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June 9 -- The Centers for Medicare & Medicaid Services (CMS) invites comments to OMB by July 11, 2022 on the extension of Transformed—Medicaid Statistical Information System (T-MSIS).

The data reported in T-MSIS are used by federal, state, and local officials, as well as by private researchers and corporations to monitor past and projected future trends in the Medicaid program. The data provide the only national level information available on enrollees, beneficiaries, and expenditures. It also provides the only national level information available on Medicaid utilization. The information is the basis for analyses and for cost savings estimates for the Department's cost sharing legislative initiatives to Congress. The collected data are also crucial to our actuarial forecasts.
Current Data Collection Environment

Medicaid statistical information is enabled via the T-MSIS. States submit claims and eligibility data contained in the States' Medicaid Management Information System (MMIS) and ancillary systems. CMS applies data ingestion processes and data quality review checks, prior to making T-MSIS data available for review by stakeholders. Each state/territory/entity submit eight data files monthly. Over 5,184 files flow into CMS a year.

T-MSIS has identified data elements and file structures for eight T-MSIS files: provider, managed care plans, third party liability, eligibility, inpatient, outpatient, prescription, and long- term care.

Current Data Dissemination Environment

The Medicaid and CHIP Business Solution (MACBIS) which include T-MSIS replaced the now decommissioned MSIS. T-MSIS modernizes and enhances the way states will submit operational data about beneficiaries, providers, claims, and encounters and will be the foundation of a robust state and national analytic data infrastructure. T-MSIS is hosted in the cloud.

T-MSIS data are reviewed through two data quality methods. The first is the T-MSIS system business rules review, performed for each monthly data submission by the state, which displays the results of the basic edits and identifies the obvious errors as the data are processed. These errors are accessible to states through the T-MSIS operational dashboard. States are expected to proactively and continuously address errors identified by the system business rules review. The second method reviews each state’s data through inferential validation. Inferential validation looks at patterns in each state’s data and identifies “warnings” where data elements fall outside of a normal range. CMS is sharing these data quality results with states during meetings as part of its ongoing data quality monitoring efforts and expects states to make corrections to address identified issues.

Improvements Needed in Medicaid Statistical Reporting

As the Medicaid program has become more complex and Medicaid expenditures consume a greater proportion of State and Federal budgets, improvements in quality, detail, and timeliness of Medicaid statistical reporting have been required.

The enhanced data from T-MSIS supports improved program and financial management, provides for more robust evaluations of demonstration programs, enhances the ability to identify potential fraud, improve program efficiency, and reduces the number of duplicative data requests from states.

Quality: CMS has shifted its T-MSIS efforts to assessing and improving the quality of T-MSIS data. CMS is actively assessing and improving T-MSIS data quality, our priorities for data quality, and how we and other stakeholders will begin to make use of T-MSIS data.

The success of the T-MSIS hinges on the reliability of the data for making informed decisions. Before states were approved to submit T-MSIS data in production, their files underwent operational readiness testing to determine if the files were sufficiently complete and reliable. States also have access to the T-MSIS operations dashboard, which allows states to monitor T- MSIS file processing. Once in production, states can use the T-MSIS operations dashboard to check for and address T-MSIS data submission errors.

Detail: T-MSIS’ expanded data collection now includes: Provider Demographics, Managed Care plan data, and Third-Party Liability information. Furthermore, additional elements were added to existing eligibility and claims files.

Timeliness: T-MSIS data is submitted monthly. Monthly submissions will enhance the early detection of problems and current trending of data.

Summary of Changes: We adjusted our number of respondents from 55 to 54. This change accounts for the 51 States (includes DC), 2 territories (Puerto Rico and Virgin Islands) and 1 program entities (PA CHIP). Iowa CHIP, Wyoming CHIP and Montana TPA are no longer submitting separate CHIP data. The number of responses per respondent and the number of hours per response remain unchanged.

We added a T-MSIS Data Dictionary Valid Value List document. CMS collects valid values from various industry and government sources. This artifact will provide information about the list of valid values for several data elements in each file type.

T-MSIS webpage: https://www.medicaid.gov/medicaid/data-systems/macbis/transformed-medicaid-statistical-information-system-t-msis/index.html
T-MSIS submission to OMB: https://www.reginfo.gov/public/do/PRAViewICR?ref_nbr=202206-0938-014 Click IC List for data collection instruments, View Supporting Statement for technical documentation. Submit comments through this webpage.
FR notice inviting comments to OMB: https://www.federalregister.gov/d/2022-12386   
For AEA members wishing to submit comments, "A Primer on How to Respond to Calls for Comment on Federal Data Collections" is available at https://www.aeaweb.org/content/file?id=5806

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