Massachusetts All-Payer Claims Database Updates and Deadlines
Stay updated on the latest information regarding the Massachusetts All-Payer Claims Database, including data intake deadlines, enrollment trends, and aggregate data submission deadlines. Ensure timely submission and compliance with the reporting requirements to CHIA for various reports and analyses.
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Presentation Transcript
Massachusetts All-Payer Claims Database: Technical Assistance Group (TAG) August 9, 2022
Agenda MA APCD Enrollment Trends Aggregate Reporting DOI Reporting Questions
MA APCD Intake All APCD submissions through June 2022 were due by July 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. Data will be used for Q2 2022 DOI membership reports, Enrollment Trends and CHIA s annual data release. 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 Version 2022 APCD submitters can now send July production files with the submission guide changes incorporated in the Medical, Pharmacy and Provider files. Production files with the submission guide changes are due by 8/31 for July 2022 data. There is no change to the version field in the header record it remains 2019 .
Enrollment Trends Update The next Enrollment Trends reporting cycle will be based on data through March 2022 and is scheduled to be published in August 2022. Thank you to all payers for reviewing the MA APCD-sourced enrollment counts in June and thank you to the payers that submitted Supplemental Data as requested in May. For questions on Enrollment Trends: Contact your CHIA liaison.
Enrollment Trends Timeline Apr 2022 May 2022 Jun 2022 Jul 2022 Aug 2022 Payers submit March 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 7 4/27/22
Aggregate Data Submissions FAQ Where can I find the data specifications and templates? On CHIA s website - TME-APM, Rx Rebates, Premiums. Where should I direct questions regarding these data submissions? For questions about TME-APM and Rx Rebates, email Lauren Coakley (Lauren.Coakley@chiamass.gov) For questions about Premiums, email (CHIAData@gormanactuarial.com) 8 4/27/22
Aggregate Data Submissions FAQ (cont) How can I request an extension for these data submissions? Please email Lauren Coakley (Lauren.Coakley@chiamass.gov) with any extension requests. My organization has a new contract with Beth Israel Lahey, does CHIA have an orgID for this Parent Provider Group? Yes, please use orgID 16665 9 4/27/22
DOI Reporting Q2 2022 HMO Membership reports will be sent later this month. Claims/Utilization: Reports using data through March 2022 are in process. We continue to meet with select payers to reconcile differences in certain report categories.
Next Meetings September 13, 2022 @ 2:00 pm October 11, 2022 @ 2:00 pm
