richard P. Kusserow | August 2019

On August 19, 2019, CMS reissued an article regarding the New Medicare Beneficiary Identifier (MBI). The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) required CMS to remove Social Security Numbers (SSN) from all Medicare cards by April 2019. The SSN-based Health Insurance Claim Number (HICN) is being replaced with the MBI. The MBI numbers are on the new Medicare cards and in the various CMS systems currently in use. CMS sent out the new article to notify providers and suppliers that all new Medicare cards have been mailed, to encourage providers to begin using the new MBIs to protect patients’ identities and remind them that the MBI must be used for Medicare transactions beginning January 1, 2020. At that time, Medicare will reject any claim submitted with a HICN instead of an MBI number. These actions are viewed as a step to help prevent fraud, help eliminate identity theft, and to protect program funding and the private healthcare and financial information of Medicare beneficiaries. CMS has mailed millions of new cards to beneficiaries and is currently processing claims and eligibility requests with the new MBI.

Details on the New Medicare Card

  1. The card design was changed to easily distinguish the new cards from the old cards, thereby reducing the chances of the old cards being used for new claims;
  2. Gender designation has been removed from the card;
  3. While the old number was comprised of the SSN followed by the letter “A,” the new MBI is a random series of numbers and capital letters;
  4. The term “Effective Date” has been changed to “Coverage Starts,” but the meaning is the same;
  5. Hospital/Medical designations were removed leaving just references to Part A and Part B;
  6. The signature line has been removed; and
  7. The new card offers information descriptions in both English and Spanish.

CMS is developing a process that will allow doctors and other healthcare providers to look up the new MBI using a secure tool at the point of service. A 21-month transition period was developed to allow the use of either the MBI or the HICN for billing purposes until December 31, 2019.  After the transition period, only MBIs will be accepted for Medicare claims.

Compliance Experts to Help Your Organization

Our compliance consultants have over 40 years of experience providing research, analysis, and program support on privacy and security rules to clients in both the commercial sector and government sector to maximize compliance effectiveness. Call us at (703) 683-9600 or contact us online for a tailored assessment of your organization’s individual needs.

About the Author

Richard P. Kusserow established Strategic Management Services, LLC, after retiring from being the DHHS Inspector General, and has assisted over 3,000 health care organizations and entities in developing, implementing and assessing compliance programs.

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