All state Medicaid agencies and territory Medicaid agencies that participate in any of the following data sharing programs maintain a CMS Information Exchange Agreement (IEA) and a Data Request & Attestation (DRA) form. Please contact the SDRC Support Team to request the current version of your state or territory’s IEA or DRA.
The five data sharing programs available for request under this process are:
Data Request Process
CMS provides Medicaid agencies with multiple data exchanges and data sharing programs to support care coordination and program operations for people who are dually eligible for Medicare and Medicaid. For more information on these data sharing programs, download the slides below.
Data Sharing Agreements
SDRC has compiled a list of frequently asked questions (FAQs) on the data request process and data sharing agreements, including the IEA and DRA, which can be accessed via the link below.
Medicare-Medicaid Data Sharing Program Overview
Medicaid agencies can find additional information on available Medicare data in the following document: “Requesting and Using Medicare Data for Medicare-Medicaid Care Coordination and Program Integrity: An Overview.”
Medicare-Medicaid Data Sharing Program Request Process Timeline
SDRC has a defined process to help Medicaid agencies request Medicare data from CMS. Medicaid agencies can find additional information on how to request Medicare data in the “Data Request Process Timeline Flyer” available for download below.
In 2020, CMS developed a single streamlined request process for state Medicaid agencies to assist with the request of data for use in several programs for dually eligible beneficiaries. The data sharing agreement provides the opportunity to request certain elective data files as well as operational data exchanges. The elective data files available for request are those files shared under the Medicare-Medicaid Data Sharing Program, the Territory Beneficiary Query (TBQ) File, and the Enrollment Database (EDB) File. The available operational data exchanges are the State Buy-In File Exchange and the Medicare Modernization Act (MMA) File Exchange.
Under the Medicare-Medicaid Data Sharing Program, a state Medicaid agency can request historical Parts A and B data—including enrollment, claims, and assessments data (Minimum Data Set (MDS), Outcome and Assessment Information Set (OASIS), Swing Bed, and Inpatient Rehabilitation Facility Patient Assessment Instrument (IRF-PAI))—and Part D data (also known as Prescription Drug Event (PDE) data). Additionally, if the state Medicaid agency establishes a Coordination of Benefits Agreement (COBA) with CMS, daily or weekly feeds of current Parts A and B data are available.
To help state Medicaid agencies determine which forms are necessary to complete their request, SDRC has compiled request package files for the elective data files and published them below. (There are two major request types—New and Additional Data Use).
NOTE: The two major request types – New and Additional Data Use – are not applicable to the MMA File Exchange or the Buy-in File Exchange
New Use Request Package
Additional Data Use Request Package
New Use Request Package
Please note if the state Medicaid agency establishes a Coordination of Benefits Agreement (COBA) with CMS, daily or weekly feeds of current Parts A and B claims data are available.
New Use Request Package
Please note that the conflict of interest templates provided below are suggested guidelines for creating conflict of interest letters. The order and format of the information does not need to follow the template exactly; however, the templates do contain key information requirements, and any variation should be submitted for approval from MMCO and/ or CPI.
New Use Request Package
The State Data Resource Center (SDRC) website was established to facilitate state access to, and use of, Medicare data for Medicare-Medicaid care coordination and program integrity.
Attention
You are leaving the SDRC Public website and are being redirected to the new SDRC Portal website, where you can submit and track data requests, ask questions, and access SDRC resources. You will need a username and password to log into the SDRC Portal. If you are Medicaid agency staff and/or associated downstream user who would like access, please contact the SDRC Support Team for more information.
