CMS must ensure that all research requests for identifiable (RIF) data have IRB documentation to satisfy the requirements of the Common Rule and the Health Insurance Portability and Accountability Act (HIPAA). This article describes the...
CMS offers files from aggregate data to individual person level data. This article describes the differences between the aggregate, public use files, the limited data sets, and research identifiable files.
Cost report variables are split between two data files depending on the format of the variable. A master table lists all cost report variables and the format. The “Usage” column in the master table specifies the format of the variable, which determines the file location.
Beginning in 2008, some hospital provider numbers appearing in the claims contain a “V” in the fifth position of the six-digit Medicare Provider Number. Usually, the fifth position is a number, not a character. These hospital provider numbers appear in the MedPAR, Inpatient and Outpatient files for both RIF and LDS versions. ResDAC recommends that researchers remove these claims.
This article provides resources for obtaining statistics and reports related to the Medicare and Medicaid programs and their beneficiaries. The following Medicare/Medicaid statistical and summary data resources address some of the most common requests for this type of information. These are by no means exhaustive.
The beneficiary eligibility and enrollment files have changed in content and name over the years. It is important to understand the timing of these changes and the unique features of each file if you are using older files or see them referenced in articles.
CMS offers several claim-level files that contain outpatient claims; that is, facility claims submitted for care covered under Part B. Three versions of the LDS files are described:Outpatient file,Outpatient Prospective Payment System (OPPS) file, and OPPS Partial Hospitalization file.