CMS is committed to better care, better health, and lower costs. As trusted partners in achieving these goals, CMS believes states should have access to Medicare data for research that is directed and partially funded by the state.
If a State Agency needs to request CMS data for other purposes beyond research, please see the CMS Privacy page for States for more information.
Overview of the New Process
A single state agency that is currently engaged in or intends to engage in research can request Medicare data from CMS for research purposes. This request can encompass a broad range of analytic activities that support multiple purposes and programs, avoiding the need to submit multiple individual research requests.
The state agency may choose whether or not they want to "opt-in" to data sharing:
- If a state agency chooses to "opt-in" to data sharing, the requesting agency will be able to reuse the data for additional research (beyond the research activities specified in their initial data request). In addition, the requesting agency will be able to further disseminate the data to other state agencies who are conducting research or to other entities conducting research that is directed and funded by the state.
- If a state agency chooses to "opt-out" of data sharing, the requesting agency will only be allowed to conduct the research activities specified in their initial data request. In order to use the data for any other research activities, the requesting agency would be required to obtain CMS approval, modify their existing data use agreement, and pay the appropriate fees.
For more detailed information on the new process, please review the CMS "State Data Requests" memo.
Data Available and Cost
States may request data for beneficiaries residing in the requesting state, plus a 5% national sample file for benchmarking.
The data files that can be requested include:
- Enrollment information
- Institutional and Non-institutional claims
- Part D event data
- Assessment data (e.g., Long Term Minimum Dataset, MDS)
- Crosswalk files that would allow the State to link to other State data
CMS plans to provide state requestors with a standardized extract of the Medicare data in order to make the cost of the files more affordable. For an estimate of the cost or a list of the standard files, please contact ResDAC at 888-973-7322.
Note: CMS does not intend this process to replace CMS’s current data request process for other researchers. Researchers that are not doing work under the direction of, and partially funded by a state, will need to request the data through the traditional CMS RIF research request process. Additionally, researchers in states that receive data under this process for studies that are under the direction of, and are partially funded by a state, may not use these data for studies conducted under different authorities or funding. These researchers will still be required to request the data through the traditional CMS research request process for studies that are not under the direction of, and partially funded by, the state.