CMS has developed a new Medicaid DQ Atlas, an interactive, web-based tool that helps policymakers, analysts, researchers, and other stakeholders explore the quality and usability of the Medicaid TMSIS Analytic File (TAF). The charts, maps, and tables in the new DQ Atlas show state-level DQ assessments and associated measure values for topics that are pertinent to Medicaid and CHIP.
This document describes the development and content of the TAF annual Demographic & Eligibility (DE) file. The TAF DE includes information on the demographic, eligibility, and enrollment characteristics of beneficiaries who were enrolled in Medicaid or in CHIP for at least one day during any given calendar year.
This document describes the development and content of the four claims files that contain service use and payment records: (1) the IP file includes institutional inpatient services and payments, (2) the LT file includes institutional long-term care services and payments, (3) the OT file includes all other medical services and payments, and (4) the RX file includes prescription drug fills and pharmacy payments.
This document describes the development and content of the TAF Annual Managed Care Plan (APL) file. The APL provides TAF users with detailed information about each managed care entity authorized to enroll Medicaid or CHIP beneficiaries, including the plan’s business characteristics (such as profit status), its contract with the state (such as type of reimbursement arrangement and operating authority), and the location and type of beneficiaries the plan is allowed to enroll.
This document describes the development and content of the TAF Annual Provider (APR) file. Based on data submitted to CMS from states through the T-MSIS process, the APR captures information about all providers authorized by a state to render services to Medicaid and CHIP beneficiaries at any point in the calendar year, as well as providers whose authorization is pending, denied, or terminated, regardless of whether or how often the providers billed the state for services.
This document provides instructions for analyzing claims data submitted by Illinois. This is a short-term solution that will help make the data usable until the state can implement changes to address this issue.