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values | col1 stringclasses 13
values | col2 stringclasses 121
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|---|---|---|---|---|---|---|---|---|---|---|---|---|
data | 41 | 22 | 42 | Pennsylvania | Claim Files Completeness | Benchmarking Inpatient Stays - IP | 2022 | Unclassified | Percent difference in adult inpatient hospital stays between the T-MSIS Analytic Files (TAF) and the Healthcare Cost and Utilization Project (HCUP) data | Missing benchmark data | TAF | Release 1 |
data | 41 | 77 | 42 | Pennsylvania | Expenditure Benchmarking | Total Medicaid Expenditures | 2022 | Low concern | Percent difference in total Medicaid expenditures for medical assistance programs between the T-MSIS Analytic Files (TAF) and the CMS-64 data | -0.3 | TAF | Release 1 |
data | 41 | 87 | 42 | Pennsylvania | Expenditure Benchmarking | Medicaid Beneficiary Expenditures | 2022 | Low concern | Percent difference in Medicaid beneficiary expenditures between the T-MSIS Analytic Files (TAF) and the CMS-64 data | 3.5 | TAF | Release 1 |
data | 41 | 67 | 42 | Pennsylvania | Expenditure Benchmarking | Total FFS Expenditures | 2022 | Medium concern | Percent difference in Medicaid fee-for-service (FFS) expenditures between the T-MSIS Analytic Files (TAF) and the CMS-64 data | -9.5 | TAF | Release 1 |
data | 41 | 68 | 42 | Pennsylvania | Expenditure Benchmarking | FFS Inpatient Expenditures | 2022 | Low concern | Percent difference in Medicaid fee-for-service (FFS) expenditures for inpatient hospital services between the T-MSIS Analytic Files (TAF) and the CMS-64 data | 2.6 | TAF | Release 1 |
data | 41 | 69 | 42 | Pennsylvania | Expenditure Benchmarking | FFS Long-Term Care Expenditures | 2022 | Medium concern | Percent difference in Medicaid fee-for-service (FFS) expenditures for institutional long-term care services between the T-MSIS Analytic Files (TAF) and the CMS-64 data | -8.2 | TAF | Release 1 |
data | 41 | 70 | 42 | Pennsylvania | Expenditure Benchmarking | FFS Other Medical Expenditures | 2022 | Medium concern | Percent difference in Medicaid fee-for-service (FFS) expenditures for all other medical services between the T-MSIS Analytic Files (TAF) and the CMS-64 data | -10.8 | TAF | Release 1 |
data | 41 | 71 | 42 | Pennsylvania | Expenditure Benchmarking | FFS Prescription Drug Expenditures | 2022 | Low concern | Percent difference in Medicaid fee-for-service (FFS) expenditures for prescription drugs between the T-MSIS Analytic Files (TAF) and the CMS-64 data | -1.2 | TAF | Release 1 |
data | 41 | 72 | 42 | Pennsylvania | Expenditure Benchmarking | Total Monthly Beneficiary Payments | 2022 | Medium concern | Percent difference in total monthly Medicaid beneficiary payments between the T-MSIS Analytic Files (TAF) and the CMS-64 data | 5.7 | TAF | Release 1 |
data | 41 | 73 | 42 | Pennsylvania | Expenditure Benchmarking | CMC Payments | 2022 | Low concern | Percent difference in comprehensive managed care (CMC) capitation payments between the T-MSIS Analytic Files (TAF) and the CMS-64 data | -1.1 | TAF | Release 1 |
data | 41 | 74 | 42 | Pennsylvania | Expenditure Benchmarking | PHP Payments | 2022 | Medium concern | Percent difference in prepaid health plan (PHP) capitation payments between the T-MSIS Analytic Files (TAF) and the CMS-64 data | -13.7 | TAF | Release 1 |
data | 41 | 75 | 42 | Pennsylvania | Expenditure Benchmarking | PCCM Fees | 2022 | Unclassified | Percent difference in primary care case management plan (PCCM) fees between the T-MSIS Analytic Files (TAF) and the CMS-64 data | Not applicable | TAF | Release 1 |
data | 41 | 76 | 42 | Pennsylvania | Expenditure Benchmarking | Premium Assistance Payments | 2022 | Unusable | Percent difference in premium assistance payments between the T-MSIS Analytic Files (TAF) and the CMS-64 data | 5,278.0 | TAF | Release 1 |
