02
jun
2023
The SDRC welcomes you to a webinar to learn about the data request process in collaboration with Indiana Family and Social Services Administration and Minnesota Department of Human Services. In this presentation, we will provide answers to recent data request questions, provide the steps necessary to complete a new or additional data request as well as update your data request. Two panel discussions and Q&A periods will occur with agencies to discuss their experiences with data requests. A list of helpful resources will be provided, and a brief Q & A session will follow the presentation. This webinar is intended for both current Medicare data users and prospective states/territories interested in requesting Medicare claims or events data.
For more information, please contact SDRC via the support line (888) 805-5228 or email SDRC@AcumenLLC.com.
03
may
2023
Calendar Year 2021 Medicare Parts A & B data from the CCW have been final-actioned and are now available for request.
04
apr
2023
The State Data Resource Center (SDRC) will outline approaches using available CMS Minimum Data Set 3.0 (MDS) data in combination with Medicare Parts A, B, and D data to identify inappropriate use of antipsychotic medications and related diagnoses (e.g., schizophrenia) in nursing facilities for dually eligible beneficiaries. We will describe the related background, review the Medicare datasets, and outline the analytical approach Medicaid agencies can take to perform this type of anti-fraud, waste, and abuse investigation. A brief Q & A session will follow the presentation.
16
mar
2023
The SDRC will host a webinar on linking various data to SDRC-available Medicare data. In this webinar, we will provide answers to recent data linking questions, examine the utilization of CCW crosswalk files for linking data, provide sample codes in various languages that can be used to link data, and present a case study on how linked data can be used to investigate trends in diabetes treatment and monitoring among your dually eligible population. A brief Q & A session will follow the presentation.
22
Feb
2023
The State Data Resource Center (SDRC) and the Centers for Medicare & Medicaid Services’ (CMS) Center for Program Integrity are hosting a program integrity virtual “open house” for the first time! We are inviting Medicaid agencies who have not previously requested Medicare data for anti-fraud, waste, and abuse activities. During this hour, SDRC will provide a high-level summary of our program integrity process and leave ample time for you to ask us questions on the process, brainstorm potential data uses, and interact with your colleagues across the United States.
This Zoom session will be on Thursday, March 2 at 3pm ET. We look forward to meeting you virtually!
01
JUN
2022
Calendar Year 2020 Medicare Parts A & B data from the CCW have been final-actioned and are now available for request.
03
MAY
2022
The Centers for Medicare & Medicaid Services (CMS) makes real-time Medicare fee-for-service (FFS) data available through the State Data Resource Center (SDRC), free of charge! States can choose to receive a secondary, enhanced feed of Coordination of Benefits Agreement (eCOBA) claims or a monthly feed of non-final action Part A and B claims.
07
NOV
2021
On, November 2, 2021, CMS issued a memorandum to Medicare Advantage and Prescription Drug Plans to provide information about enrollment and disenrollment for individuals who are incarcerated or not lawfully present in the United States. On June 26, 2022, CMS plans to disenroll individuals in accordance with eligibility requirements codified in 42 CFR §§ 417.422, 422.50,and 423.30.
States will see these changes in the CMS MMA or TBQ response file they receive after that date. States that have programs to align Medicaid with Medicare plan enrollment for dually eligible individuals may want to review CMS data for Medicare plan disenrollment, and going forward, for Medicare eligibility status on incarceration and lawful presence. Key fields within the CMS response file include:
States can find the fields on the MMA Response File Detail layout in section 7.5 of the MAPD State User Guide (SUG):
Disenrollment from Medicare plans
Change in Medicare plan eligibility status
States can find the fields on the TBQ Response File Detailfile layout, section 11.3 of the MAPD State User Guide (SUG):
Disenrollment from Medicare plans
Change in Medicare plan eligibility status
06
AUG
2021
The updated Medicare-Medicaid Linked Enrollee Analytic Data Source (MMLEADS), using 2016 data, is available in the Chronic Condition Warehouse (CCW).
MMLEADS is an individual-level dataset that integrates Medicare and Medicaid data on enrollment, eligibility, service utilization, and expenditures. All MMLEADS files in the updated version are person-level summary files. Further information on MMLEADS is available at https://resdac.org/cms-data/files/mmleads-3 and updated data documentation is available at the below links.
