Massachusetts All-Payer Claims Database Technical Assistance Group
This information pertains to the Massachusetts All-Payer Claims Database (MA APCD), including updates on data intake, enrollment trends reporting, and data quality checks. Liaisons are advised to submit files promptly and stay updated on upcoming releases and guidance.
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Presentation Transcript
Massachusetts All-Payer Claims Database: Technical Assistance Group (TAG) November 8, 2022
Agenda MA APCD Enrollment Trends DOI Reporting Questions
MA APCD Intake All APCD submissions through September 2022 were 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 further 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 CHIA is currently conducting data quality checks for our next data release scheduled for later this month. Liaisons may be reaching out to certain payers if any issues are found. This release includes data through June 2022. Potential updates/changes to Submission Guides for 2023 are now being considered. More details to follow in the coming weeks and through email communications to payers.
MA APCD Intake CHIA has updated Member Gender (ME013, MC012, PC012, DC012) to allow for more options in the lookup table based on the USCDI code set. These new values are now 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 in October. 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
DOI Reporting Q3 2022 HMO Membership reports will be sent this month. Claims/Utilization: Reports using data through March 2022 were sent 8/26. Signoff was due 10/25. Reports using data through September 2022 will be produced in November. We continue to meet with select payers to reconcile differences in certain report categories.
Next Meetings December 13, 2022 @ 2:00 pm January 10, 2023 @ 2:00 pm
