By CMS Administrator Seema Verma
Nationally expanded performance-based payment model now enrolling service suppliers
The Centers for Medicare & Medicaid Services (CMS) in April expanded the Medicare Diabetes Prevention Program (MDPP), a national performance-based payment model offering a new approach to type 2 diabetes prevention in eligible Medicare beneficiaries with an indication of pre-diabetes. For the first time, both traditional healthcare providers and community-based organizations can enroll as Medicare suppliers of health behavior change services. This innovative model promotes patient-centered care and continues to test market-driven reforms to drive quality of care and improve outcomes for America’s seniors, more than a quarter of whom have type 2 diabetes.
CMS recognizes that prevention is a critical part of creating an affordable healthcare system that puts patients first, and we encourage eligible suppliers to partner with us on this shared goal by participating in the national expansion of the MDPP.
As the CMS Innovation Center’s first preventive services model test to expand nationally, the MDPP is a key example of how we’re putting innovation to work. The model launched in 2012 as a small, voluntary model test at 17 sites across the country in partnership with the YMCA-USA, Centers for Disease Control and Prevention (CDC), and other public and private partners. Now, CMS is expanding this set of services nationwide based on promising results. In the initial model test, 45 percent of beneficiaries met the 5 percent weight loss target, which translates to a clinically meaningful reduction in the risk of developing type 2 diabetes.
Through the MDPP, trained community health workers and other health professionals empower beneficiaries at high risk of developing type 2 diabetes to take ownership of their health through curriculum-driven coaching and proven behavior change strategies for weight control. As a new preventive service for qualifying Medicare beneficiaries, MDPP services are available without a referral or co-payment.
The MDPP is not only a good value for our beneficiaries. Investing in prevention through performance-based payments and market-based incentives, this promising model will save the Medicare program more than $180 million by keeping beneficiaries healthy and averting new cases of diabetes[i].
One of the critical innovations in the MDPP is its approach to care delivery: For the first time, community-based organizations can enroll in Medicare to provide evidence-based diabetes prevention services after achieving preliminary or full recognition through the CDC. These organizations can enroll in Medicare to become an MDPP Supplier today, and CMS will continue to accept supplier applications on a rolling basis. Eligible organizations can begin the screening and enrollment process to become an MDPP Supplier by using the Provider Enrollment Chain and Ownership System (PECOS) or submitting the paper CMS-20134 Form. For information on the steps to enrollment, please refer to the MDPP Enrollment Fact Sheet.
Diabetes exerts an unacceptable toll on our beneficiaries, their families, and the Medicare program, which spends more than $104 billion every year treating patients with this preventable disease. The Medicare Diabetes Prevention Program is leveraging innovation to bring valuable preventive services to our beneficiaries, and I urge eligible organizations across the country to enroll today in this exciting performance-based payment opportunity.
[i] Federal Register. Department of Health and Human Services, Centers for Medicare and Medicaid Services. Medicare Program; Revisions to Payment Policies Under the Physician Fee Schedule and Other Revisions to Part B for CY 2018; Medicare Shared Savings Program Requirements; and Medicare Diabetes Prevention Program; Final Rule. November 15, 2017. [pg. 53355 – 53356] https://www.gpo.gov/fdsys/pkg/FR-2017-11-15/pdf/2017-23953.pdf
March 2, 2018
By Kate Goodrich, MD
Director, CMS Center for Clinical Standards and Quality & CMS Chief Medical Officer
Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) Funding Opportunity:Measure Development for the Quality Payment Program
CMS is pleased to announce a new funding opportunity for the development, improvement, updating, and expansion of quality measures for use in the Quality Payment Program. CMS will be partnering directly with clinicians, patients, and other stakeholders to provide up to $30 million of funding and technical assistance in development of quality measures over three years.
