By Virgil Dickson | June
21, 2017
Medical practices around the country are uncertain on how they
should prepare for the removal of Social Security numbers from Medicare ID
cards, as the CMS fails to provide clear guidance for the upcoming changes.
Since the beginning of the Medicare program, Social Security numbers have been used as the beneficiary identifier for administering services. But the Medicare Access and CHIP Reauthorization Act required the CMS to remove Social Security numbers from Medicare cards because of identity theft and fraud risks.
Starting in April 2018, the CMS will begin to issue Medicare cards with a new ID numbers. Approximately 60 million beneficiaries will receive the new cards by April 2019.
But the agency hasn't given providers clear guidance on their responsibilities to ensure their Medicare billing privileges aren't affected by the ID changes. Physicians risk losing their ability to bill Medicare as a result of the change. After a transition period, claims with the old numbers won't be accepted starting in 2020. Practices also need to update their EHR systems to accept the new ID numbers.
Doctors know the changes are coming, but many have done nothing to prepare.
Dr. Charles Rothberg, an ophthalmologist in Long Island, N.Y., said the CMS could do more to educate providers about the change. Although the agency may think the ID changes are minor, they can have an impact on physician practices.
"We don't have much information as to how they plan to roll this out," he said. "Maybe they feel that we don't have to have as much information as we had during other process changes."
A CMS spokesman did not respond to a request for comment.
However, on June 15 the agency did release a five-point bulletin on steps practices should take to prepare for the change.
The advice included going to the CMS' website for updates, attending quarterly calls and testing current billing systems to be sure than can handle the new format.
But physicians still need more guidance, Rothberg said. The CMS bulletin didn't clarify how long-term care facilities should help patients who come in for treatment but don't know their new ID numbers.
Nursing home providers may not keep track of new patient ID numbers, since Medicaid pays for low-income seniors' care, Rothberg, who is also president of the Medical Society of the State of New York, said.
Providers had been pushing the CMS to make the new change via a rulemaking process which would give the CMS a chance to lay out a substantive roll-out plan and clinicians an opportunity to weigh in.
Making this change with little transparency and no stakeholder input could create scenarios where providers won't be paid in a timely fashion, potentially impacting access to care, the American Medical Association, Medical Group Management Association and others have said in letters to the CMS.
A rulemaking could ensure health IT vendors are taking the appropriate steps to prepare for the change.
With ICD-10, the roll out of Merit-based Incentive Payment Systems and Alternative Pay Models under MACRA, as well as ongoing electronic medical record meaningful use activities, vendors may not have the bandwidth to address this latest change in a timely way, according to Robert Tenant, director of health information technology policy at MGMA.
However, even without a formal comment period, Tenant has seen the CMS attempt to address at least some concerns it hears from providers.
The CMS originally had no plans to create a database that would allow providers to look up the new numbers if a patient lost their card or didn't bring it in an appointment.
This would be a major problem once CMS starts to refuse to reimburse claims without the new ID number.
On May 31, the CMS announced it has decided to create a secure database where both providers and beneficiaries can look up their new ID numbers.
"That's a big change we saw," Tenant said. "It's critical that practices be able to look up these numbers."
Even without major guidance, some practice managers have begun to develop their own best practices to prepare for the changes. As the CMS starts distributing the cards, doctors' offices should call patients before appointments to obtain the new numbers, according to Lilly Timon an administrator for a small, private internal medicine clinic in Austin, Texas.
With as many as 10,000 people becoming eligible for Medicare every day across the country, a smooth roll out is critical.
"We're just hitting the peak of the tidal wave with baby boomers becoming eligible for Medicare," Timon said.
Since the beginning of the Medicare program, Social Security numbers have been used as the beneficiary identifier for administering services. But the Medicare Access and CHIP Reauthorization Act required the CMS to remove Social Security numbers from Medicare cards because of identity theft and fraud risks.
Starting in April 2018, the CMS will begin to issue Medicare cards with a new ID numbers. Approximately 60 million beneficiaries will receive the new cards by April 2019.
But the agency hasn't given providers clear guidance on their responsibilities to ensure their Medicare billing privileges aren't affected by the ID changes. Physicians risk losing their ability to bill Medicare as a result of the change. After a transition period, claims with the old numbers won't be accepted starting in 2020. Practices also need to update their EHR systems to accept the new ID numbers.
Doctors know the changes are coming, but many have done nothing to prepare.
Dr. Charles Rothberg, an ophthalmologist in Long Island, N.Y., said the CMS could do more to educate providers about the change. Although the agency may think the ID changes are minor, they can have an impact on physician practices.
"We don't have much information as to how they plan to roll this out," he said. "Maybe they feel that we don't have to have as much information as we had during other process changes."
A CMS spokesman did not respond to a request for comment.
However, on June 15 the agency did release a five-point bulletin on steps practices should take to prepare for the change.
The advice included going to the CMS' website for updates, attending quarterly calls and testing current billing systems to be sure than can handle the new format.
But physicians still need more guidance, Rothberg said. The CMS bulletin didn't clarify how long-term care facilities should help patients who come in for treatment but don't know their new ID numbers.
Nursing home providers may not keep track of new patient ID numbers, since Medicaid pays for low-income seniors' care, Rothberg, who is also president of the Medical Society of the State of New York, said.
Providers had been pushing the CMS to make the new change via a rulemaking process which would give the CMS a chance to lay out a substantive roll-out plan and clinicians an opportunity to weigh in.
Making this change with little transparency and no stakeholder input could create scenarios where providers won't be paid in a timely fashion, potentially impacting access to care, the American Medical Association, Medical Group Management Association and others have said in letters to the CMS.
