Issued by: Centers for Medicare & Medicaid Services (CMS)

Issue Date: November 26, 2014

Program Area: Distributed Data Collection (DDC) for RA Including HCRP/EDGE Server

Question: What format should issuers use for the masked Unique Enrollee ID?

Answer: The requirements for enrollee IDs submitted to the EDGE server are defined in 45 CFR 153.720. This regulation states the issuer must establish a unique masked enrollee identification number for each enrollee. The Interface Control Document (ICD) further clarifies that this number cannot be a medical record number or cardholder ID number. Issuers must establish their own method of de-identifying an enrollee ID. Also, please note that issuers must use the same Unique Enrollee ID if the enrollee switches plans within the issuer. Issuers may use an existing internal ID provided the ID was not used for exchange enrollment transaction or on the enrollee membership cards. Additionally, the ID should not include other knowable IDs such as the Social Security Number (SSN) and driver's license number.

HHS is committed to making its websites and documents accessible to the widest possible audience, including individuals with disabilities. We are in the process of retroactively making some documents accessible. If you need assistance accessing an accessible version of this document, please reach out to the guidance@hhs.gov.

DISCLAIMER: The contents of this database lack the force and effect of law, except as authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically incorporated into a contract. The Department may not cite, use, or rely on any guidance that is not posted on the guidance repository, except to establish historical facts.