Cooperative agreements provide a unique opportunity for CMS to partner with external entities, such as clinical specialty societies, clinical professional organizations, patient advocacy organizations, educational institutions, independent research organizations, and health systems, in developing, improving, updating, and expanding quality measures for the Quality Payment Program. By giving external entities needed resources to help guide their measure-development efforts though this funding opportunity, CMS can leverage the unique perspectives and expertise of these external entities, such as clinician and patient perspectives, to advance the Quality Payment Program measure portfolio. The cooperative agreements will allow CMS to collaborate with stakeholders to address essential topics such as: clinician engagement, burden minimization, consumer-informed decisions, critical measure gaps, quality measure alignment, consumer-informed decisions, clinician engagement, and efficient data collection that minimizes health care provider burden.
The priority measures developed, improved, updated or expanded under the cooperative agreements will be aligned with the CMS Quality Measure Development Plan. The CMS Quality Measure Development Plan provides a strategy for filling clinician and specialty area measure gaps and for recommendations to close these gaps in order to support the Quality Payment Program, and identifies the following initial priority areas for measure development: Clinical Care, Safety, Care Coordination, Patient and Caregiver Experience, Population Health and Prevention, and Affordable Care. The gap areas include, but not limited to: Orthopedic Surgery, Pathology, Radiology, Mental Health and substance use conditions, Oncology, Palliative Care, and Emergency Medicine.
More broadly than the CMS Quality Measure Development Plan, which is specific for the Quality Payment Program, CMS measures work is guided by the Meaningful Measurement framework which identifies the highest priorities for quality measurement and improvement. The Meaningful Measure Areas serve as the connectors between CMS goals under development and individual measures/initiatives that demonstrate how high quality outcomes for our Medicare, Medicaid, and CHIP beneficiaries are being achieved. They are concrete quality topics which reflect core issues that are most vital to high quality care and better patient outcomes.
Through these cooperative agreements, CMS aims to provide the necessary support to help external entities expand the Quality Payment Program quality measure portfolio with a focus on clinical and patient perspectives and minimizing burden for clinicians. Focusing on patient perspectives will ensure measures focus on what is important to patients and drive the improvement of patient outcomes. To accomplish this, the cooperative agreements prioritize the development of: outcome measures, including patient reported outcome and functional status measures; patient experience measures; care coordination measures; and measures of appropriate use of services, including measures of overuse.
For more information, search for the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) Funding Opportunity: Measure Development for the Quality Payment Program on Grants.gov or visit our website, https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/Value-Based-Programs/MACRA-MIPS-and-APMs/MACRA-MIPS-and-APMs.html.
By: Kate Goodrich, M.D., M.H.S., Director, Center for Clinical Standards & Quality, CMS Chief Medical Officer
Medicare and other payers are rapidly moving toward a healthcare system that rewards high quality care while spending more wisely. Foundational to the success of these efforts is having quality measures that are meaningful to patients, consumers, and providers alike. CMS recently announced the “Meaningful Measures” initiative to identify the most impactful areas for quality measurement and improvement and reflect core issues that are most vital to high quality care and better individual outcomes. Each year, CMS publishes a list of quality and cost measures that are under consideration for Medicare quality reporting and value-based purchasing programs, and collaborates with the National Quality Forum (NQF) to get critical input from multiple stakeholders, including patients, families, caregivers, clinicians, commercial payers and purchasers, on the measures that are best suited for these programs. Ultimately, these measures may help patients choose the nursing home, hospital, or clinician that is best for them, and can help providers to provide the highest quality of care across care settings.
I am happy to announce that CMS posted the Measures under Consideration (MUC) List for 2018 pre-rulemaking on the CMS website and has sent it to NQF in preparation for multi-stakeholder input.
