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SE_ID | Submitting Entity | Release Notes | Release Status |
12151 | Arcadian Health Plan (Humana entity) | Previous status: Omitted in 20B because of member ID issues. These are being addressed. Data should be available in the 20D Arkansas APCD Data Release. Versioning issues have been found in the pharmacy claims data. However, data requesters can use a workaround to determine the most recent version of a claim. See the Arkansas APCD tip sheet for versioning recommendations. No issues identified for medical claims. Current status: Pharmacy versioning corrections have been applied. Number of covered lives for this submitter: 80,789 | Issues resolved.
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12282 | Humana Regional Health Plan | Previous status: Versioning issues have been found in the pharmacy claims data. However, data requesters can use a workaround to determine the most recent version of a claim. See the Arkansas APCD tip sheet for versioning recommendations. No issues identified for medical claims. Current status: Pharmacy versioning corrections have been applied. Number of covered lives for this submitter: 2764 | Issues resolved.
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16244 | Empower Healthcare Solutions, LLC (MCD PASSE) | Current status: Issues have been identified with the APCD Unique ID (ME998) on the member data therefore data for this submitting entity will not be available for selection. The Arkansas APCD team is working with the submitting entity on data correction and resubmission. Number of covered lives for this submitter: 28,106 | Not included. |
60052 | Humana Benefit Plan of Illinois, Inc. | Previous status: Versioning issues have been found in the pharmacy claims data. However, data requesters can use a workaround to determine the most recent version of a claim. See the Arkansas APCD tip sheet for versioning recommendations. No issues identified for medical claims. Current status: Pharmacy versioning corrections have been applied. Number of covered lives for this submitter: 147 | Issues resolved. |
60217 | Anthem | Previous status: Some pharmacy claims are present that have no corresponding member records. ACHI is working with the submitter to resolve this issue. Current status: Submitter provided solution. Number of covered lives for this submitter: 67,330 | Issues resolved. |
60984 | CompBenefits Insurance Company (Humana entity) | Previous status: Versioning issues have been found in the pharmacy claims data. However, data requesters can use a workaround to determine the most recent version of a claim. See the Arkansas APCD tip sheet for versioning recommendations. No issues identified for medical claims. Current status: Pharmacy versioning corrections have been applied. Number of covered lives for this submitter: 2764 | Issues resolved. |
65676 | The Lincoln National Life Insurance Company | Previous status: An issue exists with versioning rules utilized for this submitter therefore no versioning has been applied for the 20B release. Current status: Replacement data received and corrections applied. Number of covered lives for this submitter: 43,379 | Issues resolved. Previously excluded. Now included. |
68985 | Starmount Life Insurance Company | Current status: Several data quality issues have been identified in these data. The Arkansas APCD team is working with the submitting entity on data correction and resubmission. Number of covered lives for this submitter: 6929 | Not included. |
73288 | Humana Insurance Company | Previous status: Versioning issues have been found in the pharmacy claims data. However, data requesters can use a workaround to determine the most recent version of a claim. See the Arkansas APCD tip sheet for versioning recommendations. No issues identified for medical claims. Current status: Pharmacy versioning corrections have been applied. Number of covered lives for this submitter: 392,252 | Issues resolved.
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95885 | Humana Health Plan | Previous status: Versioning issues have been found in the pharmacy claims data. However, data requesters can use a workaround to determine the most recent version of a claim. See the Arkansas APCD tip sheet for versioning recommendations. No issues identified for medical claims. Current status: Pharmacy versioning corrections have been applied. Number of covered lives for this submitter: 146,738 | Issues resolved.
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99MCD1
16256 16244 60217 47155 | Arkansas Medicaid
PASSE Carriers: Arkansas Total Care Empower Summit Delta Dental | Arkansas PASSE carriers, Arkansas Total Care, Empower, and Summit (submitted through Anthem), began managing Arkansas Medicaid medical and pharmacy claims in March 2019. Delta Dental began managing Arkansas Medicaid dental claims in January 2018. PASSE and other managing carriers must submit claims to Arkansas Medicaid’s MMIS system. These claims inputs generate Arkansas Medicaid claims in the MMIS system. Arkansas Medicaid has begun submitting these MMIS claims to the Arkansas APCD in June 2020. When data selections include both the Arkansas Medicaid, PASSE and/or other managing carrier claims, service event claims could appear to be duplicated. It is important not to use the matching Arkansas Medicaid claim for analysis as they do not represent the actual service. Refer to this data tip to be able to identify a PASSE. Tip: Identifying Arkansas PASSE data Refer to this data top be able to locate and manage duplicate claims created from the circumstance described. Tip: Identifying Claims Duplicated across Carriers | Use with caution. Refer to Data Tips for methodology to handle claim duplicates. |
99MCD1 | Arkansas Medicaid | Pharmacy Claim counts for June 2020 - The number of paid pharmacy claims increased significantly in June 2020 because the Arkansas Medicaid MMIS system received the first submission of pharmacy claims from the Arkansas PASSE carriers that support Arkansas Medicaid. PASSE claims will be received periodically and included with the traditional Medicaid FFS pharmacy clams. No additional PASSE claims were received after June 2020 but are expected in the future. Because the PASSE carriers also submit to the Arkansas APCD, the receipt of these claims through Arkansas Medicaid can create duplicates. Tip: Identifying Claims Duplicated across Carriers Pharmacy Claim counts for December 2020 - The number of paid pharmacy claims had a one time increase in December 2020 because of claims added to the MMIS system after an ad hoc member reconciliation project. Tip: Arkansas Medicaid Member Consolidation This count increase is visible in the APCD Universe counts. This increase does not include PASSE data as referenced above. |
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The APCD Unique ID (ME998 or Hash ID) is consistent with the previous build.
Review the latest Arkansas APCD 21B Universe Counts published on the APCD website for information about the latest data available.
Utilize the searchable Arkansas APCD data dictionaries and tip sheets (be sure to review all of them).
For high level descriptions of the APCD and its data, refer to the Arkansas APCD Infographic for a summary of the latest data available to data requesters for September 2021.