Posts tagged: Data

Risk Adjustment and Encounter Data 2019

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By , June 12, 2019 9:19 am


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Risk Adjustment and Encounter Data 2019

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Contract Year 2019 Medicare Advantage Organization … – CMS

Medicare Card Project. Encounter Data System. (EDS). DEDRAO, MPPG
encounterdata@cms.hhs.gov. Medicare Card Project. Risk Adjustment Suite of.

Evaluation of EDGE Data Submissions for the 2018 … – CMS.gov

Nov 15, 2018 … 1 For the 2018 benefit year, HHS operates risk adjustment in all 50 states and the
…. January 17, 2019 (Data for Interim Risk Adjustment Summary Report) … If you
encounter any technical problems submitting corrected …

Advance Questions from actuarial-bids@cms.hhs.gov for CY2020 …

6 days ago … For questions related to risk score models and released data: … questions related
to the Encounter Data Processing System: encounterdata@cms.hhs.gov … 2018
and 2019 are addressed in the projection of 2020 FFS costs?

2018-2019 Medicaid Managed Care Rate … – Medicaid.gov

payment term (e.g., risk adjustment methodology), which was included in the …. (
ii) if managed care encounter data was not used in the rate development, this.

Announcement of Calendar Year (CY) 2020 Medicare … – CMS.gov

Apr 1, 2019 … CMS-HCC 2019 ESRD Functioning Graft model & 2020 ESRD … adjustment-
eligible diagnoses from encounter data, RAPS and FFS claims …

March 1, 2019 Seema Verma, MPH Administrator Centers for …

Mar 1, 2019 … CMS–HCC Risk Adjustment Model” and the January 30, 2019 … Encounter data
and Risk Adjustment Processing System (RAPS) data as a …

The Medicare Advantage program: Status report – MedPAC

Plan payments—Using the 2018 plan bid data, before adjusting fully for coding …
Risk adjustment and coding intensity—Medicare payments to MA plans are ……
through 2019). Second …. information through the Encounter Data System (EDS).

Encounter Data Reporting Guide – Washington State Health Care …

Published January 22, 2019 … The information in this encounter data reporting
guide is not intended to change or alter the meaning or intent of …… Only
accepted encounters are used for evaluation of rate development, risk
adjustment, quality.

Contract Year Ending 2019 AHCCCS Complete Care Program …

Aug 21, 2018 … 15. I.2.B.ii.(c)(ii) Not using Managed Care Encounter Data . … I.2.B.iii.
Adjustments to the Data . …… Risk Adjustment and Acuity Adjustments .

Memo: 2019 Episodes Changes – TN.gov

made to the Episodes of Care program in Tennessee for the 2019 performance
period. ….. previous year's data is used to model the thresholds so that there is a
balance of risk … In fact, risk adjustment for episodes in Tennessee takes into
account diagnosis ….. Should providers encounter individual cases that do not.

Medicare and Medicaid Programs – Amazon S3

Federal Register on 04/16/2019 and available online at …… telehealth benefits
and encounter data and risk adjustment in the future. Summary of Regulatory …

NHSN SIR Guide – CDC

CORRECTIONS AND UPDATES AS OF MARCH 2019 … SIR Guide Supplement:
Risk Adjustment Factors Included in the SIR, 2015 Baseline ___ … were
calculated using aggregate data reported to NHSN. …… community-onset MRSA
blood events that occurred in an ED or 24-hour observation unit / total encounters
* 100.

Letter – Senate Finance Committee

Mar 29, 2019 … Reports/MCRAdvPartDEnrolData/Downloads/2019/March/Monthly-Summary-
Report-2019- … changes to Risk Adjustment Data Validation (RADV) audit
methodology;. Transition to increased use of valid encounter data; and.

Managed Long-Term Services and Supports – macpac

Jun 17, 2018 … Efforts to implement new quality measures and collect better encounter data may
improve monitoring ….. implementing MLTSS until after December 31, 2019. (Ind.
Code ….. functional assessment data for risk adjustment, but.

2017 Quality Assurance Reporting Requirements – New York State …

Mar 27, 2019 … QARR incorporates measures from HEDIS 2019. The major areas of … 3)
Experience of Care. 4) Utilization and Risk Adjusted Utilization.