This year’s MUC List contains 32 measures that have the potential to drive improvement in quality across numerous settings of care, including clinician practices, hospitals, and dialysis facilities. CMS is considering new measures to help quantify healthcare outcomes and track the effectiveness, safety and patient-centeredness of the care provided. At the same time, CMS is taking a new approach to coordinated implementation of meaningful quality measures focused on the most critical, highly impactful areas for improvement while reducing the burden of quality reporting on all providers so they can spend more time with their patients. In addition to other factors, CMS evaluated the measures on the MUC list to ensure that measures considered for adoption in a CMS program through rulemaking as necessary, focus on clearly defined, meaningful measure priority areas that safeguard public health and improve patient outcomes. For example, to generate this year’s MUC list, CMS considered 184 measures submitted by stakeholders during an open call for measures. Considering the meaningful measurement areas, CMS narrowed the list to 32 measures (17% of the original submissions) which focus CMS efforts to achieve goals of high quality healthcare and meaningful outcomes for patients, while minimizing burden. CMS will continue to use the Meaningful Measures approach to strategically assess the development and implementation of quality measure sets that are the most parsimonious and least burdensome, that are well understood by external stakeholders, and are most likely to drive improvement in health outcomes.
This year, approximately 40% of measures on the MUC list are outcome measures, including patient-reported outcome measures, which will help empower patients to make decisions about their own healthcare and help clinicians to make continuous improvements in the care provided. In addition, this year there are eight episode-based cost measures proposed that were developed by incorporating the insight and expertise of clinicians and specialty societies. CMS is committed to working with clinicians, consumers, and other stakeholders on the development and use of measures that are most meaningful to patients and clinicians and our programs.
We invite you to review the MUC List in detail and to participate in the public process. We believe it is critical to hear a wide range of voices in the selection of quality and efficiency measures that are used for accountability and transparency purposes and look forward to another successful pre-rulemaking season. For more information regarding the NQF Measure Applications Partnership public stakeholder review meeting purpose, meetings, 2017 MUC List deliberations and voting, visit the NQF website at http://www.qualityforum.org/map/.
By Kate Goodrich, MD
Director, CMS Center for Clinical Standards and Quality & CMS Chief Medical Officer
CMS is actively working to move the needle on improving quality in healthcare without additional burden to those providers on the frontlines. CMS recently launched a new initiative, ‘Meaningful Measures,’ which will streamline current measure sets – so providers can focus on the measures that are most impactful – and will move from process measures to outcome measures where possible. A great deal of attention has also been focused on alignment of quality measures within CMS and with commercial payers, and we are committed to working towards alignment of these measures to ensure delivery of high quality care to all Americans while minimizing burden on providers.
I am pleased to announce that CMS is deploying an innovative tool that provides all stakeholders improved visibility into the portfolio of CMS measures. The CMS Measures Inventory Tool (CMIT), an interactive web-based application that contains the same information that is currently included on the Excel spreadsheet, provides a comprehensive list of measures that are currently under development, implemented for use, and have been removed from a CMS quality program or initiative. The intuitive and user-friendly functions allow you to find measures quickly and to compile and refine sets of related measures. The tool increases transparency and can be used to identify measures across the continuum of care and will help coordinate measurement efforts across all conditions, settings, and populations. We have expanded the information contained in the inventory to better answer questions we have heard from the public; the CMIT lists each measure by program, dates of measure consideration and implementation, and measure specifications including, but not limited to, numerator, denominator, exclusion criteria, measure type, and National Quality Forum (NQF) endorsement status.
CMIT is an innovative approach that will help to promote the goal of increased alignment across programs and with other payers. We believe it is an easy to use valuable resource to various stakeholders, including commercial payers, clinicians, patients and measure developers.
For more information about CMIT and to access the tool, please visit the CMS.gov website.
November 16, 2017
By: Seema Verma, CMS Administrator @SeemaCMS
Today, CMS is celebrating National Rural Health Day by commemorating our partners who provide quality care to the nearly one in five Americans who reside in rural communities. CMS recognizes the unique challenges facing rural America, and we are taking action to improve access and quality for healthcare providers serving rural patients.
