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2 values
tafVersionId
int64
6
43
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float64
1
124
stateId
float64
1
78
col0
stringclasses
57 values
col1
stringclasses
13 values
col2
stringclasses
121 values
col3
stringclasses
11 values
col4
stringclasses
7 values
col5
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118 values
col6
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1
26
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2 values
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4 values
data
41
23
45
South Carolina
Service Use Information
Type of Bill - IP
2022
Unusable
Percentage of inpatient (IP) claim header records with an expected type of bill code in the T-MSIS Analytic Files (TAF)
26.9
TAF
Release 1
data
41
24
45
South Carolina
Service Use Information
Type of Bill - LT
2022
Unusable
Percentage of long-term care (LT) claim header records with an expected type of bill code in the T-MSIS Analytic Files (TAF)
0.0
TAF
Release 1
data
41
25
45
South Carolina
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
45
South Carolina
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
45
South Carolina
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)
4.7
TAF
Release 1
data
41
90
45
South Carolina
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)
0.2
TAF
Release 1
data
41
60
45
South Carolina
Non-Claim Records
Supplemental Payments
2022
Unclassified
Multiple criteria: See Background and Methods
See Background and Methods
TAF
Release 1
data
41
61
45
South Carolina
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
45
South Carolina
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
45
South Carolina
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)
0.0
TAF
Release 1
data
41
34
45
South Carolina
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)
0.0
TAF
Release 1
data
41
35
45
South Carolina
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)
20.4
TAF
Release 1
data
41
36
45
South Carolina
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
45
South Carolina
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)
21.4
TAF
Release 1
data
41
31
45
South Carolina
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
45
South Carolina
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
45
South Carolina
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)
100.0
TAF
Release 1
data
41
38
45
South Carolina
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
45
South Carolina
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)
100.0
TAF
Release 1
data
41
105
45
South Carolina
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
45
South Carolina
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
100.0
TAF
Release 1
data
41
106
45
South Carolina
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)
96.3
TAF
Release 1
data
41
107
45
South Carolina
Provider Information
Servicing Provider Type, Specialty, and Taxonomy - OT Institutional
2022
Low 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)
100.0
TAF
Release 1
data
41
26
45
South Carolina
Provider Information
Hospital Type - IP
2022
Low concern
Percentage of inpatient (IP) claim header records with an expected type of hospital code in the T-MSIS Analytic Files (TAF)
100.0
TAF
Release 1
data
41
91
45
South Carolina
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)
38.0
TAF
Release 1
data
41
94
45
South Carolina
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
45
South Carolina
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)
93.5
TAF
Release 1
data
41
97
45
South Carolina
Provider Information
Facilities - Classification Types
2022
High 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)
54.5
TAF
Release 1
data
41
96
45
South Carolina
Provider Information
Facility Characteristics
2022
Unusable
Percentage of facility providers with a valid value reported for ownership code and profit status code in the T-MSIS Analytic Files (TAF)
0.0
TAF
Release 1
data
41
102
45
South Carolina
Provider Information
Provider Location
2022
High concern
Percentage of participating providers without a usable service or practice location: ZIP code or county code
44.3
TAF
Release 1
data
41
109
45
South Carolina
Provider Information
National Provider Identifier
2022
Low concern
Percentage of TAF Annual Provider Files (APR) records with a valid NPI
96.6
TAF
Release 1
data
41
98
45
South Carolina
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)
0.0
TAF
Release 1
data
41
99
45
South Carolina