data | 41 | 66 | 42 | Pennsylvania | Payments | Missing Payment Data - FFS Claims | 2022 | Low concern | Percentage of fee-for-service (FFS) claims with a zero, missing, or negative payment amount in the T-MSIS Analytic Files (TAF) | 1.0 | TAF | Release 1 |
data | 41 | 86 | 42 | Pennsylvania | Payments | Missing Payment Data - Encounters | 2022 | Low concern | Percentage of managed care (MC) encounters with a zero, missing, or negative payment amount in the T-MSIS Analytic Files (TAF) | 3.6 | TAF | Release 1 |
data | 41 | 101 | 42 | Pennsylvania | Payments | Bundled Payments for Prenatal Care | 2022 | Medium concern | Percent of deliveries with bundled payment code including prenatal care in the T-MSIS Analytic Files (TAF) | 6.1 | TAF | Release 1 |
data | 41 | 81 | 42 | Pennsylvania | Payments | Payment Data Consistency - IP | 2022 | Medium concern | Multiple criteria: (1) Percentage of fee-for-service (FFS) inpatient (IP) claims with a header payment equal to the sum of its associated claim line payments and (2) percentage of IP claims with an unknown payment level in the T-MSIS Analytic Files (TAF) | See Background and Methods | TAF | Release 1 |
data | 41 | 80 | 42 | Pennsylvania | Payments | Payment Data Consistency - LT | 2022 | Medium concern | Multiple criteria: (1) Percentage of fee-for-service (FFS) long-term care (LT) claims with a header payment equal to the sum of its associated claim line payments and (2) percentage of LT claims with an unknown payment level in the T-MSIS Analytic Files (TAF) | See Background and Methods | TAF | Release 1 |
data | 41 | 79 | 42 | Pennsylvania | Payments | Payment Data Consistency - OT | 2022 | Low concern | Multiple criteria: (1) Percentage of fee-for-service (FFS) other service (OT) claims with a header payment equal to the sum of its associated claim line payments and (2) percentage of OT claims with an unknown payment level in the T-MSIS Analytic Files (TAF) | See Background and Methods | TAF | Release 1 |
data | 41 | 78 | 42 | Pennsylvania | Payments | Payment Data Consistency - RX | 2022 | Medium concern | Multiple criteria: (1) Percentage of fee-for-service (FFS) pharmacy (RX) claims with a header payment equal to the sum of its associated claim line payments and (2) percentage of RX claims with an unknown payment level in the T-MSIS Analytic Files (TAF) | See Background and Methods | TAF | Release 1 |
data | 41 | 111 | 42 | Pennsylvania | Financial Reporting | Category of Service Code - IP | 2022 | Low concern | Percentage of IP lines that have a category of service code consistent with program enrollment | 99.8 | TAF | Release 1 |
data | 41 | 112 | 42 | Pennsylvania | Financial Reporting | Category of Service Code - LT | 2022 | Low concern | Percentage of LT lines that have a category of service code consistent with program enrollment | 93.6 | TAF | Release 1 |
data | 41 | 113 | 42 | Pennsylvania | Financial Reporting | Category of Service Code - OT | 2022 | Medium concern | Percentage of OT lines that have a category of service code consistent with program enrollment | 87.6 | TAF | Release 1 |
data | 41 | 114 | 42 | Pennsylvania | Financial Reporting | Category of Service Code - RX | 2022 | Unusable | Percentage of RX lines that have a category of service code consistent with program enrollment | 1.9 | TAF | Release 1 |
data | 41 | 115 | 42 | Pennsylvania | Financial Reporting | Federal Reimbursement Category Code - IP | 2022 | Low concern | Percentage of IP lines that have a federal reimbursement category consistent with program enrollment | 99.9 | TAF | Release 1 |
