Medicare Redesigns Claims and Benefits Statement to Empower Seniors with Clearer Information on Health Services Used

March 16, 2012

The Acting Administrator of the Centers for Medicare & Medicaid Services (CMS), Marilyn Tavenner, announced the redesign of the statement that informs Medicare beneficiaries about their claims for Medicare services and benefits. The announcement comes as a part of National Consumer Protection Week. The redesigned statement, known as the Medicare Summary Notice (MSN), will be available online and, starting in 2013, mailed out quarterly to beneficiaries.

This MSN redesign is part of a new initiative, "Your Medicare Information: Clearer, Simpler, At Your Fingertips," which aims to make Medicare information clearer, more accessible, and easier for beneficiaries and their caregivers to understand. CMS will take additional actions this year to make information about benefits, providers, and claims more accessible and easier to understand for seniors and people with disabilities who have Medicare.

The redesign of the MSN includes several features not currently available to Medicare beneficiaries with the current MSN:

• Clearer language, including consumer-friendly descriptions for medical procedures;
• Definitions of all terms used in the form;
• A clear notice on how to check the form for important facts and potential fraud;
• An easy-to-understand snapshot of the beneficiary's deductible status, a list of providers they saw, and whether their claims for Medicare services were approved.
• Larger fonts throughout to make it easier to read;
• Information on preventive services available to Medicare beneficiaries.

Starting later this week, the redesigned MSN will be available to beneficiaries on mymedicare.gov, Medicare's secure online service for personalized information regarding Medicare benefits and services; and, in early 2013, paper copies of the redesigned MSN will start to replace the current version being mailed.

To see a side-by-side comparison of the former and redesigned MSNs, please visit: http://www.cms.gov/apps/files/msn_changes.pdf

Of particular interest to health care providers and suppliers, the new MSN provides a 1-800 number to report instances of suspected fraud and indicates that tips received may lead to a financial reward to patients reporting cases of fraud. Therefore, providers and suppliers should closely evaluate the compliance measures in place, as incentivizing patients to file complaints will likely lead to increased claims scrutiny and may lead to increased auditing activity.

For more information on this issue, please contact Abby Pendleton or Jessica Gustafson at (248) 996-8510 or visit The HLP website at www.thehealthlawparters.com.