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)
10.0
TAF
Release 1
data
41
100
45
South Carolina
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
46
South Dakota
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)
0.3
TAF
Release 1
data
41
110
46
South Dakota
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)
0.2
TAF
Release 1
data
41
92
46
South Dakota
Linking Across Files
Linking Claims to Providers
2022
Unusable
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
4.3
TAF
Release 1
data
41
88
46
South Dakota
Linking Across Files
Linking Beneficiaries to Managed Care Plans
2022
Unclassified
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
Missing TAF data
TAF
Release 1
data
41
7
46
South Dakota
Enrollment Benchmarking
Total Medicaid and CHIP Enrollment
2022
Low concern
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
-0.1
TAF
Release 1
data
41
8
46
South Dakota
Enrollment Benchmarking
Medicaid-Only Enrollment
2022
Low concern
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
-0.1
TAF
Release 1
data
41
4
46
South Dakota
Enrollment Benchmarking
M-CHIP and S-CHIP Enrollment
2022
Low concern
Average monthly percent difference in CHIP enrollment between the T-MSIS Analytic Files (TAF) and Performance Indicator (PI) data
1.1
TAF
Release 1
data
41
9
46
South Dakota
Enrollment Benchmarking
Dually Enrolled in Medicare
2022
Low concern
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
1.5
TAF
Release 1
data
41
1
46
South Dakota
Enrollment Benchmarking
Enrollment in CMC Plans
2022
Unclassified
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
Not applicable
TAF
Release 1
data
41
2
46
South Dakota
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
Missing TAF data
TAF
Release 1
data
41
3
46
South Dakota
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
46
South Dakota
Enrollment Benchmarking
Adult Expansion Enrollment
2022
Unclassified
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
Not applicable
TAF
Release 1
data
41
6
46
South Dakota
Enrollment Benchmarking
Newly Eligible Adult Enrollment
2022
Unclassified
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
Not applicable
TAF
Release 1
data
41
82
46
South Dakota
Enrollment Benchmarking
1915(c) Participation
2022
Low concern
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
46
South Dakota
Enrollment Benchmarking
SSI Participation
2022
Low concern
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
46
South Dakota
Enrollment Benchmarking
1115 Demonstration Identification
2022
Unusable
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
46
South Dakota
Enrollment Patterns Over Time
Number of Enrollment Spans
2022
Medium concern
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
46
South Dakota
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
46
South Dakota
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
46
South Dakota
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
46
South Dakota
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
46
South Dakota
Beneficiary Information
Race and Ethnicity
2022
Low 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
46
South Dakota
Beneficiary Information
Income
2022
Unusable
Percentage of beneficiaries missing family income values in the T-MSIS Analytic Files (TAF)
82.2
TAF
Release 1
data
41
15
46
South Dakota
Beneficiary Information
ZIP Code
2022
Low concern
Percentage of beneficiaries missing ZIP code values in the T-MSIS Analytic Files (TAF)
0.0
TAF
Release 1
data
41
20
46
South Dakota
Beneficiary Information
Eligibility Group Code
2022
Low concern
Multiple criteria: (1) Percentage of beneficiaries missing an eligibility group code and (2) the number of large mandatory eligibility groups with no enrollment in the T-MSIS Analytic Files (TAF)
See Background and Methods
TAF
Release 1
data
41
18
46
South Dakota
Beneficiary Information
Dual Eligibility Code
2022
Low concern
Multiple criteria: See Background and Methods
See Background and Methods
TAF
Release 1
data
41
19
46
South Dakota
Beneficiary Information
CHIP Code
2022
Low concern
Multiple criteria: See Background and Methods
See Background and Methods
TAF
Release 1
data
41
21
46
South Dakota
Beneficiary Information
Restricted Benefits Code
2022
Low concern
Percentage of Medicaid and CHIP beneficiaries with a known benefit type in the restricted benefits code field in the T-MSIS Analytic Files (TAF)
100.0
TAF
Release 1
data
41
119
46
South Dakota
Beneficiary Information
Primary Language
2022
Low concern