data | 41 | 116 | 42 | Pennsylvania | Financial Reporting | Federal Reimbursement Category Code - LT | 2022 | Low concern | Percentage of LT lines that have a federal reimbursement category consistent with program enrollment | 100.0 | TAF | Release 1 |
data | 41 | 117 | 42 | Pennsylvania | Financial Reporting | Federal Reimbursement Category Code - OT | 2022 | Low concern | Percentage of OT lines that have a federal reimbursement category consistent with program enrollment | 97.0 | TAF | Release 1 |
data | 41 | 118 | 42 | Pennsylvania | Financial Reporting | Federal Reimbursement Category Code - RX | 2022 | Low concern | Percentage of RX lines that have a federal reimbursement category consistent with program enrollment | 99.4 | TAF | Release 1 |
data | 41 | 49 | 42 | Pennsylvania | Service Use Information | Diagnosis Code - IP | 2022 | Low concern | Percentage of inpatient (IP) header records with a valid ICD-10 primary diagnosis code in the T-MSIS Analytic Files (TAF) | 91.0 | TAF | Release 1 |
data | 41 | 50 | 42 | Pennsylvania | Service Use Information | Diagnosis Code - LT | 2022 | Low concern | Percentage of long-term care (LT) header records with a valid ICD-10 primary diagnosis code in the T-MSIS Analytic Files (TAF) | 93.4 | TAF | Release 1 |
data | 41 | 51 | 42 | Pennsylvania | Service Use Information | Diagnosis Code - OT | 2022 | Low concern | Percentage of other service (OT) header records for outpatient hospital services, physician services, or clinic services with a valid ICD-10 primary diagnosis code in the T-MSIS Analytic Files (TAF) | 97.2 | TAF | Release 1 |
data | 41 | 65 | 42 | Pennsylvania | Service Use Information | Procedure Codes - IP | 2022 | Low concern | Multiple criteria: (1) Percentage of inpatient (IP) header records with a missing primary procedure code, and (2) the percentage of IP header records with any invalid procedure codes in the T-MSIS Analytic Files (TAF) | See Background and Methods | TAF | Release 1 |
data | 41 | 63 | 42 | Pennsylvania | Service Use Information | Procedure Codes - OT Professional | 2022 | Low concern | Percentage of all other service (OT) professional claim line records with missing or invalid values in the procedure code field in the T-MSIS Analytic Files (TAF) | 5.0 | TAF | Release 1 |
data | 41 | 64 | 42 | Pennsylvania | Service Use Information | Procedure Codes - OT Institutional | 2022 | Low concern | Percentage of all other service (OT) institutional claim line records with missing or invalid values in the procedure code field in the T-MSIS Analytic Files (TAF) | 5.0 | TAF | Release 1 |
data | 41 | 52 | 42 | Pennsylvania | Service Use Information | Type of Service - IP | 2022 | Low concern | Percentage of inpatient (IP) claim line records with a missing or invalid type of service (TOS) code in the T-MSIS Analytic Files (TAF) | 0.0 | TAF | Release 1 |
data | 41 | 54 | 42 | Pennsylvania | Service Use Information | Type of Service - LT | 2022 | Low concern | Percentage of long-term care (LT) claim line records with a missing or invalid type of service (TOS) code in the T-MSIS Analytic Files (TAF) | 0.0 | TAF | Release 1 |
data | 41 | 53 | 42 | Pennsylvania | Service Use Information | Type of Service - OT | 2022 | Low concern | Percentage of other service (OT) claim line records with a missing or invalid type of service (TOS) code in the T-MSIS Analytic Files (TAF) | 0.3 | TAF | Release 1 |
data | 41 | 55 | 42 | Pennsylvania | Service Use Information | Type of Service - RX | 2022 | Low concern | Percentage of pharmacy (RX) claim line records with a missing or invalid type of service code (TOS) in the T-MSIS Analytic Files (TAF) | 0.0 | TAF | Release 1 |
