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Massachusetts All-Payer Claims Database: Technical Assistance Group (TAG)

Massachusetts All-Payer Claims Database: Technical Assistance Group (TAG). June 10, 2014. Agenda. ACA Membership Reporting CHIA/DOI Data Validation Connector/Risk Adjustment V2 to V3 Profiles Compliance Retaining Copies of Data Questions. QHP Key Data Elements in MA APCD.

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Massachusetts All-Payer Claims Database: Technical Assistance Group (TAG)

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  1. Massachusetts All-Payer Claims Database:Technical Assistance Group (TAG) June 10, 2014

  2. Agenda ACA Membership Reporting CHIA/DOI Data Validation Connector/Risk Adjustment V2 to V3 Profiles Compliance Retaining Copies of Data Questions

  3. QHP Key Data Elements in MA APCD • Three fields are needed to determine whether a plan is a Qualified Health Plan, purchased inside/outside the MA Connector: • Product Line of Business (PR004) – (Updated to include QH for Qualified Health Plan) • Purchased Through MA Exchange Flag (ME045) • Risk Adjustment Covered Plan (ME126)

  4. CHIA/DOI Data Validation DOI Quarterly HMO Membership Reports Compared to MA APCD Submissions Joint Site Visits by CHIA and DOI Lessons Learned

  5. CHIA/DOI Data Validation

  6. CHIA/DOI Data Validation

  7. CHIA/DOI Data Validation Lessons Learned: Report Timing Bucketing Membership Missing NAIC Codes Situs of Account End Result: Better Data! Better Reporting! Onward Administrative Simplification!

  8. Connector/Risk Adjustment Next Simulation:

  9. V2 to V3 Profiles

  10. Version 3 Compliance We are looking to have all carriers in full compliance by July with production data through June 2014.

  11. Retaining Copies of Data Carriers should maintain copies of the data sent to CHIA

  12. QUESTIONS?

  13. Next Meetings July 8, 2014 at 2:00 pm August 12, 2014 at 2:00 pm

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