Multiple criteria: (1) Percentage of beneficiaries missing a primary language in the T-MSIS Analytic Files (TAF) and (2) the number of language categories (out of 3) in which TAF differs substantively from the American Community Survey (ACS)
See Background and Methods
TAF
Release 1
data
41
120
46
South Dakota
Beneficiary Information
English Language Proficiency
2022
Unusable
Multiple criteria: (1) Percentage of beneficiaries with a non-English primary language that are missing English proficiency in the T-MSIS Analytic Files (TAF) and (2) the percentage of beneficiaries with limited English proficiency in TAF that differs substantively from the American Community Survey (ACS)
See Background and Methods
TAF
Release 1
data
41
45
46
South Dakota
Claim Files Completeness
Claims Volume - IP
2022
Low concern
Multiple criteria: (1) Total inpatient (IP) header volume as a percentage of the national median, (2) IP line volume as a percentage of the national median, and (3) average number of IP line records per header as a percentage of the national median in the T-MSIS Analytic Files (TAF)
See Background and Methods
TAF
Release 1
data
41
46
46
South Dakota
Claim Files Completeness
Claims Volume - LT
2022
Low concern
Average number of long-term care (LT) line records per header as a percentage of the national median in the T-MSIS Analytic Files (TAF)
118.8
TAF
Release 1
data
41
47
46
South Dakota
Claim Files Completeness
Claims Volume - OT
2022
Low concern
Multiple criteria: (1) Total other service (OT) header volume as a percentage of the national median, (2) total OT line volume as a percentage of the national median, and (3) average number of OT line records per header as a percentage of the national median in the T-MSIS Analytic Files (TAF)
See Background and Methods
TAF
Release 1
data
41
48
46
South Dakota
Claim Files Completeness
Claims Volume - RX
2022
Low concern
Multiple criteria: (1) Total pharmacy (RX) header volume as a percentage of the national median, (2) total RX line volume as a percentage of the national median, and (3) average number of RX line records per header as a percentage of the national median in the T-MSIS Analytic Files (TAF)
See Background and Methods
TAF
Release 1
data
41
27
46
South Dakota
Claim Files Completeness
Service Users - IP
2022
Low concern
Percentage of non-dually eligible beneficiaries with at least one inpatient (IP) claim record in the T-MSIS Analytic Files (TAF), as a proportion of the national median
136.7
TAF
Release 1
data
41
28
46
South Dakota
Claim Files Completeness
Service Users - OT
2022
Low concern
Percentage of non-dually eligible beneficiaries with at least one other service (OT) claim record in the T-MSIS Analytic Files (TAF), as a proportion of the national median
108.0
TAF
Release 1
data
41
29
46
South Dakota
Claim Files Completeness
Service Users - RX
2022
Low concern
Percentage of non-dually eligible beneficiaries with at least one pharmacy (RX) claim record in the T-MSIS Analytic Files (TAF), as a proportion of the national median
100.0
TAF
Release 1
data
41
121
46
South Dakota
Claim Files Completeness
Availability of CMC Plan Encounter Data
2022
Unclassified
Multiple criteria: Percentage of CMC plans with no IP or OT encounter header records in the T-MSIS Analytic Files (TAF)
See Background and Methods
TAF
Release 1
data
41
56
46
South Dakota
Claim Files Completeness
CMC Plan Encounters - IP
2022
Unclassified
Multiple criteria: (1) Inpatient (IP) comprehensive managed care (CMC) encounter header record volume as a percentage of the national median, (2) IP CMC encounter line record volume as a percentage of the national median, (3) the average number of IP CMC encounter line records per header as a percentage of the national...
See Background and Methods
TAF
Release 1
data
41
57
46
South Dakota
Claim Files Completeness
CMC Plan Encounters - LT
2022
Unclassified
Multiple criteria: (1) The average number of long-term care (LT) comprehensive managed care (CMC) encounter line records per LT claim header as a percentage of the national median and (2) the number of CMC plans with no LT encounter header records in the T-MSIS Analytic Files (TAF)
See Background and Methods
TAF
Release 1
data
41
58
46
South Dakota
Claim Files Completeness
CMC Plan Encounters - OT
2022
Unclassified
Multiple criteria: (1) Other service (OT) comprehensive managed care (CMC) encounter header record volume as a percentage of the national median, (2) volume of OT CMC encounter line records as a percentage of the national median, (3) the average number of OT CMC line records per header as a percentage of the national m...
