Early Outcomes Show Limited Progress for the Transformed Medicaid Statistical Information System
Nicole Hrycyk, a team leader for the Office of Evaluation and Inspections in Chicago, is interviewed by Ann Maxwell, Regional Inspector General for the Office of Evaluation and Inspections.
WHY WE DID THIS STUDY
In response to a Congressional request, OIG agreed to determine the status of national Transformed Medicaid Statistical Information System (T-MSIS) implementation and determine whether early outcomes indicate that T MSIS data will be complete, accurate, and timely upon national implementation. T MSIS is designed to be a detailed national database of Medicaid and Children's Health Insurance Program information to cover a broad range of user needs, including program integrity. T-MSIS is a continuation of CMS's past attempts to improve the current nationally available Medicaid data after OIG and others found that the current data were not complete, accurate, or timely.
HOW WE DID THIS STUDY
To complete this early implementation review, we analyzed project schedules, meeting minutes, and milestone achievements from 12 States that volunteered to work with CMS on the planning and development of T-MSIS. These States were in a position to be some of the first States to implement T MSIS. We also analyzed CMS's T MSIS documentation regarding States' ability to report complete and accurate T-MSIS data. Finally, we conducted structured interviews with CMS staff.
WHAT WE FOUND
Overall, as of January 2013, CMS and the 12 volunteer States had made some progress in implementing T MSIS. However, most other States had not started implementing T MSIS, and they reported varied timeframes for when they plan to begin. CMS has not established a deadline for when national T-MSIS data will be available.
Further, early T MSIS implementation outcomes raised questions about the completeness and accuracy of T-MSIS data upon national implementation. None of the 12 volunteer States can make all T-MSIS data elements available. Further, both CMS and the 12 States expressed concerns about the accuracy of the data they could provide upon implementation.
WHAT WE RECOMMEND
Although CMS and 12 volunteer States have made some progress with T MSIS, it remains unclear whether T-MSIS will result in complete, accurate, and timely national Medicaid program integrity data upon implementation. We recommend that CMS, to help create a fully functional T-MSIS: (1) establish a deadline for when national T-MSIS data will be available; (2) ensure that States submit required T MSIS data; and (3) ensure that T MSIS data are complete, accurate, and timely upon T MSIS implementation. CMS concurred with our recommendations.