MMLEADS data files will remain available for calendar years (CYs) 2006-2012. As a result of the change in file structure and states transitioning from MSIS to T-MSIS over time, MMLEADS data are not available for 2013-2015. CMS intends to continue updates and further enhancements to MMLEADS as data become available for subsequent years. The 2016 MMLEADS Public Use File (PUF) will be made available on the CMS website at a future date.
07
APR
2021
To identify via Medicare claims data those dually eligible individuals with COVID-19 vaccination billed to Medicare within your state, please use the following steps.
For enhanced Coordination of Benefits Agreement (eCOBA) file:
Please use the above HCPCS codes to identify the COVID-19 vaccine claims within your eCOBA file (Medicaid COBA ID range 79000-7999; Medicaid MCO COBA ID range 77000-78999).
For Monthly Part A and B data set:
HCPCS Code(s) (Vaccine Code
Vaccine Administration Codes
Manufacturer
Vaccine Names
NDC 10/NCD11 Codes
91300 0001A(1st Dose)
Pfizer, Inc
Pfizer-BioNTech
COVID-19Vaccine
59267-1000-159267-1000-01
91300 0002A(2nd Dose)
Pfizer, Inc
Pfizer-BioNTech
COVID-19Vaccine
59267-1000-159267-1000-01
91301 0011A(1st Dose)
Moderna, Inc
Moderna
COVID-19Vaccine
80777-273-10 80777-0273-10
91301 0012A(2nd Dose)
Moderna, Inc
Moderna
COVID-19Vaccine
80777-273-10 80777-0273-10
91302 0021A(1st Dose)
AstraZeneca
AstraZeneca
COVID-19Vaccine
0310-1222-1000310-1222-10
91301 0022A(2nd Dose)
AstraZeneca
AstraZeneca
COVID-19Vaccine
0310-1222-1000310-1222-10
91303 0031A (Single Dose)
Johnson & Johnson
Johnson & Johnson
COVID-19Vaccine
59676-580-0559676-0580-05
Reference: https://www.ama-assn.org/find-covid-19-vaccine-codes
Note: This Medicare COVID-19 vaccination data only applies to those dually eligible beneficiaries for whom Medicare received and adjudicated a claim. This data does not include any dually eligible beneficiary who received a COVID-19 vaccination that was not billed to Medicare.
If your state currently does not receive either of the files discussed above, but are interested in receiving these data sets, please contact the SDRC.
23
DEC
2019
On Friday, December 13, 2019, the Centers for Medicare & Medicaid Services (CMS) released a draft Manual for State Payment of Medicare Premiums (formerly called “State Buy-in Manual”) to states and other stakeholders for review and comment. The manual update is part of CMS’ Better Care for Dual Eligible Individuals Strategic Initiative aimed at improving quality, reducing costs, and improving customer experiences. The draft manual and instructions for commenting are available at: https://www.cms.gov/medicare-medicaid-coordination/medicare-medicaid-coordination-office/state-payment-medicare-premiums.
We are welcoming comments through 5:00 p.m. EST on Saturday, February 29, 2020.
27
NOV
2023
Please be advised that starting from Sunday November 26, 2023, CMS will experience a temporary delay in processing of State MMA files. MMA processing is expected to resume by 6:00AM ET on Tuesday, November 28, 2023 at which time any MMA response files will be sent.
Visit the MAPD Help Desk Web site to find useful information about the MAPD Program, including FAQs, System Announcements, User Guide, and Plan Connectivity Instructions.
Please call 1-800-927-8069 or email the MAPD Help Desk at MAPDHelp@cms.hhs.gov with any questions or concerns.
MAPD Help Desk hours of operation are Monday – Friday, 8:00AM to 6:00 PM ET
13
NOV
2023
Please be advised that starting from Saturday November 11, 2023, CMS will experience a temporary delay in processing of State MMA files. MMA processing is expected to resume by 6:00AM ET on ** Thursday, November 16, 2023 at which time any MMA response files will be sent.
Visit the MAPD Help Desk Web site to find useful information about the MAPD Program, including FAQs, System Announcements, User Guide, and Plan Connectivity Instructions.
Please call 1-800-927-8069 or email the MAPD Help Desk at MAPDHelp@cms.hhs.gov with any questions or concerns.
