Massachusetts All-Payer Claims Database Technical Assistance Group Updates
Stay informed with the latest updates from the Massachusetts All-Payer Claims Database Technical Assistance Group (TAG) regarding APCD submissions, enrollment trends, and reporting timelines for 2022 and 2023.
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Massachusetts All-Payer Claims Database: Technical Assistance Group (TAG) October 11, 2022
Agenda MA APCD Enrollment Trends Aggregate Reporting DOI Reporting Questions
MA APCD Intake All APCD submissions through September 2022 are due by October 31st. This includes any re-submissions. Please work with your liaison in submitting any overdue files and alert them if you expect any delays this month. The data will be used for the quarterly DOI membership reports, semi-annual utilization reports and Enrollment Trends reporting. CHIA is revisiting Medical Claim versioning methods with select payers. We ll reach out when we have examples to share with each company.
MA APCD Intake 2022 APCD submission guide changes are now incorporated in the Medical, Pharmacy and Provider files. Production files with the submission guide changes started with July 2022 data. There is no change to the version field in the header record it remains 2019 .
MA APCD Intake CHIA is updating Member Gender (ME013, MC012, PC012, DC012) to allow for more options in the lookup table based on the USCDI code set. We are on target to have these new values in place for October 2022 data (due in November). Report member gender as reported on enrollment form in alpha format. Used to create Unique Member ID. EXAMPLE: F = Female Description Membe r Gender Lookup Table - Text ME01 3 8/16/2 2 Member's Gender 100 % ME 13 tlkpGender char[1] All A0 Code F Female M Male A Transgender Male/Trans Man Transgender Female/Trans Woman Genderqueer/gender nonconforming: neither exclusively male nor female Non-binary B G N O Other U Unknown C Choose not to answer
Enrollment Trends Update The next Enrollment Trends reporting cycle will be based on data through September 2022 and is scheduled to be published in February 2023. CHIA sent requests for Supplemental data to certain payers at the end of last week. The due date for the Supplemental data through September 2022 is November 15, 2022. CHIA will be sending payers MA APCD-sourced enrollment counts for review in early December 2022. For questions on Enrollment Trends: Contact your CHIA liaison.
Enrollment Trends Timeline Oct 2022 Nov 2022 Dec 2022 Jan 2023 Feb 2023 Payers submit Sept 2022 MA APCD files Supplemental enrollment reports due (select payers) MA APCD enrollment counts sent to payers for review Reporting
Aggregate Data Submission Deadlines Data Submission Due Date Submission Method TME-APM Wednesday, September 14th CHIA Submissions Platform Prescription Drug Rebates Wednesday, September 14th CHIA Submissions Platform Premiums Wednesday, September 14th Email to CHIAData@gormanactuarial.com Thursday, September 1st Email to CHIAData@gormanactuarial.com Completed MLR Forms 8
DOI Reporting Q2 2022 HMO Membership reports were sent 8/25. Signoff was due 10/10. Claims/Utilization: Reports using data through March 2022 were sent 8/26. Signoff is due 10/25. We ll be running the reports using data through September 2022 in November. We continue to meet with select payers to reconcile differences in certain report categories.
Next Meetings November 8, 2022 @ 2:00 pm December 13, 2022 @ 2:00 pm
