Updated research request forms and data security approval requirement effective 4/24/23
CMS offers files from aggregate data to individual person level data. This article describes the differences between the aggregate, public use files, the limited data sets,…
This article describes the Federal Regulations that govern the release of CMS data for research.
The purpose of this article is to identify 1) common strengths of Medicare and Medicaid administrative data and 2) broad limitations for researchers to consider when…
This article provides guidance on how to identify hospital emergency room claims from the Medicare files.
Providers that bill Medicare use codes for patient diagnoses and codes for care, equipment, and medications provided. This articles provides resources to identify the codes…
To describe the CMS cell size suppression policy and provide examples of common scenarios and possible options.
Requirements for Institutional Review Board (IRB) Review and HIPAA Waiver Documentation for RIF DUA Request Submissions
CMS must ensure that all research requests for identifiable (RIF) data have IRB documentation to satisfy the requirements of the Common Rule and the Health Insurance Portability and Accountability Act (HIPAA). This article describes the requirements…
States that have "Opted-In" to data sharing under the State Research request process are required to submit quarterly logs to CMS.
Medicare managed care enrollment has fluctuated over the years and is a frequently requested statistic. Often researchers are interested in penetration rates or the percentage of Medicare beneficiaries enrolled in a Medicare managed care plan. These plans are also referred to as Medicare Part C, Medicare Advantage (MA), or Medicare Health Maintenance Organizations (HMOs).
This article provides a link and overview of the document on finder and crosswalk files written by the CMS data distributor, HealthAPT.
Doctoral students may request CMS data for their dissertation project. Students should consider several factors when deciding which type of data to use. This article presents considerations and resources for students interested to request CMS Research identifiable data.
The Centers for Medicare & Medicaid Services (CMS) seeks to ensure the protection of CMS data disclosed to external organizations for research purposes. To accomplish this, CMS has developed the Data Privacy Safeguard Program (DPSP). The DPSP reflects the CMS priorities to both improve data stewardship and to protect the privacy and security of CMS research identifiable files (RIF) that are made available for conducting important research studies.
Beneficiary death information is available in several of the Medicare enrollment files. Limited death information is also found in other files, such as the MedPAR. This article describes the variables found in each.
The purpose of this article is to provide an overview of the Centers for Medicare & Medicaid Services' (CMS') Price (Payment) Standardization process, as well as provide methodological documentation that explains how the standardized claim payment amounts for Medicare Part A, Part B, and Part D claims are calculated.
To describe the CMS policy that prohibits non-US based researchers from accessing identifiable CMS data (RIF and LDS) and provide examples of common scenarios.
Availability of provider variables Provider variable completeness Provider variable definitions
Along with claims at the individual beneficiary (single enrollee/provider/visit) level, state Medicaid programs also submit service tracking claims which record lump sum payments to providers or managed care plans. These data are a new enhancement to the TAF RIF, and researchers have the option of requesting these claims along with TAF claims data. This article describes service tracking claims in TAF RIF data and considerations for researchers.
Identifying Medicare Managed Care Beneficiaries from the Master Beneficiary Summary or Denominator Files
The purpose of this article is to describe how to use the Medicare managed care enrollment information found in the Medicare Beneficiary Summary File (MBSF) Research Identifiable File (RIF) or Denominator in the Limited Data Set (LDS). Medicare managed care is sometimes also called Medicare Advantage, Medicare Part C or Medicare + Choice.
This article presents the data options available to researchers studying the End-Stage Renal Disease (ESRD) population.