The CMS has started making biweekly calls to state Medicaid agencies to ensure that their information technology systems are ready to handle the 60 million new identification cards the agency is preparing to send out to Medicare beneficiaries, including those dually eligible for both Medicaid and Medicare.
Under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), the CMS was required to stop using beneficiaries' Social Security numbers on their Medicare cards and replace them with a Medicare Beneficiary Identifier (MBI). As part of the effort, state Medicaid agencies will need to modify their IT systems to process crossover claims for dual-eligible beneficiaries. The CMS will begin issuing the new cards by early 2018.
Prior to the law, the U.S. Government Accountability Office and other agencies received continued calls to remove Social Security numbers from the cards to stop potential identity theft.
“In order for states to be fully compliant with this legislation and to continue critical data exchanges with the CMS, state Medicaid business processes and systems must be examined and necessary changes identified, developed, tested and implemented prior to the CMS assigning MBIs and distributing the new Medicare ID cards,” Vikki Wachino, the CMS Deputy Administrator and Director for the Center for Medicaid and CHIP Services said in a notice.
The bi-weekly calls will allow the agency to promptly communicate important guidance about necessary changes.
For states, the mandate represents an additional, unexpected cost. "Removing Social Security numbers from the ID cards is probably the right thing to do, but it just becomes one of a thousand different systems changes that states have to accommodate in order to make the whole thing work,” said Matt Salo, executive director of the National Association of Medicaid Directors. “Those changes take time and money and bandwidth.”
Exactly how much the new cards will cost states is unclear, in part because the CMS has not revealed all the requirements needed to make the change, according to Christopher Garrett, spokesman for the Maryland Department of Health and Mental Hygiene.
The Obama administration estimated that altering or removing the IDs' Social Security numbers would cost between $803 million and $845 million. Of that amount, between $512 million and $554 million would be needed to modify existing state Medicaid IT systems and CMS' IT-system, according to a 2012 GAO report.
The watchdog agency said it questioned that estimate because it was unclear what methodology was used to come up with the figures.