This fall, I have been visiting communities throughout the country to learn more about issues critical to improving access to rural healthcare. I travelled to Kansas City and visited the headquarters of the National Rural Health Association to talk with key leadership and stakeholders to hear how CMS can reduce the challenges rural communities face. CMS is committed to evaluating our policies and looking at each of them through a rural lens to ensure rural providers greater flexibility and less regulatory burden.
New technologies are emerging that have strong promise to address access issues in rural communities. CMS is trying to modernize the Medicare program so that beneficiaries can make use of the new technology. For example, CMS recently released new telehealth payment codes in Medicare so more services can be accessed in rural areas. This is only the beginning of our overall strategy to update our programs and improve access to high quality services.
Rural hospitals also face challenges in recruiting physicians. CMS is addressing this challenge by placing a two-year moratorium on the direct supervision requirement for outpatient therapeutic services at Critical Access Hospitals and small rural hospitals. This policy helps to ensure access to outpatient therapeutic services for Medicare beneficiaries living in rural communities and provides regulatory relief to America’s small rural hospitals. In Medicare Advantage plans, we are working to ensure network standards offer the flexibility needed to provide greater health care plan choices to rural beneficiaries. These reforms are in line with our focus on improving the beneficiary experience.
In response to feedback received from Critical Access Hospitals and other rural stakeholders, CMS recently announced that Critical Access Hospitals should no longer expect to receive medical record reviews related to the 96-hour certification requirement absent concerns of probable fraud, waste, or abuse.
We are also now providing technical assistance and greater flexibilities to small and rural clinicians to help facilitate their participation in the Quality Payment Program (QPP). These efforts are aligned with our goal of reducing regulatory burden so clinicians are able to spend more time on patient care and healthier outcomes, and less time on paperwork. One way we have done this is to provide free and customized technical assistance to support small and rural clinicians every step of the way, as well as assistance through our Service Center, Regional Offices, and the QPP page on cms.gov.
We have finalized several policies to reduce burdens and help clinicians in small practices successfully participate in the QPP program. Some of these include:
In our effort to consider a new direction that promotes patient-centered care and test market-driven reforms, the CMS Innovation Center is currently seeking suggestions on improving rural healthcare by way of a recently released Request for Information (RFI). The opportunity to provide recommendations for the new direction closes November 20 and if you have not already, we hope you will share your thoughts.
CMS has also developed a number of resources to help rural providers and other stakeholders. To improve the customer experience and further empower our rural providers, we are centralizing rural healthcare resources into a single website which you can find here.
And finally, CMS does not operate in a vacuum. We work closely with other federal partners including the Health Resources and Services Administration, the Office of the National Coordinator, and the Centers for Disease Control and Prevention, among others, to ensure our efforts to improve care in rural America are consistent with those agencies’ rural initiatives. CMS will continue to listen to, work with, and value the input from rural stakeholders. Together, we can improve care in rural America. Happy National Rural Health Day!
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November 15, 2017
By Kimberly Brandt, Principal Deputy Administrator for Operations (@cms.hhs.gov)
The Centers for Medicare & Medicaid Services (CMS) is committed to reducing improper payments in all of its programs, as evidenced by improper payment reduction efforts contained in the Fiscal Year 2018 President’s Budget. CMS’s new leadership is re-examining existing corrective actions and exploring new and innovative approaches to reducing improper payments, while minimizing burden for its partners. Due to the successes of actions we’ve put into place to reduce improper payments, the Medicare Fee-For-Service (FFS) improper payment rate decreased from 11.0 percent in 2016 to 9.5 percent in 2017, representing a $4.9 billion decrease in estimated improper payments. The 2017 Medicare FFS estimated improper payment rate represents claims incorrectly paid between July 1, 2015 and June 30, 2016. This is the first time since 2013 that the Medicare FFS improper payment rate is below the 10 percent threshold for compliance established in the Improper Payments Elimination and Recovery Act of 2010.
