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SE_ID

Submitting Entity

Release Notes

Release Status

99MDI1, 99MDI2 99MDI3

99MDI4, 99MDI5

MedImpact

MedImpact is a new pharmacy submitter. Member IDs and subscriber IDs are problematic on much of the member data and pharmacy claims causing orphaned claims. Use with caution. The Arkansas APCD team is working with the submitter to resolve the issue.

  • 99MDI1 is the PBM for multiple submitting entities.

  • 99MDI2 is the PBM for Arkansas State University (ASU)

  • 99MDI3 is the PBM for Arkansas State Police (ASP).

  • 99MDI4 is the PBM for EBD Arkansas State Employees (ASE) through 2023

  • 99MDI5 is the PBM for EBD Arkansas Public School Employees (PSE) through 2023

Update: Issues with 99MDI1 and 99MDI3 have been resolved.

Issue: MedImpact Pharmacy Orphans

Partially resolved. 99MDI1, 99MDI3, 99MDI4 and 99MDI5 are now correct.

99MDI1, 99MDI2, 99MDI3, 99MDI4, 99MDI5

MedImpact

MedImpact submitting data without versioning requirements, stating that their data could not be versioned. Investigation revealed that there was a versioning method. All MedImpact data in this release has been versioned. Counts for the 24C build will be lower as only the most current, versioned claims will be selected.

Submitting Entity

24B Row Count

24C Row Count

99MDI1

3885145

3161360

99MDI2

447898

355827

99MDI3

285061

207223

99MDI4

1724894

925218

99MDI5

1764885

982595

Informational

10155

WellCare

ME001_CAT has been updated to differentiate between Medicare Advantage plans (MCR_ADV) and Medicare Advantage Pharmacy plans (MCRAdvPhrm).

Informational

70998A, 95448A

QualChoice

Pharmacy NPIs (PC021) on the pharmacy claims records for these QualChoice entities were populated using the APCD provider data (PV023) when missing on the pharmacy claim records. Not all pharmacy NPIs were populated because of data quality issues between the claims records and the provider data.

Resolved in 24C

99MCD1

Medicaid

Duplicate enrollment records were identified in Arkansas Medicaid enrollment records because of conflicting data points used to set versionrank. These have been resolved so no duplicate enrollment records exist with versionrank = 1.

Resolved in 24C

17096

99NAV1

99ESA1

Caresource

Navitus

Express Scripts

ME001_CAT has been changed from COM to PASSE for all 17096 records.

ME001_CAT has been changed from COM to EBD_PBM for all 99NAV1 records.

ME001_CAT has been changed from COM to QHP for all 99ESA1 records when HIOS ID (ME992) ends in the following values: 00, 01, 02, 03, 04, 05, 06.

ME001_CAT has been changed from COM to MCD_QHP for all 99ESA1 records when HIOS ID (ME992) ends in the following values: 32, 36, 21, 41, 61,81, 11.

Informational

83470

95442

16751

USAble

HMO Partners

(

All are Arkansas BCBS)

Pharmacy NPI (PC021) was corrected using a crosswalk file from Arkansas Blue Cross and Blue Shield (BCBS).

Resolved in 24C

60054A

AETNA

There are 26% distinct Pharmacy claims in 60054A data that are orphaned (the pharmacy claim carrier specific unique member ID (PC107) does not exist in eligibility/member data (ME107) for this submitting entity). The orphaned records are from 2019 and earlier. No resolution possible.

https://achiapcd.atlassian.net/wiki/x/AQBZ7

Informational

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