Lose the Social Security Number on Medicare Cards, Congress Tells HHS

Fri, May 15, 2015 --

Coding Updates

MACRA bill contains identity theft prevention provision.

One consequence of the recently signed “doc fix” bill, more officially known as the Medicare Access and CHIP Reauthorization Act of 2015, or MACRA, is that you’re likely to see fewer Social Security numbers on your patients’ Medicare cards by 2019. The bill directs the Department of Health and Human Services (HHS) to issue new Medicare cards on which the Social Security account number “is not displayed, coded, or embedded.”

Lose the Social Security Number on Medicare Cards, Congress Tells HHS

With the rise of identity theft, most private health insurance companies abandoned the Social Security number (SSN) as a patient identifier years ago. Ironically, the federal government forbids private insurers from using the SSN on the cards they provide to people receiving contracted medical or drug benefits. But though officials from the Social Security Administration have decried the practice for years, HHS continues to use the SSN on the more than 50 million Medicare cards in use today.

The Medicare identification card change tucked into MACRA, which was signed into law by President Obama on April 16, has received minimal attention from most news outlets. The law provides $320 million over four years to pay for the change, with the money coming from the Medicare trust fund.

The New York Times reported that Medicare officials will replace the SSN on the Medicare card with a “randomly generated Medicare beneficiary identifier,” but no other details were available.

Action to Remove Social Security Numbers Was Bipartisan

Congress was motivated to enact this change as electronic health record use burgeons and hackers become more aggressive in stealing personal health information from insurers and health systems. Two Texas representatives, Sam Johnson, a Republican, and Lloyd Doggett, a Democrat, cosponsored section 501 of MACRA, formally titled Prohibition of Inclusion of Social Security Account Numbers on Medicare Cards.

“The fact that seniors are told they must carry their Medicare card with them — which clearly displays their Social Security numbers — makes no sense,” Johnson said. “If the Department of Defense can protect troops by stopping the issuance of ID cards with SSNs, we can certainly do the same for our seniors.”

“With identity thieves becoming more sophisticated, a little prevention can save a lot of heartache,” Doggett said.

Expect Change for New Recipients by 2019, Existing Medicare Beneficiaries by 2023

The bill gives HHS up to four years from the date of passage, or April 2019, to get the new identifiers on cards for new recipients. But you may not see replacement cards in the hands of existing Medicare beneficiaries until 2023, four years later.

In the next 10 years, 18 million people are expected to qualify for Medicare, bringing total enrollment in the program to 74 million people by 2025.

Congress and two presidential administrations have urged agencies to stop using Social Security numbers as identifiers since at least 2004. In 2008, Patrick O’Carroll, inspector general of the Social Security Administration, called for immediate action to remove the numbers from Medicare cards in 2008. That’s when the Departments of Defense and Veteran’s Affairs began removing Social Security numbers from their identification cards.


Susan taught health information and healthcare documentation at the community college level for more than 20 years. She has a special love for medical language and terminology. She is passionate about ensuring accurate patient healthcare documentation through education. She has a master's degree in healthcare administration, is a certified healthcare documentation specialist, and serves as immediate past president for the Association for Healthcare Documentation Integrity (AHDI).

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