Innovators and entrepreneurs may now access CMS data as part of a research study to create products or tools that they intend to sell or to conduct research that creates analyses related to their own business needs. For example, an innovator could use CMS data to develop care management or predictive modeling tools.
The agency has established certain conditions under which innovator researchers may access CMS data. These conditions include:
- Approval of a research protocol under the existing research request process,
- An additional level of review that will focus on whether the product, tool, or analyses could exploit beneficiaries or create the potential for fraud and/or abuse in CMS programs, and
- A requirement that they access data via the CMS Virtual Research Data Center (VRDC). VRDC access requires an IP address registered for use in the United States. Innovators must be a United States resident.
The following CMS program data will be available to innovator researchers in the VRDC:
- Medicare Fee-for-Service Parts A & B
- Medicare Fee-for-Service enrollment data
- Medicare Part D prescription drug event data (PDE)
- Medicare Encounter
- Medicaid data
- Assessment data
For a full list of data and data descriptions, please see the data availability table.
Request Materials and Submission Information
Email all required request materials to firstname.lastname@example.org. For the initial submission, please send draft documents only (no signatures). Following ResDAC review and appropriate revisions to your request, you will email final materials to ResDAC, and ResDAC will forward them to CMS on your behalf. CMS Privacy Board reviews will be conducted on a rolling basis. Because this is a new program with an additional level of review, the review process will require additional time.