Crosswalk

MMAPRA CrosswalkF.docx

Monthly State File of Medicaid/Medicare Dual Eligible Enrollees (CMS-10143)

Crosswalk

OMB: 0938-0958

Document [docx]
Download: docx | pdf

Crosswalk for Change of Medicare Modernization Act (MMA) Dual Eligible Reporting Application for Re-Certification

Changes to MMA Dual Eligibles File and Data Dictionary (DD)

DD Page #

Data Element

File Position

Type of Change

Rational for Change

34

Beneficiary Part A Entitlement Reason Code

1168

Removal of “H” value = Beneficiary is entitled to Medicare due to health hazard.

Change is no longer applicable and is non-substantive. The change did not have an impact on the burden estimates.

36

Beneficiary Part B Enrollment Reason Code

1258

Removal of “H” value = Beneficiary is entitled to Medicare due to health hazard.

Change is no longer applicable and is non-substantive. The change did not have an impact on the burden estimates.

39

Beneficiary DIB Entitlement Date Justification Code

1428

Removal of “H” value = Beneficiary is entitled to Medicare due to health hazard.

Change is no longer applicable and is non-substantive. The change did not have an impact on the burden estimates.

41

Plan Benefit Package Number (Occurrence 1)

1697-1699

Updated description to read: This field contains spaces if the managed care plan has no PBP. If a Cost Plan has no PBP, the field contains ‘999’.

Change was made to clarify the definition to this description field and is non-substantive. The change did not have an impact on the burden estimates.

41

PBP Coverage Type Codes

1700-1701

Updated list of values for the PBP ORG CVRG TYPE CD to add Value “14”: MMP – Medicare Medicaid Plan

Change was due to the implementation of the Financial Alignment Demonstration: Section 2602 of the Affordable Care Act directs CMS to better coordinate with states to improve care for Medicare-Medicaid enrollees. The change is non-substantive. The change did not have an impact on burden estimates.

45

Beneficiary Part A Third Party Buy-in Eligibility Code

2031

Updated to read: “This data element is obsolete.”

Change is no longer applicable and is non-substantive. The change did not have an impact on the burden estimates.

46

Beneficiary Part B Third Party Buy-in Eligibility Code

2131

Updated to include values “L” – Specified Low Income Beneficiary (SLMB) and “U” – Qualified Individual One (QI-1)

Changes were made to reflect additional values and were non-substantive. The changes did not have an impact on the burden estimates.

50

Beneficiary Enrollment Type Code

2425

Updated list of include values:

I – Non-MMP Plan

J – State submitted MMP passive enrollment.

K – CMS submitted MMP passive enrollment.

L – Beneficiary MMP election

Change was due to the implementation of the Financial Alignment Demonstration: Section 2602 of the Affordable Care Act. Changes were non-substantial. The change did not have an impact on burden estimates.

52

Beneficiary Language Indicator

2862

Revised to exclude values “C”; “D”, “F”, “G”, “I”, “J”, “N”, “P”, “R”, “V” and “W”.

Change is no longer applicable and is non-substantive. The change did not have an impact on the burden estimates.

59

Archive Indicator

3194

Change to Medicare Beneficiary Suite of Systems (MBDSS). CMS will be archiving data is no longer expected to be updated. New Data Element and value added:

A = Archived

‘ ’ = Not archived or not found in database

Changes were made to improve processing performance by reducing the volume in the main production database. Changes were non-substantive. The changes did not have an impact on the burden estimates.

59

Medicare-Medicaid Plan (MMP) Opt Out Indicator

3195

Systems changes include new data element and values based on Financial Alignment (FA) demonstration:

Y= Beneficiary has affirmatively opted out of Demo

N= Beneficiary has not opted out of Demo

‘ ’ = There is no opt out information available (should be interpreted as the beneficiary has not opted out).

Change was due to the implementation of the Financial Alignment Demonstration: Section 2602 of the Affordable Care Act. Changes were non-substantive. The changes did not have an impact on the burden estimates.


File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
AuthorGOLDY AUSTEN
File Modified0000-00-00
File Created2021-01-24

© 2024 OMB.report | Privacy Policy