2018-2019 HMO Contract – ForwardHealth Portal – Wisconsin.gov

Jan 1, 2018 … E. Risk adjustment payments or recoupments . …… submitted but for which the
HMO may supplement its encounter data set. Such services …

1 Medallion 4.0 Medicaid Managed Care Contract …

Sep 30, 2018 … Generate and submit encounter data as set forth in this Contract; . …… “
Comprehensive Risk Contract” a risk contract between the Department and an
MCO that … “Credibility Adjustment” As defined in 42 C.F.R. § 438.8, …… period of
this Contract is from [August 1, 2018 through June 30, 2019], with the.

Medicaid Fraud and Overpayments – Office of Inspector General

Jun 27, 2018 … OIG found that States' Medicaid managed care encounter data were incomplete.
…. that they pose to Medicaid, with high‐risk providers requiring more intense
scrutiny. … The President's FY 2019 Budget request includes a proposal to ….
Medicaid may have lost $1.3 billion in base and inflation‐adjusted …

Risk Adjustment Data Technical Assistance 2019

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By , June 11, 2019 1:49 pm


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Risk Adjustment Data Technical Assistance 2019

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Contract Year 2019 Medicare Advantage Organization … – CMS

CY 2019 Medicare Advantage Organization, Prescription Drug Plan, Cost Plan,
and … Risk Adjustment Data … Technical assistance with HPMS or CTM:.

Evaluation of EDGE Data Submissions for the 2018 … – CMS.gov

Nov 15, 2018 … data submitted to their EDGE servers.2 CMS will evaluate data on an EDGE
server for …. January 17, 2019 (Data for Interim Risk Adjustment Summary Report
) …. The technical committee will consider the justifications from issuers identified
…. The data quantity and quality analysis set forth above will assist …

Risk Adjustment Technical Steps and Risk Factor Specifications

Oct 15, 2018 … present on OASIS-D, which has an effective date of January 1, 2019. … Section II
describes the technical steps for calculating risk adjusted measures and …..
Cognitive Functioning: Requires assist in special circumstances.

FAQs on the SAS QI and WinQI v2018 ICD-10-CM/PCS

What year of data do the SAS QI and WinQI v2018 software support? … Is the
AHRQ QI software v2018 (SAS QI and WinQI) risk adjusted? No. … including the
risk adjustment in the next version of the software, v2019 … technical
specifications.

Proposed rule – Amazon S3

risk adjustment and risk adjustment data validation programs; … Federal Register
on 01/24/2019 and available online at ….. technologies in a convenient, timely,
and portable way is in the best interest of consumers and the health …
information that may assist consumers in selecting a QHP offered through an
Exchange and.

CMS's Management of the Quality Payment Program – Office of …

(1) Completing information technology systems to support critical QPP functions.
In the past, … the administrator of a group practice) to submit MIPS data on their
behalf. For each …. a significant risk to the QPP's success if insufficiently
addressed. … on their performance, and calculate their 2019 payment
adjustments.

Measures for Medicaid Managed Long Term … – Medicaid.gov

Risk Adjustment Tables: https://www.medicaid.gov/medicaid/managed- …
technical assistance (TA) mailbox at MLTSSmeasures@cms.hhs.gov for
assistance. … Q5: An MLTSS plan may document the data elements required for
these measures, but the information …. supplemental rates for measurement year
2019 or 2020.

Memo: 2019 Episodes Changes – TN.gov

made to the Episodes of Care program in Tennessee for the 2019 … Technical
Advisory Group (TAG) composed of expert clinicians representing a ….. In fact,
risk adjustment for episodes in Tennessee takes into account diagnosis ….
Response – Accepted: In CY 2016 TennCare data, only a small percentage of
valid.

OVW-2019-16169 – Department of Justice

Release Date: on or about February 28, 2019. Eligibility. Eligible applicants are
generally limited … About the OVW Training and Technical Assistance Initiative .

Letter – Senate Finance Committee

Mar 29, 2019 … for its support of MA and to urge that it continue to take steps to … Letter", and
Policy and Technical Changes proposed rule', show that the Administration …
Reports/MCRAdvPartDEnrolData/Downloads/2019/March/Monthly- … changes to
Risk Adjustment Data Validation (RADV) audit methodology;.

