The privileges are free for state Medicaid agencies and aim to improve care for dual eligible beneficiaries at the individual level, according to the report.
States whose requests are approved can combine Medicare Parts A and B claims and Part D prescription drug event data and link to the state’s Medicaid data for whole-person analysis of the dual eligible experience. State agencies may also request Medicare eligibility and enrollment data on their dual eligible beneficiaries.
CMS has allowed states to request access to Medicare Part D PDE final action data since 2008; this latest change allows states limited availability to Part D PDE non-final action data — that is, data that is subject to subsequent claims adjustment.
Read the AAPC report on Medicare and Medicaid.
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