data | 41 | 62 | 42 | Pennsylvania | Service Use Information | Place of Service | 2022 | Low concern | Percentage of all other service (OT) header records with the expected combination of type of bill (TOB) code and place of service code (POS) in the T-MSIS Analytic Files (TAF) | 95.3 | TAF | Release 1 |
data | 41 | 41 | 42 | Pennsylvania | Service Use Information | Admission Date - IP | 2022 | Low concern | Percentage of inpatient (IP) records with a missing or invalid admission date in the T-MSIS Analytic Files (TAF) | 0.0 | TAF | Release 1 |
data | 41 | 42 | 42 | Pennsylvania | Service Use Information | Admission Date - LT | 2022 | Low concern | Percentage of long-term care (LT) records with a missing or invalid admission date in the T-MSIS Analytic Files (TAF) | 0.0 | TAF | Release 1 |
data | 41 | 43 | 42 | Pennsylvania | Service Use Information | Discharge Date - IP | 2022 | Low concern | Percentage of inpatient (IP) records with an unexpectedly missing or invalid discharge date in the T-MSIS Analytic Files (TAF) | 0.0 | TAF | Release 1 |
data | 41 | 44 | 42 | Pennsylvania | Service Use Information | Discharge Date - LT | 2022 | Unusable | Multiple criteria: Percentage of long-term care (LT) records with (1) a missing discharge date and (2) an unexpectedly missing or invalid discharge date in the T-MSIS Analytic Files (TAF) | See Background and Methods | TAF | Release 1 |
data | 41 | 23 | 42 | Pennsylvania | Service Use Information | Type of Bill - IP | 2022 | Low concern | Percentage of inpatient (IP) claim header records with an expected type of bill code in the T-MSIS Analytic Files (TAF) | 98.2 | TAF | Release 1 |
data | 41 | 24 | 42 | Pennsylvania | Service Use Information | Type of Bill - LT | 2022 | Medium concern | Percentage of long-term care (LT) claim header records with an expected type of bill code in the T-MSIS Analytic Files (TAF) | 87.1 | TAF | Release 1 |
data | 41 | 25 | 42 | Pennsylvania | Service Use Information | Type of Bill - OT | 2022 | Low concern | Multiple criteria: (1) Percentage of other service (OT) claim header records with an unexpected or invalid type of bill code and (2) percentage of OT claim header records with a missing type of bill code in the T-MSIS Analytic Files (TAF) | See Background and Methods | TAF | Release 1 |
data | 41 | 40 | 42 | Pennsylvania | Service Use Information | Generic Indicator - RX | 2022 | Low concern | Multiple criteria: See Background and Methods | See Background and Methods | TAF | Release 1 |
data | 41 | 89 | 42 | Pennsylvania | Service Use Information | National Drug Code - RX | 2022 | Low concern | Percentage of pharmacy (RX) line records with a missing or invalid National Drug Code (NDC) code in the T-MSIS Analytic Files (TAF) | 8.8 | TAF | Release 1 |
data | 41 | 90 | 42 | Pennsylvania | Service Use Information | Days' Supply, Quantity, and Units - RX | 2022 | Low concern | Percentage of pharmacy (RX) line records with either (1) a days' supply value that is missing, invalid, or greater than 180, or (2) a missing or unusable National Drug Code (NDC) quantity in the T-MSIS Analytic Files (TAF) | 0.0 | TAF | Release 1 |
data | 41 | 60 | 42 | Pennsylvania | Non-Claim Records | Supplemental Payments | 2022 | Low concern | Multiple criteria: See Background and Methods | See Background and Methods | TAF | Release 1 |
data | 41 | 61 | 42 | Pennsylvania | Non-Claim Records | Non-Program (Other) Claims | 2022 | Low concern | Percentage of claim records with other, non-program claim type code in the T-MSIS Analytic Files (TAF) | 0.0 | TAF | Release 1 |
data | 41 | 85 | 42 | Pennsylvania | Non-Claim Records | Service Tracking Claims | 2022 | Low concern | Multiple criteria: Percentage of service tracking claims that meet any of the following criteria: (1) problematic MSIS ID value, (2) missing service tracking type code, or (3) missing service tracking payment in the T-MSIS Analytic Files (TAF) | See Background and Methods | TAF | Release 1 |