Improper payments are not always indicative of fraud, nor do they necessarily represent expenses that should not have occurred. For example, instances where there is insufficient or no documentation to support the payment as proper are cited as improper payments under current Office of Management and Budget guidance. The majority of Medicare FFS improper payments are due to documentation errors where CMS could not determine whether the billed items or services were actually provided, were billed at the appropriate level, and/or were medically necessary. A smaller proportion of Medicare FFS improper payments are payments for claims CMS determined should not have been made or should have been made in a different amount, representing a known monetary loss to the program.
Figure 1 provides information on Medicare FFS improper payments that are a known “monetary loss” to the program (i.e. medical necessity, incorrect coding, and other errors). The estimated known “monetary loss” improper payment rate is 3.0 percent, representing an estimated known monetary loss of $11.3 billion out of the total estimated improper payments of $36.2 billion. In the figure, “unknown” represents payments where there was no or insufficient documentation to support the payment as proper or a known monetary loss. In other words, when payments lack the appropriate supporting documentation, their validity cannot be determined. These are payments where more documentation is needed to determine if the claims were payable or if they should be considered monetary losses to the program.
Figure 1: FY 2017 Medicare FFS Improper Payments (in Millions) and Percentage of Improper Payments by Monetary Loss and Type of Error
CMS continues to implement tools and work with law enforcement partners and other key stakeholders to help focus on prevention, early detection, and data sharing to prevent and reduce improper payments in Medicare FFS. Although documentation errors are the largest cause of improper payments, CMS employs multi-layered efforts to target all root causes of improper payments, with an emphasis on prevention-oriented activities.
CMS is pleased to have achieved this reduction in the improper payment rate, but we still have work to do. We remain committed to collaborating across CMS and with stakeholders to address potential vulnerabilities and continuing to strengthen our program integrity efforts, while minimizing burden for our partners.
November 9, 2017
By: Seema Verma, CMS Administrator
Thank You for Your Service
We’ve all heard the stories of bravery and sacrifice, or have personally experienced the inspiring dedication to service of our US Military veterans, but for me their heroism was made real on a visit to Normandy.
Early in the morning on D-Day, June 6, 1944, Army Rangers climbed the cliffs of Point-du-Hoc to the west of Omaha Beach to destroy a battery of 155mm German cannons on top of the cliff. As I stood there, viewing these cliffs as a tourist, I couldn’t help but imagine the fear that must’ve been going through their minds as they scaled those massive, rocky cliffs under heavy German fire, only to reach the top and face even heavier opposition. How, in the face of what they must have considered certain death, they pressed on knowing the importance of their mission, and that their actions would save countless American and foreign lives.
I then went to see the cemetery where those lost on D-Day, including the Army Rangers who died while taking that hill, were buried. While looking at that field of graves, I found myself emotionally overwhelmed thinking about how these men died for the freedom and safety of people they didn’t know and would never meet.
As a public servant, on this day and every day, I think about the sacrifices of America’s Veterans, both dead and living, that inspire me to also make sacrifices so that others can live better lives. When I think about the work we do at CMS, I think about those Rangers, I think about the price they paid for our freedoms, and I think about the fact that their sacrifice should be honored by making sure that we serve our country in a manner worthy of their heroism.
America’s veterans are heroes. CMS currently employs 591 veterans, comprising 10% of our workforce. Last year we hired 38 veterans, and will continue to recruit and retain veterans within our ranks because they not only bring a wealth of knowledge and skill, but a profound sense of honor and dedication to public service that is an important quality in all CMS employees.
To America’s veterans, thank you for your service, and your devotion to our country. We at CMS will never take for granted what you have done for us and for this country. On behalf of myself, my family, and CMS employees currently serving all across our country, I hope you have a great Veterans Day, you’ve earned it.
