Sneak Preview: HHS To Assist States in Submitting T-MSIS Data

January 19, 2018 | By Jerry Ashworth | Post a Comment

xgran_bookshot(The following was excerpted from a recent article in the Federal Grants Management Handbook.) Department of Health and Human Services (HHS) officials said they are taking measures to help states submit compete Transformed Medicaid Statistical Information System (T-MSIS) data that will enable the Centers for Medicare and Medicaid Services (CMS) to better oversee state programs, in response to a recent recommendation by the Government Accountability Office (GAO).

Data that states report to CMS often originate from states’ Medicaid Management Information Systems, which are claims processing and information retrieval systems that support the administration of the program. For expenditure and utilization data that can be linked to individual enrollees, states historically submitted data into CMS’ Medicaid Statistical Information System (MSIS). However, GAO and the HHS Office of Inspector General reported on insufficiencies in available MSIS Medicaid data that have affected CMS’ ability to ensure proper payments and beneficiaries’ access to care.

To address the need for improved Medicaid data, CMS launched T-MSIS in 2011 to replace MSIS and improve its collection of Medicaid expenditure and utilization data. CMS said T-MSIS would provide a national data repository that would support federal and state program management, financial management and program integrity activities, among other functions. Although CMS earlier last year had expected all states to be submitting T-MSIS claims data by the end of 2016, only 18 states were doing so in November 2016. However, GAO found that 49 states were reporting T-MSIS data as of November 2017.

GAO reviewed how well states were handling the T-MSIS implementation process and assessed how CMS planned to use the T-MSIS data. After evaluating the experiences of eight surveyed states, GAO found that mapping the data — the process by which states convert their data to the T-MSIS format on an element-by-element basis — was the primary challenge these states faced in reporting T-MSIS data. In some cases, before converting their data to the T-MSIS format, states had to obtain data they had not previously collected. For example, Minnesota had to begin collecting information on denied claims from managed care organizations, while Utah had to collect third-party liability information from other state agencies.

(The full version of this story has now been made available to all for a limited time on Thompson’s Grants Compliance Expert site.)

As a reminder, we have all of our Federal Funding Training Forums scheduled for 2018. Please let me know if you have questions or can make any of these. We hope to see you there!

  • Wednesday Feb 7 – Friday Feb 9 in PHOENIX

  • Wednesday May 1 – Friday May 4 in ST LOUIS

  • Wednesday July 25 – Friday July 27 in MINNEAPOLIS

  • Wednesday October 17 – Friday October 19 in ATLANTA


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