Removal of Medicare Number from Reimbursement Checks

200 - Removal of Medicare Number from Reimbursement Checks (Rev. 21, Issued: 04-29-05; Effective: 10-01-05; Implementation: 10-03-05) Contractors (A/B MACS (A and B), A/B MACs (HHH) and DME MACs) shall stop printing the Medicare Number on reimbursement checks to Medicare beneficiaries. Reimbursement checks going to Medicare beneficiaries are subject to others (e.g. banks) seeing the Medicare Number. CMS has determined that there is no business reason for the Medicare Number to be printed on the reimbursement check to the beneficiary. Therefore, CMS is directing Medicare contractors to stop printing the Medicare Number on reimbursement checks to Medicare beneficiaries. This change in policy does not affect the use of the Medicare Number by Medicare contractors. The Medicare program uses the Medicare Number to meet administrative responsibilities to pay for health care and to operate the Medicare program. In performance of these duties, Medicare is required to protect individual privacy and confidentiality in accordance with applicable laws, including the Privacy Act of 1974 and the Privacy Rule of the Health Insurance Portability and Accountability Act of 1996 (HIPAA). Exhibit A - Freedom of Information Act Request Exhibit B - Summary Sheet for the CMS Monthly FOIA Report MAC/CENTRAL OFFICE COMPONENT SUMMARY SHEET FOR THE CMS MONTHLY FOIA REPORTS Data on this Summary Sheet is a summation of the data from all Forms CMS-632-FOI completed during the month. INSTRUCTIONS 1. Enter the month and year that this summary sheet covers. 2. Enter, in the applicable space, appropriate identifying information concerning your unit. 3. Enter the total number of 632s completed during the identified month. 4. Enter the number of times the 632s showed a request was closed by the cited action. 5. Enter the total of all staff hours used during the identified month. Use only whole numbers and fractions or decimals, e.g., 102 1/2 or 102.25, not 102 hours and fifteen minutes. 6. Enter the total of actual cost figures, based on the salaries of the staff involved. 7. Enter the total of copying charges. 8. Enter the mailing/postage costs. 9. Enter the total dollar amount of fees charged. This figure is not the same as actual costs. 10. Enter the total of all fees waived. (Unless the FOI Office, CMS has granted a waiver, this figure is a compilation of all fees which were waived because they were lower than CMS' $15.00 threshold). 11. Enter the name, office and address of the person who completed this summary sheet. 12. Enter the date the summary sheet was completed. PLEASE FILL OUT COMPLETELY 1. Month: ________________ Year: __________ MAC: __________________________________________________ CENTRAL OFFICE COMPONENT: _____________________________________________ Total 632s: _________________ Actions: ___________ Direct Reply (Records Sent) _____________ No Records Found ___________ Request Withdrawn _____________ Not FOIA ___________ Records Not Reasonably Described _____________ Subpoena Denial ___________ Fee Related Closure _____________ Other Staff Hours: ___________ Staff Charges: ____________ Copy Charges: ____________ Postage: ____________ Fees Charged: ____________ Fees Waived: ____________ Name/Phone: ____________________________________________ Office: _________________________________________________ Address: ________________________________________________ Date: __________ Exhibit C - Invoice of Fees for FOIA Services Exhibit E - “Medicare Authorization to Disclose Personal Health Information” form and “Information to Help You Fill Out the Medicare Authorization to Disclose Personal Health Information Form”