data | 41 | 33 | 42 | Pennsylvania | Provider Information | Billing Provider NPI - IP | 2022 | Low concern | Percentage of records in the IP file with a missing billing provider National Provider Identifier (NPI) in the T-MSIS Analytic Files (TAF) | 0.1 | TAF | Release 1 |
data | 41 | 34 | 42 | Pennsylvania | Provider Information | Billing Provider NPI - LT | 2022 | Low concern | Percentage of records in the LT file with a missing billing provider National Provider Identifier (NPI) in the T-MSIS Analytic Files (TAF) | 0.1 | TAF | Release 1 |
data | 41 | 35 | 42 | Pennsylvania | Provider Information | Billing Provider NPI - OT | 2022 | High concern | Percentage of records in the OT file with a missing billing provider National Provider Identifier (NPI) in the T-MSIS Analytic Files (TAF) | 30.2 | TAF | Release 1 |
data | 41 | 36 | 42 | Pennsylvania | Provider Information | Billing Provider NPI - RX | 2022 | Low concern | Percentage of records in the RX file with a missing billing provider National Provider Identifier (NPI) in the T-MSIS Analytic Files (TAF) | 0.0 | TAF | Release 1 |
data | 41 | 30 | 42 | Pennsylvania | Provider Information | Servicing Provider NPI - OT | 2022 | High concern | Percentage of other service (OT) line records with a missing servicing provider National Provider Identifier (NPI) in the T-MSIS Analytic Files (TAF) | 43.2 | TAF | Release 1 |
data | 41 | 31 | 42 | Pennsylvania | Provider Information | Prescribing Provider NPI - RX | 2022 | Low concern | Percentage of pharmacy (RX) header records with a missing prescribing provider National Provider Identifier (NPI) in the T-MSIS Analytic Files (TAF) | 0.0 | TAF | Release 1 |
data | 41 | 32 | 42 | Pennsylvania | Provider Information | Dispensing Provider NPI - RX | 2022 | Low concern | Percentage of pharmacy (RX) header records with a missing dispensing provider National Provider Identifier (NPI) in the T-MSIS Analytic Files (TAF) | 0.0 | TAF | Release 1 |
data | 41 | 37 | 42 | Pennsylvania | Provider Information | Billing Provider Type, Specialty, and Taxonomy - IP | 2022 | Low concern | Percentage of inpatient (IP) header records with an expected billing provider type, specialty, state-reported taxonomy, or NPPES taxonomy code in the T-MSIS Analytic Files (TAF) | 98.0 | TAF | Release 1 |
data | 41 | 38 | 42 | Pennsylvania | Provider Information | Billing Provider Type, Specialty, and Taxonomy - LT | 2022 | Low concern | Percentage of long-term care (LT) header records with an expected billing provider type, specialty, state-reported taxonomy, or NPPES primary taxonomy code in the T-MSIS Analytic Files (TAF) | 100.0 | TAF | Release 1 |
data | 41 | 104 | 42 | Pennsylvania | Provider Information | Billing Provider Type, Specialty, and Taxonomy - OT Professional | 2022 | Low concern | Percentage of header records on other service (OT) professional claims with a valid billing provider type, specialty, state-reported taxonomy, or NPPES primary taxonomy code in the T-MSIS Analytic Files (TAF) | 95.6 | TAF | Release 1 |
data | 41 | 105 | 42 | Pennsylvania | Provider Information | Billing Provider Type, Specialty, and Taxonomy - OT Institutional | 2022 | Low concern | Percentage of header records on other service (OT) institutional claims with a valid billing provider type, specialty, state-reported taxonomy, or NPPES primary taxonomy code in the T-MSIS Analytic Files (TAF) | 100.0 | TAF | Release 1 |
data | 41 | 103 | 42 | Pennsylvania | Provider Information | Billing Provider Specialty and Taxonomy - RX | 2022 | Low concern | Percentage of RX header records with an expected billing provider specialty or taxonomy code | 99.0 | TAF | Release 1 |
