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Transformed Medicaid Statistical Information System (T-MSIS)

With the on-going changes to the national health care environment, the Centers for Medicare & Medicaid Services (CMS) has made significant investments to meet the organizational and information technology (IT) infrastructure to adequately represent CMS’ role in the healthcare marketplace. The Transformed Medicaid Statistical Information System (T-MSIS) is a critical data and systems component of the CMS Medicaid and CHIP Business Information Solution (MACBIS).

CMS has been working with states to transform our MSIS system, which was used to collect utilization and claims data as well as other key Medicaid and CHIP program information, to keep pace with the data needed to improve beneficiary quality of care, assess beneficiary to care and enrollment, improve program integrity, and support our states, the private market, and stakeholders with key information.

The T-MSIS data set contains:

  • Enhanced information about beneficiary eligibility
  • Beneficiary and provider enrollment
  • Service utilization
  • Claims and managed care data
  • Expenditure data for Medicaid and CHIP

Learn more in the T-MSIS Informational Bulletin (PDF, 134.56 KB), T-MSIS State Health Official (PDF, 136.4 KB) and T-MSIS State Medicaid Director (PDF, 159.18 KB) letters.

    T-MSIS Data Quality Progress for Outcomes Based Assessment (OBA)

    The success of T-MSIS hinges on the reliability of Medicaid and CHIP data for making informed decisions. States can check for and address T-MSIS data submission errors or data quality concerns through T-MSIS dashboards available on the CMS Enterprise Portal. CMS additionally provides States with data quality technical assistance to monitor and address specific data quality issues.

    The map below displays each state and territory’s T-MSIS reporting data quality assessment using the Outcomes Based Assessment (OBA) methodology. The numbers presented on the map indicate the number of OBA criteria that have not been met, out of three total assessment criteria. States must meet data quality targets for (1) critical priority, (2) high priority, and (3) expenditure, in order to be assessed as meeting data quality expectations under the OBA methodology.

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    T-MSIS Data Quality Progress for Outcomes Based Assessment (OBA) as of 04/29/2022

    22 states and 1 territory (Puerto Rico) met the targets for critical priority, high priority, and expenditures data content category

    17 states passed on the critical priority criterion but did not meet at least one of the targets for the high priority and/or expenditures data content category

    13 states and 1 territory (Virgin Islands) did not meet the target for critical priority criterion

    3 territories do not yet submit T-MSIS data

    Notes on Map for Outcomes Based Assessment

    • If a state fails one or more of the three OBA criteria, the failed criteria will be included in the count of failed OBA criteria reflected on the map.
    • Pennsylvania only includes T-MSIS data submitted by the state Medicaid agency. T-MSIS data submitted separately by the state’s S-CHIP program are not included.
    • This map identifies the status of state activities in addressing T-MSIS data quality areas currently prioritized by CMS. The map is reflective of potential data quality issues identified using the OBA methodology and is not a representation of all T-MSIS data quality issues.
    • Timely, accurate, and complete T-MSIS data submission continues to be a CMS priority and is even more critical to national analyses of Medicaid and CHIP services, activities, and expenditures. While states are strongly encouraged to continue to improve data quality, CMS does not plan to use state data quality assessment results as the basis to initiate state compliance actions during or immediately following the COVID-19 public health emergency.
    • The T-MSIS DQ Map will be updated on the last week of the month.
    • The following states were updated with data from the February 2022 reporting period: Alaska, California, Florida, Idaho, Illinois, Indiana, Iowa, Kentucky, Massachusetts, Michigan, Missouri, Montana, Nevada, North Carolina, North Dakota, Oklahoma, Oregon, Rhode Island, Tennessee, Texas, Vermont, Washington.
    • The following states were updated with data from the March 2022 reporting period: Alabama, Arizona, Arkansas, Colorado, Connecticut, Delaware, District of Columbia, Georgia, Hawaii, Kansas, Louisiana, Maine, Maryland, Minnesota, Mississippi, Nebraska, New Hampshire, New Jersey, New Mexico, New York, Ohio, Pennsylvania, Puerto Rico, South Carolina, South Dakota, Utah, Virgin Islands, Virginia, West Virginia, Wisconsin, Wyoming.