By Seema Verma, Administrator, Centers for Medicare & Medicaid Services (CMS)
Each October, as the days grow shorter, time seems to speed up. Maybe it’s because we start planning for the looming holidays or begin bracing for the cold winter, but before we know it we’re saying goodbye to one year and ringing in a new one. That’s why it’s important to set aside some time between now and early December to think about your 2018 healthcare needs by shopping for high-quality Medicare health and drug plans during Open Enrollment.
Medicare Open Enrollment kicked off on October 15 and will run through December 7. I’m pleased to share that you will have better access to high-quality health coverage choices offering more options and lower premiums in 2018. This means you should be able to find plans that cost less but still give you quality care and better customer service. In fact, the number of Medicare Advantage plans available to individuals across the country is increasing from about 2,700 to more than 3,100 – and more than 85 percent of people with Medicare will have access to 10 or more Medicare Advantage plans. We are estimating that the average Medicare Advantage monthly premium will decrease by $1.91 in 2018, from an average of $31.91 in 2017 to $30. The Medicare prescription drug plan average basic premium is projected to decline for the first time since 2012 (a decrease of approximately $1.20 below the 2017 average basic premium of $34.70).
The choices available demonstrate the benefits of supply and demand market forces in a strong healthcare market. Consumers are demanding more from their insurance plans and in turn Medicare Advantage and Part D plans, like any business, are responding with better service at a lower cost leading to a truly patient-centered approach to healthcare.
Medicare is making some exciting changes of our own to make it easier for you to make an informed choice between Original Medicare and Medicare Advantage. You may have noticed a few of these changes in your Medicare & You handbook, but it doesn’t stop there. We’re improving our digital features on Medicare.gov, where you can sign-up to get timely notices about Open Enrollment and other important Medicare updates directly to your inbox. While on Medicare.gov be sure to check out the new help wizard that will point you to resources that will help you make informed healthcare decisions. These updates mirror the private sector and reflect a few ways we’re modernizing the customer service experience.
If you’ve been thinking about starting your new year with a Medicare Advantage or Prescription Drug Plan, or you’re interested in making some changes to your current plan, now is the time to shop for your coverage. Medicare health and drug plans change each year, and so can your health needs. That’s why it’s always a good idea to consider what needs you may have for 2018 and take a look at the available plans in your area.
Your coverage will begin on January 1, 2018. If you miss the deadline, you will likely have to wait a full year before you are able to make changes to your plan. During Open Enrollment, you can decide to stay in Original Medicare or join a Medicare Advantage Plan. If you find your current coverage still meets your healthcare needs, then you’re done.
Open Enrollment is also a good opportunity to make sure you’re doing everything you can to protect your identity and your health by guarding your Medicare card like you would a credit card. Identity theft resulting from stolen Medicare numbers is becoming more and more common. Medicare is here to help in the fight by removing Social Security Numbers from Medicare cards and replacing them with a new, unique number for each person with Medicare. Medicare will mail new Medicare cards with the new numbers between April 2018 and April 2019.
Don’t let the opportunity to have better quality healthcare at a lower price pass you by. Get a jump start on your new year’s health resolution today. You can visit Medicare.gov (http://www.medicare.gov), call 1-800-MEDICARE, or contact your State Health Insurance Assistance Program (SHIP) to learn more.
Por: Seema Verma, Administradora de los CMS
Como podría haber escuchado ya, o quizás ya vio un comercial de televisión, los Centros de Servicios de Medicare y Medicaid pronto emitirán a cada beneficiario de Medicare una nueva Tarjeta de Medicare, sin números de Seguro Social, para prevenir el fraude, mantener seguros los fondos de los contribuyentes, y para asegurar que siempre ponemos las necesidades de los pacientes primero.
Desafortunadamente los criminales están cada vez más interesados en las personas de 65 años o más para el robo de identidad médica, incluso cuando alguien usa ilegalmente el número de Medicare de otra persona. Un ladrón de identidad puede facturarle a Medicare por servicios costosos que nunca fueron proporcionados o cobrar más por los servicios proporcionados. Esto puede resultar en ambigüedades en los registros médicos, lo que puede significar el retraso en la atención o servicios negados para los pacientes y también impacta los fondos de los contribuyentes.