data | 41 | 106 | 42 | Pennsylvania | Provider Information | Servicing Provider Type, Specialty, and Taxonomy - OT Professional | 2022 | Low concern | Percentage of line records on other service (OT) professional claims with a valid servicing provider type, specialty, state-reported taxonomy, or NPPES primary taxonomy code in the T-MSIS Analytic Files (TAF) | 90.3 | TAF | Release 1 |
data | 41 | 107 | 42 | Pennsylvania | Provider Information | Servicing Provider Type, Specialty, and Taxonomy - OT Institutional | 2022 | High concern | Percentage of line records on other service (OT) institutional claims with a valid servicing provider type, specialty, state-reported taxonomy, or NPPES primary taxonomy code in the T-MSIS Analytic Files (TAF) | 57.7 | TAF | Release 1 |
data | 41 | 26 | 42 | Pennsylvania | Provider Information | Hospital Type - IP | 2022 | Medium concern | Percentage of inpatient (IP) claim header records with an expected type of hospital code in the T-MSIS Analytic Files (TAF) | 85.3 | TAF | Release 1 |
data | 41 | 91 | 42 | Pennsylvania | Provider Information | Active Enrollment Status Indicator | 2022 | Unusable | Percentage of unique Annual Provider (APR) file provider IDs where the active enrollment status indicator aligns with the claims in the T-MSIS Analytic Files (TAF) | 44.0 | TAF | Release 1 |
data | 41 | 94 | 42 | Pennsylvania | Provider Information | Facility/Group/Individual Code | 2022 | Low concern | Multiple criteria: (1) Percentage of providers that are facility providers, (2) percentage of providers that are group providers, (3) percentage of providers that are individual providers, and (4) percentage of providers with a valid facility/group/individual code in the T-MSIS Analytic Files (TAF) | See Background and Methods | TAF | Release 1 |
data | 41 | 95 | 42 | Pennsylvania | Provider Information | Group and Individual Providers - Classification Types | 2022 | Low concern | Percentage of individual and group providers with a valid, usable, and applicable value reported for at least one classification type in the T-MSIS Analytic Files (TAF) | 91.9 | TAF | Release 1 |
data | 41 | 97 | 42 | Pennsylvania | Provider Information | Facilities - Classification Types | 2022 | Low concern | Percentage of facility providers with a valid, usable, and applicable value reported for at least one classification type in the T-MSIS Analytic Files (TAF) | 96.8 | TAF | Release 1 |
data | 41 | 96 | 42 | Pennsylvania | Provider Information | Facility Characteristics | 2022 | High concern | Percentage of facility providers with a valid value reported for ownership code and profit status code in the T-MSIS Analytic Files (TAF) | 73.1 | TAF | Release 1 |
data | 41 | 102 | 42 | Pennsylvania | Provider Information | Provider Location | 2022 | Low concern | Percentage of participating providers without a usable service or practice location: ZIP code or county code | 0.4 | TAF | Release 1 |
data | 41 | 109 | 42 | Pennsylvania | Provider Information | National Provider Identifier | 2022 | Low concern | Percentage of TAF Annual Provider Files (APR) records with a valid NPI | 96.4 | TAF | Release 1 |
data | 41 | 98 | 42 | Pennsylvania | Managed Care Plans | Managed Care Plan Program and Population Characteristics | 2022 | Low concern | Percentage of records missing key managed care plan program and population characteristics in the T-MSIS Analytic Files (TAF) | 0.9 | TAF | Release 1 |
data | 41 | 99 | 42 | Pennsylvania | Managed Care Plans | Managed Care Plan Operational Characteristics | 2022 | Medium concern | Percentage of records missing key managed care plan operational characteristics in the T-MSIS Analytic Files (TAF) | 16.5 | TAF | Release 1 |
