Trying to wade through the alphabet soup

  • Fri Oct 28th, 2016 11:00pm
  • Life

By Mark Harvey

Here’s how much I like you. I’m going to summarize this entire column in one sentence, allowing you to briskly proceed to the next important thing in your day. Ready?

In order to comply with MACRA, CMS is implementing the SSNRI and will replace your HICN with a MBI by 4/1/18.

You’re welcome. Have a nice day.

What? You don’t understand? What do you mean, you don’t understand?! What could be clearer? Sigh. Oh, alright, but I really don’t have time for this.

It seems that last year — 2015, in case that’s a little vague — Congress actually managed to pass a law. Specifically, it managed to pass the “Medicare Access and CHIP Reauthorization Act (MACRA).” That little law did a number of things, but I’m just going to step around CHIP and move on to the Medicare stuff (What? Oh, OK, CHIP has to do with health insurance for kids, but don’t let something as inconsequential as children distract you).

The “Medicare Access” part means that the Centers for Medicare and Medicaid Services (CMS) is now forced to develop a Social Security Number Removal Initiative (SSNRI), which will take our Social Security numbers off of our Medicare cards.

I know – You’re right. It is about time, because a lot of us have been complaining about this for YEARS. How can you, Federal Government, beat us up about Medicare/consumer fraud and abuse, while spewing our Social Security numbers hither and yon? Answer: Logic is another thing that we’ll just step around.

Besides, our Social Security numbers weren’t really Social Security numbers when they appeared on our Medicare cards. They were actually Health Insurance Claim Numbers (HICN). We just thought that they were our Social Security numbers. Alas.

So, CMS would use our SSN-based HICN’s (Stay with me – this was your idea.) to do business with folks like Social Security, the Railroad Retirement Board, State Medicaid agencies, health care providers and health plans (think, health insurance), so our SSNs (Sorry, HICNs) have been orbiting several galaxies, while we conscientiously shredded our old Christmas cards, in order to protect ourselves from identity theft. Go figure.

Anyway, what’s going to happen is that CMS is developing a shiny, new “Medicare Beneficiary Identifier (MBI),” that will be 11 characters in length and made up of only numbers and uppercase letters (no “special characters” for the password wonks among us).

Said MBIs will kick in by April of 2018, when we’ll start getting new Medicare cards with our new MBIs; apparently, there’s going to be a “transition period” that will run from April, 2018, through December, 2019, when either the HICN or MBI will work.

I can only imagine (well, I probably CAN’T imagine!) the chaos this will cause for multitudes of computer systems throughout the Medicare universe, who have been chugging along with our SSN’s – And, I suspect, we’ll hear more about that, but one crisis at a time.

The Christmas card-shredders among us are already thinking, “Wait a minute! For years, you’ve been warning us about deceptive sales crap that comes in the mail, looking very officil’ and, sometimes, even looking kinda like Medicare cards, and telling us to ignore it and shred it and generally ridicule it, and now you’re telling us that we’re going to get the real thing. How are we supposed to know?

Answer: I don’t know.

No, really. I don’t. If I knew, I’d tell you – And I’m guardedly certain (if not guardedly optimistic) that more will be revealed on that aspect of the SSNRI (it’s OK to look back and review) roll-out, but somethingwill have to be done in order for us to effectively differentiate between the crap and the card (…oops…MBI).

In fairness, do I think this is a good idea? YES! I think it was a good idea 30 years ago, but here we are, so…And, NO: This will NOT change your Medicare benefits – only your Medicare number.

Yes, I know you’re going to forget about this, between now and then – I probably will, too. Will I remind you? Yes.

What do you need to do about this, between now and then? Nothing, except continue to try to be as prudent, discriminating and thoughtful as possible about how you handle — and distribute — your SSN, which is also your HICN.

A final, reasonable question would be, “Why does ‘government’ insist on generating and using these weird acronyms?” Probably the same reason that businesses, corporations, multi-nationals and financial institutions do. But that’s probably a rant for another day.

Here’s all you really need to know for today: In order to comply with MACRA, CMS is implementing the SSNRI and will replace your HICN with a MBI by 4/1/18.

I tried.

Mark Harvey is the director of Information and Assistance for Olympic Area Agency on Aging. He can be reached at or 532-0520 in Aberdeen, (360) 942-2177 in Raymond or (360) 642-3634. FACEBOOK: Olympic Area Agency on Aging-Information &Assistance.