MAPD Help Desk hours of operation are Monday – Friday, 8:00AM to 6:00 PM ET
03
Feb
2023
Please be advised that as of 2:30am ET on Saturday, February 4, 2023, CMS will experience a temporary delay in processing of State MMA files. MMA processing is expected to resume by 10:00AM ET on Tuesday, February 7, 2023 at which time any MMA response files will be sent.
Visit the MAPD Help Desk Web site to find useful information about the MAPD Program, including FAQs, System Announcements, User Guide, and Plan Connectivity Instructions.
Please call 1-800-927-8069 or email the MAPD Help Desk at MAPDHelp@cms.hhs.gov with any questions or concerns.
MAPD Help Desk hours of operation are Monday – Friday, 8:00AM to 6:00 PM ET
30
NOV
2022
Please be advised that as of 2:30am ET on Friday, December 2, 2022, CMS will experience a temporary delay in processing of State MMA files. MMA processing is expected to resume by 10:00AM ET on Tuesday, December 6, 2022 at which time any MMA response files will be sent.
Visit the MAPD Help Desk Web site to find useful information about the MAPD Program, including FAQs, System Announcements, User Guide, and Plan Connectivity Instructions.
Please call 1-800-927-8069 or email the MAPD Help Desk at MAPDHelp@cms.hhs.gov with any questions or concerns.
MAPD Help Desk hours of operation are Monday – Friday, 8:00AM to 6:00 PM ET
17
NOV
2022
Please be advised that as of 2:30am ET on Friday, November 18, 2022, CMS will experience a temporary delay in processing of State MMA files. MMA processing is expected to resume by 6:00AM ET on Tuesday, November 21, 2022 at which time any MMA response files will be sent.
Visit the MAPD Help Desk Web site to find useful information about the MAPD Program, including FAQs, System Announcements, User Guide, and Plan Connectivity Instructions.
Please call 1-800-927-8069 or email the MAPD Help Desk at MAPDHelp@cms.hhs.gov with any questions or concerns.
MAPD Help Desk hours of operation are Monday – Friday, 8:00AM to 6:00 PM ET
04
NOV
2022
Please be advised that as of 9:00pm ET on Friday, November 4, 2022, CMS will experience a temporary delay in processing of State MMA files. MMA processing is expected to resume by 6:00AM ET on Saturday, November 12, 2022 at which time any MMA response files will be sent.
Visit the MAPD Help Desk Web site to find useful information about the MAPD Program, including FAQs, System Announcements, User Guide, and Plan Connectivity Instructions.
Please call 1-800-927-8069 or email the MAPD Help Desk at MAPDHelp@cms.hhs.gov with any questions or concerns.
MAPD Help Desk hours of operation are Monday – Friday, 8:00AM to 6:00 PM ET
27
oct
2022
Please be advised that as of 2:30am ET on Saturday, October 29, 2022, CMS will experience a temporary delay in processing of State MMA files. MMA processing is expected to resume by 6:00AM ET on Tuesday, November 1, 2022 at which time any MMA response files will be sent.
Visit the MAPD Help Desk Web site to find useful information about the MAPD Program, including FAQs, System Announcements, User Guide, and Plan Connectivity Instructions.
Please call 1-800-927-8069 or email the MAPD Help Desk at MAPDHelp@cms.hhs.gov with any questions or concerns.
MAPD Help Desk hours of operation are Monday – Friday, 8:00AM to 6:00 PM ET
18
OCT
2022
On August 12, 2022, the Centers for Medicare and Medicaid Services (CMS) distributed a Medicare Advantage Prescription Drug (MAPD) Help Desk email advising if a beneficiary states they have been incorrectly disenrolled due to Incarceration or Not Lawfully present status, the Plan should refer the beneficiary to the Social Security Administration (SSA) to correct the information in their systems. If the Medicare Advantage Prescription Drug System (MARx) shows that the beneficiary has an open-ended period of Incarceration, an open-ended period of Not Lawfully Present period, or the dates are incorrect, the beneficiary must contact SSA. Plans should only contact the MAPD Help Desk if SSA indicates that the data has already been corrected, MARx has the correct dates on file, or if there is an end date and the Plan is not able to reinstate the beneficiary. All other inquiries to the MAPD Help Desk will be provided a response to contact SSA.
