CMS is pleased to announce that updated Medicaid T-MSIS Analytic Files (TAFs) for service years 2017 and 2018 are now available. The TAF research files contain data on Medicaid and Children's Health Insurance Program (CHIP) beneficiary demographics, program enrollment, service use, and payments. In September 2020, CMS made TAF enrollment and claims files* for service years 2017 and 2018 available to researchers. Since that release, CMS has worked diligently with state Medicaid agencies to identify and rectify data quality issues associated with their Medicaid data submissions. As a result, states have begun resubmitting updated Medicaid data with significant improvements to the overall quality of the data. Researchers who request the 2017-2018 TAF data will now get the updated version. Please note, CMS continues to work with states to address data quality issues, and there is a possibility of additional releases in the future for these service years.
Some key improvements include:
- Newly available claim records which identify non-person service payments, such as lump-sum payments to home and community-based service providers, non-emergency medical transportation providers and value-based payment incentives for plans and providers. These records are sometimes referred to as “service tracking claims”, and are now available to the research community for TAF service years 2017 and 2018. For more information on this new TAF data, please see this ResDAC article.
- A new variable in all claim file types to distinguish a non-person claim record in the claim TAF research files, “PRSN_CLM_IND”, where a ‘1’ indicates a traditional beneficiary claim and ‘0’ indicates a non-person claim record.
- Annual Plan and Provider TAF research files, which are included in this release to supplement the TAF claims and eligibility research files. With this data, users can link additional plan and provider information to existing beneficiary and claims data and perform more complex analyses by plan and provider.
- Separate submitting state FIPS codes for the additional entities of three states (Wyoming [WY], Pennsylvania [PA], and Montana [MT]) which submit separate T-MSIS data to CMS for those entities. WY and PA submit separate data for their CHIP entities, while MT submits for its Third-Party Administrator entity. These more granular FIPS codes allow users to easily filter data for the additional entities, and are available in all TAF research file types.
*The TAF research files currently include 7 file types:
- Annual Demographics and Eligibility (DE)
- Inpatient (IP)
- Long-Term Care (LT)
- Pharmacy (RX)
- Other Services (OT)
- Annual Managed Care Plan (APL)
- Annual Provider (APR)
The DE file contains demographic, eligibility and enrollment information for all Medicaid and CHIP beneficiaries enrolled for at least one day during the calendar year. The IP, LT, RX, and OT files contain fee-for-service claims, managed care encounter claims, and per-person-per-month capitated payments, plus newly available non-person service payments, for Medicaid and CHIP services, organized by service month. The APL file contains information about each Medicaid and CHIP managed care plan/entity that CMS authorized to operate in a state during the calendar year. Finally, the APR file contains information about the providers that are eligible to render services to Medicaid and CHIP beneficiaries for any month of the year.