A rulemaking could ensure health IT vendors are taking the appropriate steps to prepare for the change.
With ICD-10, the roll out of Merit-based Incentive Payment Systems and Alternative Pay Models under MACRA, as well as ongoing electronic medical record meaningful use activities, vendors may not have the bandwidth to address this latest change in a timely way, according to Robert Tenant, director of health information technology policy at MGMA.
However, even without a formal comment period, Tenant has seen the CMS attempt to address at least some concerns it hears from providers.
The CMS originally had no plans to create a database that would allow providers to look up the new numbers if a patient lost their card or didn't bring it in an appointment.
This would be a major problem once CMS starts to refuse to reimburse claims without the new ID number.
On May 31, the CMS announced it has decided to create a secure database where both providers and beneficiaries can look up their new ID numbers.
"That's a big change we saw," Tenant said. "It's critical that practices be able to look up these numbers."
Even without major guidance, some practice managers have begun to develop their own best practices to prepare for the changes. As the CMS starts distributing the cards, doctors' offices should call patients before appointments to obtain the new numbers, according to Lilly Timon an administrator for a small, private internal medicine clinic in Austin, Texas.
With as many as 10,000 people becoming eligible for Medicare every day across the country, a smooth roll out is critical.
"We're just hitting the peak of the tidal wave with baby boomers becoming eligible for Medicare," Timon said.
Virgil Dickson reports from Washington on the
federal regulatory agencies. His experience before joining Modern Healthcare in
2013 includes serving as the Washington-based correspondent for PRWeek and as
an editor/reporter for FDA News. Dickson earned a bachelor's degree from DePaul
University in 2007
Not certain if I entirely agree with this article, as CMS has sent this communication multiple times through multiple sources:
ReplyDelete________________________________________
5 Ways for Healthcare Providers to Get Ready for New Medicare Cards
Medicare is taking steps to remove Social Security numbers from Medicare cards. Through this initiative the Centers for Medicare & Medicaid Services (CMS) will prevent fraud, fight identity theft and protect essential program funding and the private healthcare and financial information of our Medicare beneficiaries.
CMS will issue new Medicare cards with a new unique, randomly-assigned number called a Medicare Beneficiary Identifier (MBI) to replace the existing Social Security-based Health Insurance Claim Number (HICN) both on the cards and in various CMS systems we use now. We’ll start mailing new cards to people with Medicare benefits in April 2018. All Medicare cards will be replaced by April 2019.
CMS is committed to helping providers by giving them the tools they need. We want to make this process as easy as possible for you, your patients, and your staff. Based on feedback from healthcare providers, practice managers and other stakeholders, CMS is developing capabilities where doctors and other healthcare providers will be able to look up the new MBI through a secure tool at the point of service. To make this change easier for you and your business operations, there is a 21-month transition period where all healthcare providers will be able to use either the MBI or the HICN for billing purposes.
Therefore, even though your systems will need to be able to accept the new MBI format by April 2018, you can continue to bill and file healthcare claims using a patient’s HICN during the transition period. We encourage you to work with your billing vendor to make sure that your system will be updated to reflect these changes as well.
Beginning in April 2018, Medicare patients will come to your office with new cards in hand. We’re committed to giving you information you need to help your office get ready for new Medicare cards and MBIs.
Here are 5 steps you can take today to help your office or healthcare facility get ready:
1. Go to our provider website and sign-up for the weekly MLN Connects® newsletter.
2. Attend our quarterly calls to get more information. We’ll let you know when calls are scheduled in the MLN Connects newsletter.
3. Verify all of your Medicare patients’ addresses. If the addresses you have on file are different than the Medicare address you get on electronic eligibility transactions, ask your patients to contact Social Security and update their Medicare records.
4. Work with us to help your Medicare patients adjust to their new Medicare card. When available later this fall, you can display helpful information about the new Medicare cards. Hang posters about the change in your offices to help us spread the word.
5. Test your system changes and work with your billing office staff to be sure your office is ready to use the new MBI format.
We’ll keep working closely with you to answer your questions and hear your concerns. To learn more, visit: cms.gov/Medicare/SSNRI/Providers/Providers.html.
More info from CMS:
ReplyDeleteCMS is committed to a successful transition to the new Medicare card number for people with Medicare and for the health care provider community. Stay up-to-date with the latest information by attaching one of these widgets (buttons) to your website, and share with members of your organization. Clicking on the widget will link you to the cms.gov SSNRI home page. If you’d like to use our widgets, be sure that wherever you’re using them accepts rich text format. Then, follow the steps described on the cms.gov/Medicare/SSNRI website. Having the widget will give you the shortcut to the latest posts on the SSNRI page.
https://www.cms.gov/Medicare/SSNRI/Partners-and-Employers/SSNRI-widgets.html
Again:
ReplyDelete________________________________________
New Medicare Card (formerly called SSNRI)
CMS is removing Social Security Numbers from Medicare cards to help fight identity theft and safeguard taxpayer dollars. In previous messages, we said that you must be ready by April 2018 for the change from the Social Security Number based Health Insurance Claim Number to the randomly generated Medicare Beneficiary Identifier (the new Medicare number). Up to now, we referred to this work as the Social Security Number Removal Initiative (SSNRI). Moving forward, we will refer to this project as the New Medicare Card.
To help you find information quickly, we designed a new homepage linking you to the latest details, including how to talk to your Medicare patients about the new Medicare Card. Bookmark the New Medicare Card homepage and Provider webpage, and visit often, so you have the information you need to be ready by April 1.