The CMS is getting to work on replacing Social Security numbers as identifiers for 150 million Medicare recipients, both living and dead.
By the end of 2019 the agency intends to use randomly generated identifiers instead of the health insurance claim number, composed of a Social Security number plus one or two letters. The proposed new ID will have seven numeric and four alphabetical characters.
This is happening because Congress, in the 2015 Medicare Access and CHIP Reauthorization Act, gave the CMS four years to issue cards to Medicare beneficiaries that don't have Social Security numbers printed on them. The provision is intended to make seniors less vulnerable to identity theft. Some industry stakeholders, however, are already griping that the way the Obama administration is carrying out the mandate will further stratify the flow of healthcare data.
The planned conversion requires reprogramming 75 complex legacy information technology systems that the CMS and its contractors use to process Medicare claims, according to the agency. It would also mean updating hundreds of thousands of private-sector computers that handle healthcare claims. The users will include hospitals, physician practices, claims clearinghouses, billing companies, post-acute providers and Medicare Advantage carriers.
A CMS spokesman said the agency would solicit input from the industry “at various points throughout the project to ensure a smooth transition that maintains beneficiaries' access to care while avoiding disruptions to the payment process.”
Finding the right approach to matching patients to their health information has been controversial for decades. Twenty years ago, Congress called for the creation of a national patient identifier—to be used by all payers, not only Medicare—in the Health Insurance Portability and Accountability Act.
But the Clinton administration blocked federal spending on the initiative because of privacy concerns, and Congress then passed a similar ban that still stands.