Response to Public Comments

TMSIS- Response to Tribal Technical Advisory Group’s Comments

Introduction: Transformed Medicaid Statistical Information System (T-MSIS). TMSIS is the reporting of detailed person-level data extracted from States’ eligibility systems and the Medicaid Management Information System (MMIS). In the Balanced Budget Act of 1997, Congress mandated the electronic submission of Medicaid program data on a quarterly basis through MSIS for every State and that an annual report be sent to Congress by CMS with aggregate statistics on each State’s Children Health Insurance Program (CHIP). The law also mandates that CMS provide a standardized format for States to provide claims level information on CHIP enrollees. Demographic and enrollment information are extracted from State eligibility and claims processing systems and are sent to CMS for each individual on the Medicaid rolls, along with their utilization and payment information. Section 6504 of the Affordable Care Act strengthened this provision by requiring states to include data elements the Secretary determines necessary for program integrity, program oversight, and administration.

CMS submits the following response to address comments received from the Tribal Technical Advisory Group (TTAG) on PRA collection package CMS-R-284 (OMB 0938-0345)

Comment 1: We support the monthly submissions of data to CMS by states on Medicaid enrollees and providers

• Response: No response required

• CMS Action: No action required

Comment 2: We request that Indian-status is included in the information being collected by states on Medicaid enrollees and providers, including Indian health care providers:

• Response: This information is being collected via the following T-MSIS data elements and File

T-MSIS Data Elements

ELIGIBILITY FILE

Data Element Name:   AMERICAN-INDIAN/ALASKAN-NATIVE-INDICATOR. This field identifies AI/AN

Data Element Name:   RACE.  Identifies AI/AN.

CLAIMS FILES

Data Element Name: PLACE-OF-SERVICE. This may be used to identify IHS, tribal, or urban Indian (I/T/U) providers.                                                                  

Data Element Name: PROGRAM TYPE. 

Data Element Name: TYPE-OF-SERVICE.

Third Party Liability (TPL) FILE

Data Element Names: HEALTH-INSURANCE-BENEFIT-PLAN-TYPE.

• CMS Action: No further action required

Comment 3: We request that the TTAG is provided regular reports on a quarterly basis to monitor the use of measures, AI/AN protections, and I/T payments from T-MSIS to ensure the quality, utility, and clarity of the information to be collected.

• Response: To address this comment several meetings have been held with the TTAG and CMCS’s division Director Loretta Schickner to provide information on how states are progressing to T-MSIS readiness. The TTAG has also be added to the T-MSIS monthly Newsletter distribution list to receive updates on states production readiness.  

• CMS Action: No further action required