SDRC

State Data
Resource Center

Resources for States Integrating Medicare and Medicaid Data

Medicare-Medicaid Coordination Office-Advancing Care for People with Medicaid and Medicare

The Federal Coordinated Health Care Office (Medicare-Medicaid Coordination Office - MMCO) serves people who are enrolled in both Medicare and Medicaid. MMCO's goal is to make sure Medicare-Medicaid enrollees, also known as dual eligibles, have full access to seamless, high quality health care and to make the system as cost-effective as possible.

MMCO works with the Medicaid and Medicare programs, across Federal agencies, states agencies, and stakeholders to align and coordinate benefits between the two programs effectively and efficiently. MMCO partners with states to develop new care models and improve the way Medicare-Medicaid enrollees receive health care.

Medicare Data Available to States

State Medicaid Agencies may request timely access to certain Medicare data for Medicare-Medicaid enrollees to support care coordination. Having access to Medicare data is an essential tool for states seeking to coordinate care, improve quality, and control costs for dual eligible beneficiaries. Data that may be requested, subject to procedural limitations, are:

  • Medicare Parts A & B claims and Part D event data
  • Medicare Parts A, B, C, and D eligibility and enrollment data
  • Assessments data including MDS, OASIS, Swing Bed, and IRF-PAI

Additional information on the Medicare-Medicaid Coordination Office can be found on the Medicare-Medicaid Coordination Office website .

For background information on the Medicare data available to states for care coordination for Medicare-Medicaid enrollees, download the Access to Medicare Data to Coordinate Care for Dual Eligible Beneficiaries memorandum.

Additional information on Medicare data available to states for care coordination for Medicare-Medicaid enrollees can also be found at the Integrated Care Resource Center (ICRC) website .