Express Scripts - Medicare Beneficiary Identifier and E1 transactions

Author: Erica Lawrence/Tuesday, March 27, 2018/Categories: APCI Choice

In adherence of the terms and conditions of your Provider Agreement with Express Scripts and to ensure our network pharmacies’ compliance with any guidance from Centers for Medicare and Medicaid Services (CMS) we are providing the following information. There is a new requirement for transition to Medicare Beneficiary Identifier (MBI) as it pertains to E1 transactions. It is advised that pharmacies test and be prepared to meet this requirement.

"The Medicare Access and CHIP Reauthorization Act (MACRA) of 2015 requires that Social Security Numbers (SSN) be removed from all Medicare cards by April 2019. The SSN-based Health Insurance Claim Number (HICN) will be replaced by the Medicare Beneficiary Identifier (MBI). More information about the New Medicare Card Project can be found at https://www.cms.gov/Medicare/New-Medicare-Card/index.html.

*Please see attached for more information*

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