Commonwealth of Massachusetts Executive Office of Health and Human Services Office of Medicaid 600 Washington Street Boston, MA 02111 www.mass.gov/masshealth MassHealth All Provider Bulletin 191 May 2009 TO: All Providers Participating in MassHealth FROM: Tom Dehner, Medicaid Director RE: New MassHealth Member ID Card Introduction Beginning in October 2008, as part of the preparation for the implementation of the NewMMIS, MassHealth began issuing new member identification numbers and new MassHealth cards to all MassHealth members to help address HIPAA (Health Insurance Portability and Accountability Act) privacy and security concerns. While some newly enrolled members continue to get the old card, beginning May 23, 2009, the new MassHealth card will be the only card that will be issued for any member. MassHealth has mailed approximately one million new cards to members and will complete the remainder of this mailing within the next few weeks. New Number, New Card Each new MassHealth card will display the member’s name and a new 12-digit identification (ID) number. The new member ID number will not be based on the member’s social security number. The new member ID number will remain the same no matter how many times the member receives a replacement card, moves to another residence, has a change in name or marital status, or has a gap in MassHealth coverage. Additionally, following the practice of other health-insurance plans, MassHealth cards will no longer be issued at the head-of-household level. MassHealth cards will list only one member per card. Please remember that a MassHealth card does not guarantee eligibility for services. You must continue to verify eligibility on the date of service. New Card and NewMMIS The new cards can be used immediately by MassHealth members. MassHealth providers have already begun to use the new MassHealth cards to verify eligibility. Beginning May 23, 2009, if you plan to use the Provider Online Service Center (POSC) to verify eligibility, you will be able to check eligibility only by using one of the following options: * the 12-digit ID that appears on the new MassHealth card; * the member’s social security number or other agency ID (old number that begins with an X or a Y); or * the member’s name, gender, and date of birth. For any electronic claims submitted to MassHealth beginning May 16, 2009, and for paper claims submitted to MassHealth beginning May 4, 2009, providers can use the 12-digit ID for billing purposes. New Card and POPS Providers billing through the Pharmacy Online Processing System (POPS) can use either the old or the new member ID number. Claims and prior-authorization requests not submitted through POPS will also require the use of the new 12-digit ID number. Old Number, Old Card If a member presents an old MassHealth card that has the old member ID, ask the member to bring the new MassHealth card for the next visit. However, you can verify the member’s eligibility on the POSC using the member’s social security number, other agency ID (old number that begins with an X or a Y), or name, gender, and date of birth. The process to replace or request a new MassHealth card has not changed. To help ensure that MassHealth members receive their new card, please remind members that they must call MassHealth Customer Service if they need to report an address change. Questions If you have any questions about the information in this bulletin, please contact MassHealth Customer Service at 1-800-841-2900 or e-mail your inquiry to providersupport@mahealth.net.