Richter ShareSource Blog

CMS to Implement Changes to Beneficiary Identifiers

Since the inception of the Medicare program in 1965, beneficiaries have been identified by a Social Security number-based identifier known as the Health Insurance Claim (HIC) number.  This unique identifier has been used to determine the beneficiary for all Medicare transactions such as eligibility, billing and claim status inquiries. 

As a means to help fight identity theft, The Medicare Access and CHIP Reauthorization Act (MACRA) of 2015 requires the Centers for Medicare and Medicaid Services (CMS) to remove the beneficiary’s Social Security number from all Medicare cards by April 2019 and replace it with an identifier that will help to secure the integrity of the beneficiary health data. This new number will be known as the Medicare Beneficiary Identifier (MBI). These new numbers will be randomly generated and will consist of a set of alpha-numeric digits that are not logically related to any identifiable background information.

CMS is already working to implement these sweeping changes and will be be sending out new Medicare ID cards to random geographic locations beginning in April 2018. There will be a transition period when either the traditional HIC number or the new MBI number can be used for transactions. This will begin no earlier than April 1, 2018 and will extend through December 31, 2019. It is anticipated that the new MBI will be the sole source of identification for Medicare beneficiaries beginning in January 2020.

What these new numbers will look like:

The new numbers will be a randomly generated combination of alpha and numeric characters consisting of the following:

  • 11 digits
  • Numbers 0-9
  • Uppercase and lowercase letters

How you can prepare:

  • Share this information with your residents, families and staff
  • Make sure they are aware of this upcoming change and will be watching their mailboxes for the new MBI cards starting in April 2018. Keep in mind that you may have resident families who are also Medicare beneficiaries.
  • Check the Richter Healthcare Consultants website and blog regularly for updates and announcements during the implementation and transition period.

The positions identify the 11 characters the new ID number will comprise of. The values tell you whether that position will be alpha or numeric. See example at the top of the figure.

For more information on the change to beneficiary identifiers, click here.

Contact Richter Healthcare Consultants:

Do you have questions about Medicare or Medicaid challenges? Call Richter's Medicaid consultants at 866-806-0799 to schedule a free consultation. 

Bobbie Tiedt Donohew, CEAL, is the Associate Director of Consulting Services for Richter Healthcare Consultants.