In response to a May 2023 data breach, nearly one million Medicare beneficiaries are being issued new Medicare Beneficiary Identifiers (MBIs) and Medicare cards. This change may affect your clients’ healthcare coverage and enrollment applications. Here’s what you need to know to assist your clients with this transition.
What Occurred?
Between May 27 and May 31, 2023, a data breach at Wisconsin Physicians Service Insurance Corporation (WPS) potentially exposed the personal information of some Medicare beneficiaries. WPS, a contractor for the Centers for Medicare & Medicaid Services (CMS), manages Medicare Part A and B claims and related services. The breach occurred through a third-party software called MOVEit, which WPS used to transfer files.
The following information may have been compromised:
- Name
- Social Security Number or Taxpayer ID
- Date of Birth
- Mailing Address
- Gender
- Hospital Account Number
- Dates of Service
- Medicare Beneficiary Identifier (MBI) or Health Insurance Claim Number
WPS informed CMS of the incident on July 8, 2024, leading CMS to initiate the reissuing of MBIs and Medicare cards for impacted beneficiaries.
Who is Affected?
CMS reports that unauthorized access to personal data may have impacted 946,801 beneficiaries connected to the WPS breach. Although WPS doesn’t operate in Wisconsin, it processes Medicare claims for states like Indiana, Iowa, Kansas, Michigan, Missouri, and Nebraska. Beneficiaries living outside these areas may also be affected if they received services in these states.
Affected beneficiaries will receive a notification letter detailing the situation and their new MBI and Medicare card.
Timeline for New MBIs in 2024
Throughout October 2024, CMS has been processing the issuance of new MBIs. The effective date of the new MBIs will be provided in the notification letter, and clients should start using their new numbers immediately.
Potential Impacts of MBI Changes
Changing MBIs may create challenges for clients, agents, providers, and others involved. Clients should be aware of their new MBI to avoid issues when applying for health coverage or receiving care. Insurance applications and claims might be denied if the old MBI is used, which can create additional stress for everyone involved. Delays in claim processing and eligibility verification may occur as well.
Clients may reach out if their healthcare services aren't covered or if an insurance application is denied. Reassure them of your support and assistance. If an enrollment application includes an old MBI, the application may be held until the new MBI is provided. Some carriers may validate old MBIs through Medicare, but if unsuccessful, the client will be required to submit the new number within a specified timeframe. Failure to do so could lead to enrollment denial.
Steps for Agents
Advise your clients to watch for a letter from CMS regarding the data breach or their new MBI or Medicare card. They should follow CMS's instructions, including:
1. Reviewing the letter accompanying the new card.
2. Destroying their old Medicare card.
3. Informing their providers of the new Medicare number.
To prevent delays, new MBIs should be used on all enrollment applications. CMS will provide updated MBIs to some carriers, like Aetna, for current members, so no action may be required by beneficiaries for specific carriers. However, encourage your clients to actively manage their coverage to ensure a smooth transition.
In response to the data breach, WPS is offering affected clients 12 months of free credit monitoring through Experian. Additionally, U.S. citizens are entitled to one free credit report from each of the three major credit reporting agencies — Equifax, Experian, and TransUnion — every year. Make sure your affected clients are aware of these options. Knowing that personal information may have been exposed can be unsettling, and these precautions may help ease your clients' concerns.
For those affected by this change, the Medicare Resource Center is here to help. Whether you’re a beneficiary needing guidance on your new Medicare ID or an agent assisting clients through this transition, our team can provide the support and resources you need. Reach out to us for personalized assistance in understanding the updates and ensuring a smooth adjustment to the new Medicare Beneficiary Identifiers.