Fraud Prevention Resources

CMS has published information about helping patients avoid fraud and scams, which may be particularly important with the release of the New Medicare Cards.

Medicare will never call beneficiaries uninvited and ask for personal or private information to get their new Medicare Number and card.  Scam artists may try to get personal information (like their current Medicare Number) by contacting them about their new card.  If your Medicare patient is asked for their information, for money, or someone threatens to cancel their health benefits if they don’t share their personal information, have them call 1-800-MEDICARE (1-800-633-4227).

The new Medicare Number is also called the Medicare Beneficiary Identifier (MBI) and is replacing the current Social Security-based Health Insurance Claim Number (HICN) on Medicare health insurance cards.  Medicare will continue to accept the HICN through the transition period; see https://www.cms.gov/Medicare/New-Medicare-Card/index.html#target.  Identity theft resources for people with Medicare can be found at https://www.medicare.gov/forms-help-and-resources/identity-theft/identity-theft.html.

NMC Ombudspersons

CMS has announced the appointment of a Provider Ombudsman for the New Medicare Card, to serve as a resource for the provider community.  The Ombudsman will ensure that CMS hears and understands any implementation problems experienced by clinicians, hospitals, suppliers, and other providers, will communicate about the New Medicare Card to providers, and help to develop solutions to any implementation problems that arise.  To reach the Provider Ombudsman, contact: NMCProviderQuestions@cms.hhs.gov .

The Medicare Beneficiary Ombudsman and other CMS staff will address inquiries from Medicare beneficiaries and their representatives through existing inquiry processes.  For more information on the Beneficiary Ombudsman see https://www.medicare.gov/Pubs/pdf/11173.pdf and https://www.medicare.gov/claims-and-appeals/medicare-rights/get-help/ombudsman.html .

New Medicare Card Design

CMS has unveiled the design for the new Medicare cards that will be mailed to beneficiaries between April 2018 and April 2019.  For security, the new cards will not contain Social Security Numbers, but a randomly-assigned number instead.  The old cards should be shredded or otherwise destroyed.  For the CMS press release on the design of the new cards, see https://www.cms.gov/Newsroom/MediaReleaseDatabase/Press-releases/2017-Press-releases-items/2017-09-14.html .

New Medicare Card

CMS has renamed their Social Security Number Removal Initiative or SSNRI to New Medicare Card or NMC, and created three new web pages for it:

New Medicare Cards

CMS has announced that facilities may need to change their healthcare records systems to:

  • Accept the new Medicare Beneficiary Identifier or MBI.  Use the MBI format specifications at https://www.cms.gov/Medicare/New-Medicare-Card/index.html if you currently have edits on the current HICN.
  • 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 we will return a message on the eligibility transaction response for a RRB patient.  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 at https://www.palmettogba.com/palmetto/providers.nsf/DocsCatHome/Railroad%20Medicare .
  • Update your practice management system’s patient numbers to automatically accept the new MBI from remittance advice (835) transactions.  Beginning in October 2018, through December 2019, 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 currently get the “changed HICN”:  835 Loop 2100, Segment NM1 (Corrected Patient/Insured Name), Field NM109 (Identification Code).

If you use vendors to bill Medicare, contact them if they haven’t already shared their new Medicare card system changes with you; they can also tell you how they will pass the new Medicare number to you.  The New Medicare Card Provider webpage at https://www.cms.gov/Medicare/New-Medicare-Card/index.html will provide the latest information.

Texting Orders Banned

JCAHO and CMS have issued a new ruling that texting of medical orders from a personal mobile device (such as a smartphone) is no longer permitted, whether or not the texting service claims to be secure.  The preferred method is to enter orders directly into the Electronic Health Record.  Written order are still permitted, as are verbal orders when neither EHR nor written orders are feasible.

This is the headline article in the June 2017 issue of Network 16 News.  This issue also contains:

Find all Network 16 News issues at https://nwrn.org/providers-and-professional-staff/nw16n.html .