MMCO has established a free-of-charge process for state Medicaid agencies to request timely access to certain Medicare data to coordinate the care of Medicare-Medicaid enrollees and to help ensure the integrity of the state's Medicaid program.
A state Medicaid agency may request the following data, subject to procedural limitations:
These data include summary files, which contain summary-level information on Medicare beneficiary demographic and claims data, and claims/event/eligibility files, which contain information on the services paid for by Medicare as well as demographic and service-level identifiers. State Medicaid agencies can find additional information on Medicare data options for care coordination and program integrity in the document entitled, Requesting and Using Medicare Data for Medicare-Medicaid Care Coordination and Program Integrity: An Overview .
In addition to the document referenced above, there are a number of data resources available to state Medicaid agencies that explain the variables and layouts of these data. Learn More >
Additional information on coordinating care for Medicare-Medicaid enrollees can be found on the About Care Coordination for Medicare-Medicaid Enrollees page.
More information about CMS support of state program integrity activities can be found on the About Program Integrity page.