The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) requires the Centers for Medicare and Medicaid Services (CMS) to remove Social Security numbers from Medicare cards to prevent identity theft. CMS has said it will in 2018 begin issuing new Medicare cards that replace the current identification number—which is the beneficiary's Social Security Number—with an all-new Medicare Beneficiary Identification (MBI) number.

CMS has developed a new webpage to help physicians navigate the transition to the new MBI number, including a recently developed resource on how to talk to your Medicare patients about the new Medicare card. Physicians should also talk to their practice managers and health IT vendors now to ensure their systems will be ready to accept the MBI.

What can physicians do now to prepare?

Identify your patients who qualify for Medicare under the Railroad Retirement Board (RRB). You will no longer be able to distinguish RRB patients by the number on the new Medicare card. You will be able to identify them by the RRB logo on their card and a unique message on the eligibility transaction response. The message will say, "Railroad Retirement Medicare Beneficiary" in 271 Loop 2110C, Segment MSG. If you use the number only to identify your RRB patients beginning in April 2018, you must identify them differently to send Medicare claims to the RRB Specialty Medicare Administrative Contractor, Palmetto GBA.

Ensure your practice management system is ready to accept the new MBI numbers. Beginning in October 2018, through the transition period, CMS will return your patient's MBI on every electronic remittance advice for claims you submit with a valid and active HICN. It will be in the same place you now get the "changed HICN": 835 Loop 2100, Segment NM1 (Corrected Patient/Insured Name), Field NM109 (Identification Code). Practices will need to ensure their system is prepared to accept the new format and length of the new ID numbers.