The State Data Resource Center (SDRC) will outline approaches to identify inappropriate prescribing of opioids and related medications using available Medicare Part D PDE data in combination with Medicare Parts A and B data. We will provide an overview of the overdose crisis and its impact on Medicare and Medicaid, go over CMS’s response and action plan, and outline the analytical approach undertaken within Medicare to evaluate fraud, waste, and abuse analyses. A brief Q & A session will follow the presentation.

Calendar Year 2022 Medicare Parts A & B data from the CCW have been final-actioned and are now available for request.

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 (COBA) claims or a monthly feed of non-final action Part A and B claims.

• COBA claims data: shared as often as daily or weekly, with only a two-week maturity/processing lag time. Examples of how your state could utilize the enhanced COBA feed includes, but is not limited to, (1) perform analyses on patient- or provider-levels in real-time, and/or (2) analyze aberrant utilization and/or billing patterns.
• non-final action Part A and B claims data: shared monthly, with only a three-month lag time from the month of service. Examples of how your state could utilize the non-final action Part A and B claims includes, but is not limited to, (1) analyze, monitor, and provide feedback related to care coordination and/or program integrity, (2) analyze patient- or provider-levels on a monthly basis, and/or (3) analyze aberrant utilization and/or billing patterns on a monthly basis.

The SDRC welcomes you to a webinar hosted by the state of Connecticut to learn about their recent research on racial and ethnic disparities in hospice use among Medicaid-only and dually eligible beneficiaries. In this webinar, the state will present background on their research; detail their methodology; present their findings, including descriptive statistics and findings from logistic regression models; and highlight the implications of their research. A brief Q & A session will follow the presentation.

Calendar Year 2021 Medicare Parts A & B data from the CCW have been final-actioned and are now available for request.