Medicare Data Request Process Overview

To acquire and use Centers of Medicare & Medicaid Services (CMS) data for Medicare-Medicaid care coordination or program integrity activities, state Medicaid agencies must first complete a data request package, then submit it to CMS for approval.

Request Process Overview

Data request processes vary according to the type of data requested; however, the approval process for data requests generally consists of the following four steps:

STEP 1

State develops a data request package with the support of the SDRC Team.

STEP 2

Medicare-Medicaid Coordination Office and/or Center for Program Integrity and Business Owner review the data request and determine whether it meets the care coordination and/or program integrity requirements.

STEP 3

A DRA number is assigned by CMS.*

*Not applicable to Coordination of Benefits Agreement requests.

STEP 4

Data distribution groups provide data to requestors.

Looking for more detailed information on this process?

State Medicaid agencies can find additional information on Medicare data options in the following document: Requesting and Using Medicare Data for Medicare-Medicaid Care Coordination and Program Integrity: An Overview.

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