A state Medicaid agency may request the following data, subject to procedural limitations:
- Medicare Parts A and B claims and Part D prescription drug event data.
- Medicare Parts A, B, C, and D eligibility and enrollment data.
- Assessments data, including Minimum Data Set (MDS), Outcome and Assessment Information Set (OASIS), Swing Bed, and Inpatient Rehabilitation Facility Patient Assessment Instrument (IRF-PAI).
- Medicare Provider and Analysis Review (MedPAR) and Medicaid Enrollee Supplemental File (MESF) data.
These data include summary files, which contain summary-level information on Medicare beneficiary demographics 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.Click to Learn More