data | 41 | 100 | 42 | Pennsylvania | Managed Care Plans | Plan Name and Type | 2022 | Low concern | Percentage of records missing managed care plan name or type in the T-MSIS Analytic Files (TAF) | 0.0 | TAF | Release 1 |
data | 41 | 108 | 72 | Puerto Rico | Linking Across Files | Linking Claims to Beneficiaries | 2022 | Low concern | Percentage of service use records that do not link to an eligibility record in the same month of service in the T-MSIS Analytic Files (TAF) | 0.1 | TAF | Release 1 |
data | 41 | 110 | 72 | Puerto Rico | Linking Across Files | Linking Expenditures to Beneficiaries | 2022 | Low concern | Percentage of absolute value of Medicaid and CHIP expenditures that do not link to an eligibility record in the month of service in the T-MSIS Analytic Files (TAF) | 0.5 | TAF | Release 1 |
data | 41 | 92 | 72 | Puerto Rico | Linking Across Files | Linking Claims to Providers | 2022 | High concern | Percentage of unique provider IDs on medical claims in the T-MSIS Analytic Files (TAF) that link to a provider ID on the TAF Annual Provider (APR) file | 77.7 | TAF | Release 1 |
data | 41 | 88 | 72 | Puerto Rico | Linking Across Files | Linking Beneficiaries to Managed Care Plans | 2022 | Low concern | Percentage of beneficiary-plan combinations in the T-MSIS Analytic Files (TAF) Demographic and Eligibility (DE) file that link to a plan ID in the TAF Annual Managed Care Plan (APL) file | 100.0 | TAF | Release 1 |
data | 41 | 7 | 72 | Puerto Rico | Enrollment Benchmarking | Total Medicaid and CHIP Enrollment | 2022 | Unclassified | Average monthly percent difference in the count of Medicaid and CHIP beneficiaries with comprehensive benefits between the T-MSIS Analytic Files (TAF) and Performance Indicator (PI) data | Missing benchmark data | TAF | Release 1 |
data | 41 | 8 | 72 | Puerto Rico | Enrollment Benchmarking | Medicaid-Only Enrollment | 2022 | Unclassified | Average monthly percent difference in the count of Medicaid beneficiaries with comprehensive benefits between the T-MSIS Analytic Files (TAF) and Performance Indicator (PI) data | Missing benchmark data | TAF | Release 1 |
data | 41 | 4 | 72 | Puerto Rico | Enrollment Benchmarking | M-CHIP and S-CHIP Enrollment | 2022 | Unclassified | Average monthly percent difference in CHIP enrollment between the T-MSIS Analytic Files (TAF) and Performance Indicator (PI) data | Missing benchmark data | TAF | Release 1 |
data | 41 | 9 | 72 | Puerto Rico | Enrollment Benchmarking | Dually Enrolled in Medicare | 2022 | Unclassified | Average percent difference in the count of dually eligible beneficiaries in March, June, September, and December between the T-MSIS Analytic Files (TAF) and Medicare Modernization Act (MMA) data | Missing benchmark data | TAF | Release 1 |
data | 41 | 1 | 72 | Puerto Rico | Enrollment Benchmarking | Enrollment in CMC Plans | 2022 | Low concern | Percent difference in comprehensive managed care (CMC) organization enrollment between the T-MSIS Analytic Files (TAF) and the Medicaid Managed Care Enrollment and Program Characteristics (MMCEPC) report | -8.5 | TAF | Release 1 |
data | 41 | 2 | 72 | Puerto Rico | Enrollment Benchmarking | Enrollment in PCCM Programs | 2022 | Unclassified | Percent difference in primary care case management (PCCM) enrollment between the T-MSIS Analytic Files (TAF) and the Medicaid Managed Care Enrollment and Program Characteristics (MMCEPC) report | Not applicable | TAF | Release 1 |
data | 41 | 3 | 72 | Puerto Rico | Enrollment Benchmarking | Enrollment in BHO Plans | 2022 | Unclassified | Percent difference in behavioral health organization (BHO) enrollment between the T-MSIS Analytic Files (TAF) and the Medicaid Managed Care Enrollment and Program Characteristics (MMCEPC) report | Not applicable | TAF | Release 1 |
