CMS Allows Partial Social Security Numbers on Future Reporting

In accordance with Section 204 of the Strengthening Medicare and Repaying Taxpayers Act of 2012 (SMART Act), the Centers for Medicare and Medicaid Services (CMS) has issued an Alert that allows Responsible Reporting Entities (RREs) to report partial Social Security numbers to CMS.

Specifically, effective January 5, 2015, when a Non-Group Health Plan (NGHP) cannot obtain Medicare beneficiaries Health Insurance Claim number (HICN) or full Social Security number (SSN), they may instead report the following information instead to enable CMS to properly identify a Medicare Beneficiary:

  • Last five digits of SSN
  • First initial
  • Surname
  • Date of Birth and
  • Gender

If NGHP RREs are unable to obtain or do not provide the HICN, full SSN, or any of the above listed data elements, they must document their attempts to obtain this information.


Leave a Reply

Your email address will not be published. Required fields are marked *