Medicaid Data Available

Courses offered relating to Medicaid Data

Research Identifiable Files (RIFs):

CMS State Medicaid Research Files (SMRF) and the Medicaid Analytic Extract files (MAX which replace SMRF for 1999 data forward) are considered research identifiable files. Person-level identifiable information is included in these Medicaid enrollment and utilization files. Data with beneficiary or physician identifiers are subject to the Privacy Act, Freedom of Information Act and other Federal government rules and regulations. As such, the information is confidential and is to be used only for reasons compatible with the purpose(s) for which the data are collected.
CMS employs strict security measures to safeguard individual privacy. CMS data release policies seek to ensure that files containing physician and/or beneficiary identifiers are used only when necessary and in accordance with disclosure provisions of the Privacy Act. Researchers need to submit to CMS a data request packet containing a written request, study protocol, evidence of funding, and Data Use Agreements (DUA). If CMS approves the data file request, researchers need to pay the cost incurred in the processing of data.
The CMS Medicaid enrollment and claims data contains information for Medicaid eligibles who actually do enroll in their state's Medicaid program. CMS Medicaid files cannot, therefore, be used to study individuals who are eligible but not enrolled.
Medicaid Analytic Extract (MAX) 1999 forward: [brief file description] [data dictionary]

The MAX files remain similar to the SMRF files, containing beneficiary-level enrollment, utilization, and expenditure data on a calendar year basis. They will be available for all 50 states (Look for the document in the ZIP archive that addresses current availability), due to a requirement of the BBA which mandated that all states participate in MSIS.
As with the SMRF files, MAX files include one file with enrollment information (Personal Summary File) and four claim files (Inpatient, Other Therapy, Long Term Care, Prescription Drug) for each year of data. The claims represent final action claims. SMRFs have undergone extensive edit checks.
Public Use Files:

The PUFs have been edited and stripped of all information that could be used to identify individuals. In general the PUFs contain aggregate level information on Medicaid utilization and demographics and summary Medicaid beneficiary enrollment. Medicaid PUFs can be downloaded from the CMS web site free of charge.
- Aggregated statistics and data from the Medicaid Statistical Information System (MSIS) for 1999 to current are available at http://www.cms.hhs.gov/MedicaidDataSourcesGenInfo/02_MSISData.asp
- Data on both the Medicare and Medicaid programs is included in the 2002 Data Compendium. Some tables and ordering information are available at CMS. The data is current to 1999.
- The Medicare and Medicaid Statistical Supplement includes data on both programs.
- The Medicaid Drug Rebate Product Description File and the Medicaid Drug Rebate Utilization File can be downloaded from CMS.
Specifications for the Drug Utilization data are available and include the record layout and data definitions.
Statistical Compendium: Medicaid Pharmacy Benefit Use and Reimbursement in 1999

The Centers for Medicare & Medicaid Services (CMS) has made available for the first time the Statistical Compendium: Medicaid Pharmacy Benefit Use and Reimbursement in 1999, which provides detailed state-by-state and national data on the use of and reimbursement for prescription drugs in Medicaid. These data, prepared from Medicaid Analytic eXtract (MAX) files for calendar year 1999 by Mathematica Policy Research, Inc. under contract with CMS, show use and reimbursement by beneficiary demographic characteristics (age, sex, and race), basis of eligibility (children, adults, disabled, and aged), and Medicare-Medicaid dual eligible status. There are detailed tables for all Medicaid beneficiaries' combined and separate tables for dual eligibles and for full-year residents of nursing facilities. The tables show drug use and reimbursement by brand status (patented brand name, off-patent brand name, and generic), therapeutic category (cardiovascular agents, central nervous system drugs, etc.) and drug group (anti-psychotics, anti-depressants, ulcer drugs, etc.).
Data is available for 48 states and DC. State tables for Arizona and Tennessee were not prepared because reporting of prescription drug use and reimbursement under the capitated managed care plans that predominate in those states is incomplete and inconsistent in the 1999 MSIS and MAX files.
A policy brief prepared by Mathematica Policy Research, Inc, provides examples of how data in this statistical compendium can be applied. The brief is entitled, "New State Data on Medicaid Drug Use and Cost Can Help States Solve Problems”, authored by James M. Verdier and Myoung Kim, March 2005, Number 4.
Medicaid Summary Data Resource: The Medicaid Analytic eXtract (MAX) Chartbook

A new Medicaid chartbook with an extensive data appendix summarizing enrollee demographic and eligibility characteristics, Medicaid service use, and Medicaid expenditures in 2002 is now available on the Centers for Medicare & Medicaid Services (CMS) website. The Medicaid Analytic eXtract (MAX) Chartbook is a research tool and reference guide on the Medicaid program and the MAX data system for calendar year 2002. Developed for state Medicaid directors, policymakers, researchers, and others interested in the Medicaid program, the chartbook presents summary information about Medicaid enrollees and their Medicaid experience at the national and state levels. Special topic chapters provide supplementary information on managed care, dual Medicare/Medicaid enrollees, and service use and expenditures by detailed type of service. The MAX Chartbook (in PDF format) can be downloaded here. The chartbook's appendix tables (as zipped Excel files) are available here.

Last Modified August 5, 2008