Para ayudar a combatir esto, les enviaremos a todos los beneficiarios de Medicare una nueva tarjeta con un número único asignado al azar. Cuenta con once caracteres, una combinación de números y letras mayúsculas.
Debido a que el número se genera al azar, no hay conexión a otra información de identificación personal. Este nuevo número reemplazará al número actual basado en el Seguro Social, y está diseñado para proteger la información personal de los beneficiarios de Medicare.
Comenzaremos a enviar por correo las recién diseñadas tarjetas de Medicare en abril de 2018, y reemplazaremos todas las tarjetas antes de abril de 2019. Si usted es beneficiario de Medicare o pronto lo será, no tendrá que hacer nada y podrá comenzar a usar su nueva tarjeta tan pronto como la reciba.
Cuando reciba su nueva tarjeta, le pediremos que destruya su tarjeta de Medicare de una manera segura. Asegúrese de traer la nueva tarjeta a las citas de sus médicos, y mantenga siempre confidencial su nuevo número. Esto ayudará a proteger su identidad personal y prevenir el fraude de identidad médica porque los ladrones de identidad no pueden facturar a Medicare sin un número de Medicare válido. Además, usted y sus proveedores de atención médica podrán utilizar herramientas seguras en línea que estamos desarrollando y que brindarán acceso rápido a su número de Medicare cuando sea necesario.
Usted va a escuchar mucho más acerca de esta iniciativa en las próximas semanas y meses, y también estamos ayudando a los médicos y otros proveedores de atención médica a prepararse para el cambio. Queremos hacer este proceso tan fácil como sea posible para todos los involucrados. Sobre todo, queremos que las personas con Medicare y los proveedores de atención médica sepan estos cambios con anticipación y tengan la información necesaria para asegurar una transición fácil a la nueva tarjeta.
By: Seema Verma, CMS Administrator
As you may have heard, or perhaps you’ve seen a recent TV commercial, the Centers for Medicare & Medicaid Services will soon be issuing every Medicare beneficiary a new Medicare Card, without Social Security Numbers, to prevent fraud, fight identity theft, and keep taxpayer dollars safe, and to help ensure that we always put the needs of patients first.
It’s unfortunate that criminals are increasingly targeting people age 65 or older for medical identity theft, including when someone illegally uses another person’s Medicare number. An identity thief may bill Medicare for expensive services that were never provided or overbill for provided services. This can lead to inaccuracies in medical records, which can mean delayed care or denied services for patients and impacts taxpayer funding.
To help combat this, we’ll be sending all Medicare beneficiaries a new card with a unique, randomly-assigned Medicare number. It will consist of eleven characters, a combination of numbers and uppercase letters.
Because it is randomly generated, there is no connection to any other personal identifying information. This new number will replace the Social Security-based number currently used on all Medicare cards, and it’s designed to protect the personal information of Medicare beneficiaries.
We’ll begin mailing the newly designed Medicare cards in April 2018, and we’ll replace all cards by April 2019. If you’re a Medicare beneficiary, or soon will be, you don’t need to do anything, and you can start using your new card as soon as you get it.
When you get your new card, we’ll ask you to safely and securely destroy your current Medicare card. Make sure you bring the new card to your doctors’ appointments, and always keep your new number confidential. This will help protect your personal identity and prevent medical identity fraud because identity thieves can’t bill Medicare without a valid Medicare number. Additionally, you and your health care providers will be able to use secure online tools that we’re developing that will support quick access to your Medicare number when needed.
You’ll be hearing a lot more about this initiative in the coming weeks and months, and we’re also helping doctors and other healthcare providers get ready for the change. We want to make this process as easy as possible for everyone involved. Above all, we want to ensure that people with Medicare and healthcare providers know about these changes well in advance and have the information needed to ensure an easy transition to the new card.
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