Managed Care Research and Demonstration Task Order Medicare Choices Demonstration

摘要

This report presents a summary of MEDSTAT's evaluation of the data submitted as part of the encounter data validation project. In the report a description is provided of the completeness, accuracy, timeliness, and overall quality of data submitted by the Medicare Choices Demonstration plans. The plans experienced significant challenges in the submission of their data to fiscal intermediaries and carriers using established Medicare fee-for-service billing regulations. MEDSTAT provided extensive technical assistance that included visiting plans in person to address their data availability and submission capabilities, facilitating communication between plans and their fiscal intermediaries and carriers, supplying CMS-approved workarounds to address missing data required for submission, helping plans interpret submission specifications and error reports, and reviewing programming specifications to identify errors as needed.