Notice of Benefit & Payment Parameters for 2019 – IN.gov

Apr 17, 2018 … risk adjustment data validation program that are intended to … cost sharing for the
2019 benefit year for cost-sharing … Navigator assistance personnel subject ……
technical revision to the name of this data element to ''sex'' in …

OJJDP FY 2019 Coordinated Assistance to States Program

Mar 26, 2019 … For technical assistance with submitting an application, contact the Grants.gov
Customer … Grants.gov number assigned to this solicitation: OJJDP-2019-14996
….. financial or performance data already required under this program. …. to
approval of the costs are incurred at the sole risk of the applicant.

Program NOFA – HUD

Feb 14, 2019 … 2018 funding for its Community Compass Technical Assistance and … the right to
award FY 2019 funds based on this single NOFA …. (HMIS) data, CoC
application information, HUD monitoring results, …. Review Process: We adjusted
our Rating Factor 2 review process. …… Assessing Applicant Risk.

Mid-scale Research Infrastructure-1 (Mid-scale RI-1) (nsf19537) | NSF

Feb 19, 2019 … disciplinary perspectives to support convergence research. As such, when ….
Estimated FY 2019 program budget is subject to the availability of funds. ……
wider U.S. research community (access, data products, technology, etc.),
including the … The estimated risk-adjusted project cost is the sum of the …

2019 IHP 2.0 Contract – Minnesota.gov

Jul 13, 2018 … to Medical Assistance and MinnesotaCare …… and strengthen health care data
and technology in a timely and ….. and receive a risk-adjusted.

To the California Legislature Regular Session 2019-20

Jan 9, 2019 … GOVERNOR'S BUDGET SUMMARY — 2019-20. 1 …. investing in technology
and data analytics that will support CAL FIRE's incident … cost-of-living
adjustment (COLA) proposed in the Budget for 2019-20. School ….. improve
screening for adverse childhood experiences (ACEs) and to link at-risk families.

Major Savings and Reforms – The White House

All years referenced for budget data are fiscal years unless otherwise noted. …
Act, 2019; the Department of Defense Appropriations Act, 2019; and the
Departments of Labor, Health …. Technical Assistance Programs. …. Flood
Hazard Mapping and Risk Analysis Program…………………………………………………………
………….47.

Financial Alignment Initiative for Beneficiaries Dually … – macpac

programs wrap around this coverage by providing financial assistance with …
services; moreover, data regarding Medicaid costs are not yet available (CMS
2017a). ….. 2019. January 2015. 75,941. 93,000. Rhode Island Integrated. Care
Initiative …. The Medicare components of the rate are risk adjusted based on the
risk.

Raps Data Submission 2019

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By , June 6, 2019 7:28 am


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Raps Data Submission 2019

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Announcement of Calendar Year (CY) 2020 Medicare … – CMS.gov

Apr 1, 2019 … CMS received many submissions in response to our request for comments on ….
CMS-HCC 2019 ESRD dialysis model & 2020 ESRD dialysis model: 1.059 …
RAPS inpatient data) and FFS data and (2) 50% of the risk score …

Contract-Level RADV Industry Wide Teleconference … – CMS.gov

Jan 29, 2019 … January 29, 2019 … Term. Definition. RADV. Risk Adjustment Data Validation.
RAPS …. MAOs submit RAPS diagnosis data to CMS: – Enrollee …

Announcement of Calendar Year (CY) 2019 Medicare … – CMS.gov

Apr 2, 2018 … CMS received many submissions in response to our request for …. RAPS
inpatient data) and FFS diagnoses with 75% of the risk score …

What New Home Health Agencies (HHAs) Need to Know … – CMS.gov

Feb 15, 2019 … However, a new HHA must still submit a RAP for each home … full name of CMS-
1689-FC is “Medicare and Medicaid Programs; CY2019 Home …

March 1, 2019 Seema Verma, MPH Administrator Centers for …

Mar 1, 2019 … CMS–HCC Risk Adjustment Model” and the January 30, 2019 “Advance Notice
of … Encounter data and Risk Adjustment Processing System (RAPS) ….. that
many revisions to the encounter data submission process have …

The Medicare Advantage program: Status report – MedPAC

Report to the Congress: Medicare Payment Policy | March 2019. The Medicare
…… (RAPS), where plans submit the minimum information necessary to identify …

February 23, 2018 Seema Verma, MPH Administrator … – MedPAC

Feb 23, 2018 … Year (CY) 2019 for Medicare Advantage (MA) CMS–HCC Risk Adjustment Model
, …. risk adjustment model used in 2017, with RAPS data used as the data source
. … CMS has already extended encounter data submission.

