Data Breach Affects Nearly One Million Medicare Beneficiaries—What You Need to Know
In May 2023, the Wisconsin Physicians Service Insurance Corporation (WPS), a contractor for the Centers for Medicare and Medicaid Services (CMS) that handles Medicare Part A and B claims, experienced a significant data breach. The breach impacted approximately one million Medicare beneficiaries, prompting CMS to issue new Medicare Beneficiary Identifiers (MBIs) and Medicare cards to those affected.
As an agent, it’s essential to contact clients who may be impacted by this breach to help minimize any disruptions to their healthcare coverage and enrollment processes.
Who Is Affected and What Should You Do?
CMS became aware of the breach in July 2023, and it is believed to have affected up to 946,802 Medicare beneficiaries, primarily in Indiana, Iowa, Kansas, Michigan, Missouri, and Nebraska. If your clients have received care in these states, they may also be impacted.
The affected clients should have received, or will soon receive, a letter from CMS detailing the breach and their new MBI. They should also expect a new Medicare card to be mailed to them. CMS began processing these new MBIs in October 2024. Connect with your clients to ensure they understand the importance of using their new MBI immediately to avoid delays in their healthcare services or claims processing.
How the MBI Change May Affect Clients
The MBI change can be confusing for clients and providers. Your clients must know their updated MBI, especially when applying for health coverage or visiting healthcare providers.
Without the updated MBI, insurance applications or claims could be rejected, and delays in claims processing or eligibility verification are possible. This can cause frustration and delays in healthcare access. If clients experience issues—such as denied claims or coverage problems—it’s important to offer assistance in resolving the situation.
What Agents Should Do Next
First, check with your clients to see if they’ve received a letter or a new MBI and Medicare card. If they have, they must follow the instructions in the letter, which include:
- Following any directions for using the new card
- Discarding their old Medicare card
- Notifying their healthcare providers of the new MBI
Beneficiaries should use their new MBI when completing enrollment applications to avoid processing delays. Although some carriers will automatically update their records with the new MBI, it’s still a good idea for your clients to confirm the update with their carrier directly.
How to Protect Your Clients from Potential Risks
Due to the data breach, WPS offers affected individuals free 12-month credit monitoring services through Experian. Additionally, under federal law, your clients are entitled to one free credit report per year from the three major credit reporting agencies: Equifax, Experian, and TransUnion.
These resources can help your clients safeguard their personal information and provide peace of mind regarding the breach. Be sure to inform them about these services to help them stay vigilant against potential identity theft or fraudulent activity.
By staying proactive and supportive, you can help your clients navigate this challenging situation and ensure their healthcare coverage remains uninterrupted.
Contact the UIG Brokerage Team for more information or additional questions.