See Background and Methods
TAF
Release 1
data
41
59
46
South Dakota
Claim Files Completeness
CMC Plan Encounters - RX
2022
Unclassified
Multiple criteria: (1) The average number of pharmacy (RX) comprehensive managed care (CMC) encounter line records per RX claim header as a percentage of the national median and (2) the number of CMC plans with no RX encounter header records in the T-MSIS Analytic Files (TAF)
See Background and Methods
TAF
Release 1
data
41
22
46
South Dakota
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
46
South Dakota
Expenditure Benchmarking
Total Medicaid Expenditures
2022
Medium concern
Percent difference in total Medicaid expenditures for medical assistance programs between the T-MSIS Analytic Files (TAF) and the CMS-64 data
-19.4
TAF
Release 1
data
41
87
46
South Dakota
Expenditure Benchmarking
Medicaid Beneficiary Expenditures
2022
Medium concern
Percent difference in Medicaid beneficiary expenditures between the T-MSIS Analytic Files (TAF) and the CMS-64 data
-18.9
TAF
Release 1
data
41
67
46
South Dakota
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
-19.0
TAF
Release 1
data
41
68
46
South Dakota
Expenditure Benchmarking
FFS Inpatient Expenditures
2022
Medium 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
-9.6
TAF
Release 1
data
41
69
46
South Dakota
Expenditure Benchmarking
FFS Long-Term Care Expenditures
2022
High 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
-30.9
TAF
Release 1
data
41
70
46
South Dakota
Expenditure Benchmarking
FFS Other Medical Expenditures
2022
High 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
-21.0
TAF
Release 1
data
41
71
46
South Dakota
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
-1.4
TAF
Release 1
data
41
72
46
South Dakota
Expenditure Benchmarking
Total Monthly Beneficiary Payments
2022
Low concern
Percent difference in total monthly Medicaid beneficiary payments between the T-MSIS Analytic Files (TAF) and the CMS-64 data
1.0
TAF
Release 1
data
41
73
46
South Dakota
Expenditure Benchmarking
CMC Payments
2022
Unclassified
Percent difference in comprehensive managed care (CMC) capitation payments between the T-MSIS Analytic Files (TAF) and the CMS-64 data
Not applicable
TAF
Release 1
data
41
74
46
South Dakota
Expenditure Benchmarking
PHP Payments
2022
Unclassified
Percent difference in prepaid health plan (PHP) capitation payments between the T-MSIS Analytic Files (TAF) and the CMS-64 data
Not applicable
TAF
Release 1
data
41
75
46
South Dakota
Expenditure Benchmarking
PCCM Fees
2022
Low concern
Percent difference in primary care case management plan (PCCM) fees between the T-MSIS Analytic Files (TAF) and the CMS-64 data
1.0
TAF
Release 1
data
41
76
46
South Dakota
Expenditure Benchmarking
Premium Assistance Payments
2022
Unclassified
Percent difference in premium assistance payments between the T-MSIS Analytic Files (TAF) and the CMS-64 data
Not applicable
TAF
Release 1
data
41
66
46
South Dakota
Payments
Missing Payment Data - FFS Claims
2022
Medium concern
Percentage of fee-for-service (FFS) claims with a zero, missing, or negative payment amount in the T-MSIS Analytic Files (TAF)
11.1
TAF
Release 1
data
41
86
46
South Dakota
Payments
Missing Payment Data - Encounters
2022
Unclassified
Percentage of managed care (MC) encounters with a zero, missing, or negative payment amount in the T-MSIS Analytic Files (TAF)
Not applicable
TAF
Release 1
data
41
101
46
South Dakota
Payments
Bundled Payments for Prenatal Care
2022
High concern
Percent of deliveries with bundled payment code including prenatal care in the T-MSIS Analytic Files (TAF)
40.1
TAF
Release 1
data
41
81
46
South Dakota
Payments
Payment Data Consistency - IP
2022
Low 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
46
South Dakota
Payments
Payment Data Consistency - LT
2022
Low 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
46
South Dakota
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
46
South Dakota
Payments
Payment Data Consistency - RX
2022
Low 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
46
South Dakota
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
99.9
TAF
Release 1
data
41
112
46
South Dakota
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
100.0
TAF
Release 1
data
41
113
46
South Dakota
Financial Reporting
Category of Service Code - OT
2022
Low concern
Percentage of OT lines that have a category of service code consistent with program enrollment
99.1
TAF
Release 1
data
41
114
46
South Dakota
Financial Reporting
Category of Service Code - RX
2022
Low concern
Percentage of RX lines that have a category of service code consistent with program enrollment
99.6
TAF
Release 1