Medicare beneficiaries may want to pay extra close attention to their mailboxes over the coming weeks and months.
In an effort to improve overall efficiency and to curtail fraud and abuse, the Centers for Medicare and Medicaid Services (CMS) are issuing new Medicare cards in 2018. Unlike the current Medicare cards, the new cards will not display the Social Security number of the beneficiary. In its place, there will be a randomly generated identification number that has no connection to any personal data of the beneficiary.
In previous years, a Medicare beneficiary’s Social Security number was also used as their Medicare identification number. This was intended to help health care providers identify patients and process billing transactions. As millions of people carried around their Medicare cards with their name and Social Security number printed on the front, however, they faced increased opportunities for identity theft and Medicare fraud.
The move to issue new, more secure Medicare cards comes in response to the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015. MACRA aims to improve Medicare’s efficiency through a number of different measures, including the removal of Social Security numbers in an effort to combat fraud, minimize burden for both beneficiaries and providers and to minimize the disruption of Medicare operations.
The CMS will be taking a full year to send out the new cards to the more than 58 million people enrolled in Medicare¹. Mailings will be staggered in waves according to geographic location and the schedule is as follows:
The statutory deadline for replacing all existing Medicare cards is April 16, 2019. It’s quite possible that people in some states may not receive their new Medicare cards until sometime in 2019.
New details regarding the mailing schedule are expected to emerge once the process gets underway. Beginning in April of 2018, beneficiaries can check the shipping status of their new Medicare card online at Medicare.gov or by signing up to receive email updates (which you can also do on the federal Medicare website). Keep in mind that your friend’s or neighbor’s card may arrive before yours, as mailing schedules can vary within each state.
The new Medicare cards will be red, white and blue. They will look much like the current cards but will be paper and won’t be laminated like the current Medicare cards. The main difference is that the card holder’s Social Security number (which currently appears on the card, under the beneficiary’s name) will be replaced by the randomly-generated Medicare Beneficiary Identifier (MBI). The MBI which will be 11 characters long and will contain both numbers and uppercase letters. The MBI is “non-intelligent,” which means that the codes do not have any hidden or special meaning, and spouses will each be assigned their own MBI.
The beneficiary’s gender designation will also be removed, as will the beneficiary’s signature.
The MBI will be used for processes such as billing, service transactions, eligibility questions and claim status checks that previously required the beneficiary’s Social Security number. Health care providers are required to have systems and processes in place that will be equipped to accept the MBI for all patient interactions by April of 2018.
Beneficiaries who qualify for Medicare through the Railroad Retirement Board (RRB) will receive a card with the RRB logo in the upper left corner and the designation of “Railroad Retirement Board” at the bottom.
Medicare Advantage, Medicare Supplement Insurance (also called Medicare Supplement Insurance) and Medicare Part D prescription drug plans will continue using their own cards at their own discretion, but patients enrolled in these plans should still expect to receive a new Medicare card and should carry these new cards with them, along with any additional health care cards.
When your new Medicare card arrives in the mail, you are encouraged to destroy your old card. Cards should be shredded, and not merely thrown in the trash. There is no need to activate the new card; it is ready to use as soon as you take it out of the mailbox.
Although your new Medicare card will be safer than the old one, it should still be safeguarded with the same level of care. Carry your card with you in a safe place and don’t share your MBI with anyone except your health care provider, pharmacist or insurer. Should you forget to bring your new card to an appointment, your health care provider may be able to look up your MBI in their system.
The CMS will not reach out to beneficiaries to confirm whether or not they have received their new card. Anyone enrolled in Medicare should double-check to make sure that their current address is accurate and consistent with the one on file with the Social Security Administration. To check, you can create an online account with the Social Security Administration here or call 800-772-1213 (24 hours a day, 7 days a week) for assistance. TTY users may call 1-800-325-0778. You may use these same resources if your Medicare card (old or new) is ever lost, stolen or destroyed.
Do not engage with any unfamiliar individuals or organizations who contact you inquiring about information from your new Medicare card. CMS officials will not ask a beneficiary for personal or private information, and they will not ask for money during the process of issuing the new cards.
Some scammers may attempt to contact Medicare beneficiaries pretending to represent Medicare or the Social Security Administration in an effort to obtain information that can be used to compromise one’s identity. In fact, some cases of this happening have already been reported.
Beneficiaries may continue to use their old Medicare card until the new one arrives. There is no need to wait until the new card arrives in order to receive any medical care.
Medicare fraud is big business. According to the Pulitzer Prize-winning Center for Public Integrity, improper Medicare payments tallied nearly $60 billion in 2016 alone. That number is more than twice as much as the National Institutes of Health spends annually on medical research and is equivalent to more than $1,000 per each Medicare beneficiary in the nation.
These enormous losses aren’t solely due to intentional fraud. Billing mistakes can also contribute to wasted Medicare funds, and Original Medicare’s payment error rate in 2016 was an alarming 11 percent. Billing errors may include simple overcharges and underpayments, as well as mistakes made with billing codes. Inefficiencies, such as overestimating the amount of diagnostic testing needed for a Medicare beneficiary, can also contribute to Medicare waste.
Medicare fraud can be committed by doctors, insurance billers and patients. The acts can be carried out by a single person or by an entire organization or group. According to the CMS, Medicare fraud is defined as:
Some examples of Medicare fraud include:
Medicare fraud also happens when someone takes the name and Social Security number of a Medicare beneficiary and uses that person’s identity to receive Medicare benefits on their behalf. The CMS hopes to reduce this type of fraud by removing Social Security numbers from the new Medicare cards.
Medicare “abuse” is classified differently than Medicare “fraud.” Medicare abuse is the practice of billing for unnecessary medical services, billing excessive charges for services or supplies or billing for multiple service or supply codes that should have been bundled together.
Medicare fraud and abuse lead to higher health care costs for everyone and can lead to increased taxes. A Medicare Fraud Strike Force was established in 2007 and has recouped around $3 billion that had been lost due to fraud and abuse.
There are a few things you can do to help minimize your risk for being a victim of Medicare fraud.
Medicare beneficiaries that suspect they may have been a victim of Medicare fraud may call the CMS hotline at 1-800-MEDICARE (1-800-633-4227), TTY users may call 1-877-486-2048.
Medicare Advantage and Medicare Part D beneficiaries may call 1-877-772-3379.