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Quality of Medicaid Encounter Data

Effective oversight of Medicaid requires a national Medicaid dataset. Although all States submit Transformed Medicaid Statistical Information System (T-MSIS) data, OIG has consistently identified deficiencies in the quality of managed care encounter data, including inaccurate and missing information, which can render the data of limited use. We will determine whether the encounter data for selected States contain the required elements and include the quality data needed to more effectively oversee the Medicaid program. We will also determine what steps these States have taken to ensure that all required data elements are submitted to T-MSIS and identify any factors that contributed to data quality issues. This study will be based on a review of three to five States.

Announced or Revised Agency Title Component Report Number(s) Expected Issue Date (FY)
Completed Centers for Medicare & Medicaid Services Quality of Medicaid Encounter Data Office of Evaluation and Inspections OEI-02-19-00180 2021