CMS has been receiving several tickets regarding Plans seeing disenrollment actions for periods prior to January 1, 2019. When this change was implemented on June 26, 2022, CMS communicated that periods prior to January 1, 2019, would not be affected. An email communication about this issue was sent stating CMS identified some periods prior to January 1, 2019, that were processed and has corrected most of these enrollments. However, for periods sent after June 26, 2022, if SSA does send CMS a period of Incarceration or Not Lawfully Present that is prior to January 1, 2019, MARx will take the appropriate disenrollment action.
CMS also wants Plans to know that SSA only sends CMS Incarceration data once a month. Any recent changes by SSA will require a month for CMS to receive the changes; however, CMS receives Not Lawfully Present data daily. Plans should check on beneficiaries with a Not Lawful status frequently to see if they are eligible to be re-enrolled.
Visit the MAPD Help Desk Web site to find useful information about the MAPD Program, including FAQs, System Announcements, User Guide, and Plan Connectivity Instructions.
Please call 1-800-927-8069 or email the MAPD Help Desk at MAPDHelp@cms.hhs.gov with any questions or concerns.
MAPD Help Desk hours of operation are Monday – Friday, 8:00AM to 6:00 PM ET
05
oct
2022
Please be advised that as of 2:30am ET on Saturday, October 8, 2022, CMS will experience a temporary delay in processing of State MMA files. MMA processing is expected to resume by 10:00AM ET on Tuesday, October 11, 2022 at which time any MMA response files will be sent.
Visit the MAPD Help Desk Web site to find useful information about the MAPD Program, including FAQs, System Announcements, User Guide, and Plan Connectivity Instructions.
Please call 1-800-927-8069 or email the MAPD Help Desk at MAPDHelp@cms.hhs.gov with any questions or concerns.
MAPD Help Desk hours of operation are Monday – Friday, 8:00AM to 6:00 PM ET
03
OCT
2022
The Centers for Medicare & Medicaid (CMS) provides updates to Medicaid agencies when there will be delays in the processing of the MMA Response File. The best way to ensure your Medicaid agency is receiving the state/territory file suspension notices is to ensure that the appropriate staff have a state/territory role in the CMS Identity Management System (IDM) with a current email address.
To add a state/territory role in IDM, refer to the instructions in the MAPD State User Guide (SUG), Section 2 [“Medicare Advantage Prescription Drug User Interface (MARx UI) System)” Sub-section 2.1.1 [“Register in IDM”].
The attached image provides an example of what your Medicaid agency can expect to see in the State/Territory File Processing Suspension notification emails.
03
OCT
2022
The Centers for Medicare & Medicaid (CMS) provides multiple notifications to ensure your Medicaid agency is kept up to date on the status of your MMA file submissions.
CMS sends notifications like the one attached to your Medicaid agency each time an MMA Request file is submitted. These notifications provide important information regarding the status of the submitted request file.
If you are not receiving these notifications, please submit a ticket to the MAPD Help Desk at 1-800-927-8069 or MAPDHelp@cms.hhs.gov. In that ticket, please include:
We strongly suggest that the Medicaid agency consider creating a shared email address mailbox versus individual staff emails (e.g., MMAteam-recipient@statename.gov) to receive the notifications.
The attached image is an example of what your Medicaid agency can expect to see in the notification emails.
30
sep
2022
Please be advised that as of 2:30 AM ET on Saturday, October 1, 2022, CMS experienced a temporary delay in processing of State MMA files. MMA processing is expected to resume by 10:00AM ET on Tuesday, October 4, 2022 at which time any MMA response file will be sent.
Visit the MAPD Help Desk Web site to find useful information about the MAPD Program, including FAQs, System Announcements, User Guide, and Plan Connectivity Instructions.
Please call 1-800-927-8069 or email the MAPD Help Desk at MAPDHelp@cms.hhs.gov with any questions or concerns.
MAPD Help Desk hours of operation are Monday – Friday, 8:00AM to 6:00 PM ET
22
sep
2022
Please be advised that as of 4:00 PM ET on Friday, September 23, 2022, CMS will experience a temporary delay in processing of State MMA files. MMA processing is expected to resume by 6:00AM ET on Tuesday, September 27, 2022 at which time any MMA response files will be sent.
