CMS-1409S (0938-1197).Justification of Non-substantive Change

Non-substantive Change Request for 0938-1197

Background

Since the inception of the Medicare program in 1965, CMS and its program stakeholders [e.g., health care providers, Social Security Administration (SSA), Railroad Retirement Board (RRB), State Medicaid programs, payers, and researchers] have used a Social Security Number (SSN)- based identifier when filing and processing all Medicare claims and when exchanging data related to the Medicare program. This identifier, referred to as the Health Insurance Claim Number (HICN), is displayed on beneficiaries’ Medicare cards and consists of an individual’s SSN along with a supplemental code.

On April 16, 2015, President Obama signed the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015. Section 501 of this legislation prohibits inclusion of SSNs on Medicare cards and specifically states that “The Secretary of Health and Human Services, in consultation with the Commissioner of Social Security, shall establish cost-effective procedures to ensure that a Social Security account number (or derivative thereof) is not displayed, coded, or embedded on the Medicare card issued to an individual who is entitled to benefits under part A of title XVIII or enrolled under part B of title XVIII and that any other identifier displayed on such card is not identifiable as a Social Security account number (or derivative thereof).”

MACRA requires CMS to remove SSNs from all Medicare cards by April 2019. A new randomly generated Medicare Beneficiary Identifier (MBI) will replace the SSN-based HICN on the new Medicare cards for Medicare transactions like billing, eligibility status, and claim status.

Changes to the Form CMS-1490S

CMS Number	Location of Change to Form	Description of Change
CMS 1490S	Page 1, Section1, Block 2: Print your Health Insurance Claim Number including the letter at the end exactly as it is shown on your Medicare card.	The term “Health Insurance Claim Number” was replaced with the term “Medicare Number.”
CMS 1490S	Page 6, Section 1:  Print your Health Insurance Claim Number including the letter at the end	The instructions were revised to state “Print your Medicare Number exactly as it is shown on the Medicare card.”
CMS 1490S	With one exception, which is discussed below, there are no penalties under Social Security law for refusing to supply information. However, failure to furnish information regarding the medical services rendered or the amount charged would prevent payment of the claim. Failure to furnish any other information, such as name or claim number, would delay payment of the claim.	The term “Claim Number” was replaced with “name or Medicare number.”