Request for Alternate Procurement (RAP) – Alaska Department of …

Feb 7, 2019 … RAP Number …. The Centers for Medicaid and Medicare Services (CMS); b. …
2019. The Plan of Correction has been submitted, but has not yet …

Proposed rule – Amazon S3

Nov 1, 2018 … In the Medicare Program; Contract Year 2019 Policy and Technical …… The HCC
data that MA organizations submit to CMS via the RAPS and …

Juvenile Referral, Pre-Adjudication & Court Packet 2019 – Texas …

*CONTRIBUTOR ORI – Nine digit alphanumeric identifier of the agency
submitting the data to the. Department for inclusion in the Computerized Criminal
History …

SIRS Manual – nysed / p-12

Aug 17, 2018 … 8. SIRS Data Reporting Levels …… and 2019–20 school year, the student will be
counted for State Aid and BEDS enrollment purposes in …

2019 New York State Annual Progress and … – OCFS – NY.gov

This APSR is the fourth update to the 2015-2019 Child and Family Services Plan
(CFSP) … webinars, county-specific data, and draft submissions of the County
Plan. …… the validity of the risk elements on the RAP, the element weightings,
and …

Standard Project Manual for Utility and Street … – Woodbury, MN

Jan 4, 2019 … 2019 Woodbury Standard Project Manual for Utility and Street Construction …. E.
Submit Product Data for the following items consistent with …

North College Hill RAP – Ohio Department of Education – Ohio.gov

Aug 31, 2018 … Thank you for submitting the North College Hill City School District Reading …. By
the end of the 2018-2019 school year, all students in grades K-12 … RAP Writing
Team (based on what your data reveals) How will the team …

nato security investment program – Under Secretary of Defense …

Military. Construction. Program. FY 2020 BUDGET. North Atlantic Treaty
Organization. Security Investment Program. March 2019. Justification Data
Submitted to …

Reclaimed Asphalt Pavement (RAP) – IDoT

Revise: January 1, 2019. Revise Section … RAP and RAS stockpiles shall be
according to the following. (a) RAP … For testing after stockpiling, the Contractor
shall submit a plan for approval … All test data and acceptance ranges shall be
sent.

2019 Annual Energy Report – Vermont Legislature – Vermont.gov

Jan 15, 2019 … 2019 Annual …. K. Recommendations Related to Tracking Data . ….. Appendix B –
Proposed Statutory Language Regarding Reporting Modifications . …… Potential.
Annual Energy (MWh). RAP. 106,494. 206,269. 295,100.

please read – Department of Commerce and Consumer Affairs

Oct 24, 2018 … If you submit an application on or after July 1, 2017 or before. July 1, 2017, but
your license … of Hawaii (Hawaii Criminal Justice Data Center) criminal history
record checks in … and national rap back programs. You have the …

CMS Hospital Compare Data Set 2018

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By , February 10, 2019 2:29 pm


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CMS Hospital Compare Data Set 2018

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Hospital Value-Based Purchasing – CMS.gov

CMS bases hospital performance on an approved set of measures and
dimensions … Table 1. Hospital VBP Domains and Relative Weights for Fiscal
Year (FY) 2018 and ….. https://www.medicare.gov/HospitalCompare/Data/total-
performance-.

DDB Data Dictionary_December 2017 – Medicare Data – Medicare.gov

Dec 20, 2017 … Hospital Compare provides data on over 4,000 Medicare-certified …. for each
measure set included on Hospital Compare: …. Data for the FY 2018 recalibrated
PSI measures only represent the 15-month performance period of …

Issues and Challenges in Measuring and Improving the Quality of …

Dec 10, 2017 … Data Sources Used to Construct Quality Measures . ….. 2018–2036, …. include
patient safety measures in their measurement sets, they are ….. Medicare's
Hospital Compare Performance Measures and Mortality Rates,” …

NHSN & CMS Quality Reporting and Payment Programs – CDC

May 15, 2018 … Evaluate current measure sets and inform measure development. Give us … Data
published on the CMS Hospital Compare website. ▫ Hospitals … Safety
Performance Period: January 1–December 31, 2018. • Safety Baseline …