data | 41 | 5 | 72 | Puerto Rico | Enrollment Benchmarking | Adult Expansion Enrollment | 2022 | Low concern | Average monthly percent difference in adult expansion group enrollment between the T-MSIS Analytic Files (TAF) and the Medicaid Budget and Expenditure System (MBES) data | 0.9 | TAF | Release 1 |
data | 41 | 6 | 72 | Puerto Rico | Enrollment Benchmarking | Newly Eligible Adult Enrollment | 2022 | Low concern | Average monthly percent difference in 'newly eligible' adult expansion group enrollment between the T-MSIS Analytic Files (TAF) and the Medicaid Budget and Expenditure System (MBES) data | 0.0 | TAF | Release 1 |
data | 41 | 82 | 72 | Puerto Rico | Enrollment Benchmarking | 1915(c) Participation | 2022 | Unclassified | Multiple criteria: (1) Percentage of total Medicaid beneficiaries in TAF particpating in 1915(c) waivers and (2) alignment of participant reporting in TAF with 1915(c) waiver status | See Background and Methods | TAF | Release 1 |
data | 41 | 122 | 72 | Puerto Rico | Enrollment Benchmarking | SSI Participation | 2022 | Unclassified | Multiple criteria: Percent difference between TAF and SSI Annual Statistical Report using eligibility group codes, SSI indicator, and SSI status code | See Background and Methods | TAF | Release 1 |
data | 41 | 123 | 72 | Puerto Rico | Enrollment Benchmarking | 1115 Demonstration Identification | 2022 | Unclassified | Multiple criteria: (1) Percentage of expected demonstration numbers present in the T-MSIS Analytic Files (TAF) and (2) the number of demonstration numbers unexpectedly present in TAF | See Background and Methods | TAF | Release 1 |
data | 41 | 10 | 72 | Puerto Rico | Enrollment Patterns Over Time | Number of Enrollment Spans | 2022 | Unusable | Multiple criteria: (1) Percentage of Medicaid and CHIP beneficiaries with only one enrollment span during the calendar year and (2) percentage of beneficiaries with three or more enrollment spans during the calendar year in the T-MSIS Analytic Files (TAF) | See Background and Methods | TAF | Release 1 |
data | 41 | 11 | 72 | Puerto Rico | Enrollment Patterns Over Time | Length of Enrollment Gaps | 2022 | Low concern | Multiple criteria: (1) Average length of enrollment gap (in days) for Medicaid and CHIP beneficiaries with an enrollment gap and (2) percentage of beneficiaries with an enrollment gap in the T-MSIS Analytic Files (TAF) | See Background and Methods | TAF | Release 1 |
data | 41 | 12 | 72 | Puerto Rico | Enrollment Patterns Over Time | Overlapping Enrollment Spans | 2022 | Low concern | Percentage of beneficiaries with overlapping Medicaid and S-CHIP enrollment spans in the T-MSIS Analytic Files (TAF) | 0.0 | TAF | Release 1 |
data | 41 | 13 | 72 | Puerto Rico | Beneficiary Information | Age | 2022 | Low concern | Percentage of beneficiaries missing age values in the T-MSIS Analytic Files (TAF) | 0.0 | TAF | Release 1 |
data | 41 | 14 | 72 | Puerto Rico | Beneficiary Information | Gender | 2022 | Low concern | Percentage of beneficiaries missing gender values in the T-MSIS Analytic Files (TAF) | 0.0 | TAF | Release 1 |
data | 41 | 16 | 72 | Puerto Rico | Beneficiary Information | Race and Ethnicity | 2022 | Medium concern | Multiple criteria: (1) Percentage of beneficiaries missing race and/or ethnicity values in the T-MSIS Analytic Files (TAF) and (2) the number of race/ethnicity categories (out of 6) with a percentage point difference greater than 10 between the TAF and American Community Survey (ACS) data | See Background and Methods | TAF | Release 1 |
data | 41 | 17 | 72 | Puerto Rico | Beneficiary Information | Income | 2022 | Low concern | Percentage of beneficiaries missing family income values in the T-MSIS Analytic Files (TAF) | 0.0 | TAF | Release 1 |
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