    T-MSIS Priority Items (TPIs) 1 – 23 Status
    (2021 T-MSIS DQ Assessment)

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    T-MSIS Data Quality Progress for T-MSIS Priority Items (TPI) 1-23 as of 04/29/2022

    35 states and 2 territories (Puerto Rico and Virgin Islands) have data quality issues in 2 or fewer T-MSIS Priority Items

    19 states have data quality issues in 3 to 5 T-MSIS Priority Items

    2 states have data quality issues in 6 or more T-MSIS Priority Items

    3 territories do not yet submit T-MSIS data

    Notes on Map for T-MSIS Priority Items (TPI) 1 – 23

    • TPI categories are identified on the T-MSIS Coding Blog.
    • If a state has one or more data quality issues in TPIs 1 - 23, then that category will be included in the count of total TPIs reflected on the map.
    • Pennsylvania submits Medicaid and CHIP program data to T-MSIS separately. The count of TPIs on the map reflect only those TPIs identified for the Medicaid T-MSIS file submission.
    • The TPI map identifies the status of state activities in addressing T-MSIS data quality areas currently prioritized by CMCS. The map indicates the measures related to the TPIs that identify potential data quality issues. This map is not a representation of all T-MSIS data quality issues.
    • TPIs 1 – 23 will be used as the T-MSIS data quality criteria for the 2020 assessment.
    • While states are strongly encouraged to continue to improve on TPIs 1 – 23, CMS does not plan to use State Data Quality Assessment results as the basis to initiate state compliance actions during or immediately following the COVID-19 public health emergency (PHE).
    • The T-MSIS DQ Map will be updated on the last week of the month.
    • The following states were updated with data from the February 2022 reporting period: Alaska, California, Florida, Idaho, Illinois, Indiana, Iowa, Kentucky, Massachusetts, Michigan, Missouri, Montana, Nevada, North Carolina, North Dakota, Oklahoma, Oregon, Rhode Island, Tennessee, Texas, Vermont, Washington.
    • The following states were updated with data from the March 2022 reporting period: Alabama, Arizona, Arkansas, Colorado, Connecticut, Delaware, District of Columbia, Georgia, Hawaii, Kansas, Louisiana, Maine, Maryland, Minnesota, Mississippi, Nebraska, New Hampshire, New Jersey, New Mexico, New York, Ohio, Pennsylvania, Puerto Rico, South Carolina, South Dakota, Utah, Virgin Islands, Virginia, West Virginia, Wisconsin, Wyoming.

    T-MSIS State File Submission Status

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    T-MSIS State Overall Progress as of 04/29/2022

    51 states (includes DC), 4 entities (IA CHIP, PA CHIP, WY CHIP, and Montana TPA) and 2 territories (Virgin Islands and Puerto Rico) are in production and submitting monthly (100%)

    0 states in production and no longer current by 2 -6 months

    0 states in production and no longer current by 6+ months

    1 territory (Guam) working towards production

    2 territories (American Samoa and Northern Mariana Islands) do not participate in T-MSIS

    Notes on Map for T-MSIS State File Submission Status

    • Currency of state data – Files for a reporting period are submitted before the end of the subsequent month.
    • Completeness of state data – Current or historical resubmissions contain all data for those reporting months, and the data is complete and usable.
    • States completing Large System Enhancements (LSE) remain compliant, with no gaps in reporting

    T-MSIS Coding Guidance Updates

    Receive announcements as well as new and updated CMS guidance about coding information related to the Transformed Medicaid Statistical Information System (T-MSIS).

    T-MSIS Data Dictionary

    The T-MSIS Data Dictionary provides the requirements for States to correctly map State system data to T-MSIS record layouts in order to accurately send Medicaid and CHIP data to CMS via monthly file submissions.

    MSIS Information

    The Medicaid and Statistical Information System (MSIS) used by the Centers for Medicare and Medicaid Services (CMS) to gather key eligibility, enrollment, program, utilization and expenditure data for the Medicaid and Children's Health Insurance Program (CHIP) has been decommissioned and replaced by T-MSIS.