GAO-18-574, DEFENSE HEALTH CARE – Government …

Sep 17, 2018 … Used in the Military Health System, as of March 31, 2018. Furthermore ….
included in the Hospital Compare measure set for inpatient care and the. Core
Quality ….. These hospitals supply data to CMS for quality measures of …

2018 Hospital Report Card Reporting Manual for Community Hospitals

Mar 15, 2018 … submistted to CMS by hospitals. VDH downloads data quarterly from. Hospital
Compare. •Hospitals collect & submit discharge data set to …

CON – Maryland Health Care Commission – Maryland.gov

Mar 30, 2018 … Hospital applicants must submit data to the Maryland Health Care … Using the
January 2018 CMS Home Health Compare dataset (refer to …

Fiscal Year 2018 Vermont Hospital Budget Submissions

Jul 27, 2017 … Hospitals exceeding net patient revenues in Budget 2016 were required ….. the
annual public hearings and from budget adjustments if they met a set of ….. 37

https://www.medicare.gov/hospitalcompare/Data/Overview.html …

Core Set of Children's Health Care Quality Measures … – Medicaid.gov

Feb 8, 2018 … specifications and “HEDIS data/rate” refers to and assumes data/rate audited …
For the CMS measures in the Child Core Set: … 2018 American Dental
Association on behalf of the Dental Quality Alliance (DQA). ….. conducting a pilot
of the Child Hospital Consumer Assessment of Healthcare Providers and.

Rural Hospitals and Medicaid Payment Policy – macpac

Aug 1, 2018 … states have established special payment policies for rural hospitals. Compared to
urban … Source: MACPAC, 2018, analysis of Medicare cost reports. … Below we
describe how states set two types of …. 6 Provider-specific data on non-DSH
supplemental payments for all hospitals are not available.

Washington State Common Measure Set, Approved 2018 (as of …

source IIS); and (2) immunization for 18 and older (data source: … Hospitals.
Required Units for Public Reporting in 2018. 7 Youth Obesity ….. CMS. Yes 0166.
Survey. (H CAHPS). Hospital. Compare. Results are reported for two questions …

Appendices for: Report to Congress: Social Risk Factors and …

STRATEGY 2: Set High, Fair Standards for All Beneficiaries … CONSIDERATION
1: Consider enhancing data collection and developing statistical …… Hospital-
wide readmission rates are reported in the Hospital Compare database …..
Starting in FY 2018, CMS will adopt a revised version of the measures which
expands the …

eCQM Logic and Guidance – eCQI Resource Center – HealthIT.gov

May 4, 2018. Page 2. Centers for Medicare & Medicaid Services / ONC.
Electronic Clinical Quality … and Eligible Hospital eCQM Types and Versions.
Section 4: • Updated language and logic sample in …. Data Elements and Value
Sets .

Medicare Supplement Insurance 2018 Shopper's Guide

Medicare Deductible and Coinsurance Amounts for 2018. Page 5. Part A … Find
and Compare Medicare Plans. Page 11 … database. What is Medicare? Part A (
Hospital Insurance). Part B (Medical Insurance). & …. Carolina Department of
Insurance but the benefits, however, are set by the federal government. Medigap.

Hospital‐Acquired Infections in New York State, 2016, Part 1 …

June 2018 …. provide the public with data to compare hospital infection rates. ….
Staphylococcus aureus (MRSA) BSIs to participate in CMS reporting …… on a
selected set of HAIs and with limited adjustment for differences between patient.

Household healthcare spending: comparing the Consumer …

Sep 22, 2017 … understanding of the data sets that measure healthcare spending is crucial. …
and the Centers for Medicare & Medicaid Services' National Health … hospitals
and other providers of care, and to insurance companies, for private group and
….. to the income-related premium for both Part B and Part D. In 2018,.

Connecticut Department of Public Health Final Report – CT.gov

Aug 7, 2017 … Section 639f sets out timelines for the series of events associated with the CMIR
… with its data requests, it has 90 days to issue a Preliminary Report. …… Using
the CMS Hospital Compare overall rating, Charlotte …… HealthCare included in
each year FY 2018 and FY 2019 a projected shift of activity from.



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