Visit the MAPD Help Desk Web site to find useful information about the MAPD Program, including FAQs, System Announcements, User Guide, and Plan Connectivity Instructions.
Please call 1-800-927-8069 or email the MAPD Help Desk at MAPDHelp@cms.hhs.gov with any questions or concerns.
MAPD Help Desk hours of operation are Monday – Friday, 8:00AM to 6:00 PM ET
01
sep
2022
Please be advised that as of 8:00 PM ET on Thursday, September 1, 2022, CMS will experience a temporary delay in processing of State MMA files. MMA processing is expected to resume by 6:00AM ET on Tuesday, September 6, 2022 at which time any MMA response files will be sent.
Visit the MAPD Help Desk Web site to find useful information about the MAPD Program, including FAQs, System Announcements, User Guide, and Plan Connectivity Instructions.
Please call 1-800-927-8069 or email the MAPD Help Desk at MAPDHelp@cms.hhs.gov with any questions or concerns.
MAPD Help Desk hours of operation are Monday – Friday, 8:00AM to 6:00 PM ET
24
may
2022
Please be advised that as of 8:00 PM ET on Friday, May 27, 2022, CMS will experienced a temporary delay in processing of State MMA files. MMA processing is expected to resume by 6:00AM ET on Tuesday, May 31, 2022 at which time any MMA response files will be sent.
Visit the MAPD Help Desk Web site to find useful information about the MAPD Program, including FAQs, System Announcements, User Guide, and Plan Connectivity Instructions.
Please call 1-800-927-8069 or email the MAPD Help Desk at MAPDHelp@cms.hhs.gov with any questions or concerns.
MAPD Help Desk hours of operation are Monday – Friday, 8:00AM to 6:00 PM ET
04
may
2022
Please be advised that as of 2:30AM ET on Saturday, May 7, 2022, CMS will experience a temporary delay in processing of State MMA files. MMA processing is expected to resume by 10:00AM ET on Monday, May 9, 2022 at which time any MMA response files will be sent.
Visit the MAPD Help Desk Web site to find useful information about the MAPD Program, including FAQs, System Announcements, User Guide, and Plan Connectivity Instructions.
Please call 1-800-927-8069 or email the MAPD Help Desk at MAPDHelp@cms.hhs.gov with any questions or concerns.
MAPD Help Desk hours of operation are Monday – Friday, 8:00AM to 6:00 PM ET
02
may
2022
Please be advised that as of 2:30 AM ET on Tuesday, May 3, 2022, CMS will experience a temporary delay in processing of State MMA files. MMA processing is expected to resume by 6:00AM ET on Wednesday, May 4, 2022 at which time any MMA response files will be sent.
Visit the MAPD Help Desk Web site to find useful information about the MAPD Program, including FAQs, System Announcements, User Guide, and Plan Connectivity Instructions.
Please call 1-800-927-8069 or email the MAPD Help Desk at MAPDHelp@cms.hhs.gov with any questions or concerns.
MAPD Help Desk hours of operation are Monday – Friday, 8:00AM to 6:00 PM ET
28
apr
2022
Please be advised that as of 2:30AM ET on Wednesday, April 27, 2022, CMS will experience a temporary delay in processing of State MMA files. MMA processing is expected to resume by 10:00AM ET on Friday, April 29, 2022 at which time any MMA response files will be sent.
Visit the MAPD Help Desk Web site to find useful information about the MAPD Program, including FAQs, System Announcements, User Guide, and Plan Connectivity Instructions.
Please call 1-800-927-8069 or email the MAPD Help Desk at MAPDHelp@cms.hhs.gov with any questions or concerns.
MAPD Help Desk hours of operation are Monday – Friday, 8:00AM to 6:00 PM ET
The State Data Resource Center (SDRC) website was established to facilitate state access to, and use of, Medicare data for Medicare-Medicaid care coordination and program integrity.
Attention
You are leaving the SDRC Public website and are being redirected to the new SDRC Portal website, where you can submit and track data requests, ask questions, and access SDRC resources. You will need a username and password to log into the SDRC Portal. If you are Medicaid agency staff and/or associated downstream user who would like access, please contact the SDRC Support Team for more information.
