Tip: TPA and PBM Replacement Data for EBD - REVISED

0124 (2)

99EBD1, 95442, 95448B, 99MDI4, 99MDI5

18 Sep 2023

EBD data submission has changed. Older EBD data is still sourced from EBD while new data is now sourced by third party administrators (TPA) and pharmacy benefit managers (PBM).

A new field has been added to the APCD enrollment data - ME001_CAT. See data tip https://achiapcd.atlassian.net/wiki/spaces/ADRS/pages/3167027315/Redefined+field+-+ME001+CAT for definitions.

The table below contains an overview of which EBD data should be selected based on a time period. For example, if the study population required EBD members from 2020, the criteria to pull those members where ME001 = 99EBD1, ME001_CAT = EBD and the enrollment period is between 1/1/2020 and 12/31/2020.

After selecting the EBD study population, concatenate the member ID on the enrollment record (ME001+ME107) for claim selection.

Select the desired medical data by matching to the medical claims member ID (MC001+MC137).

Select the desired pharmacy data by matching to the pharmacy claims member ID (PC001+PC107)

Previous data tip (still active for older data requests: Tip: TPA and PBM Replacement Data for EBD - Original

Active

Use with data requests fulfilled after March 2023.

EBD

TPA

Tip

ME001

ME001_CAT

Enrollment Date (ME162A)

Disenrollment Date (ME163A)

Description

Notes

99EBD1

EBD

1/1/2013

5/31/2022

Enrollment for Medical and Pharmacy coverage. 

Data exists after to this date.  If used, account for possible duplication with 95442. Use Study ID (ME998+ME013) to fine members between 95442 and 99EBD1.

95442

EBD

6/1/2022

12/31/9999

Enrollment for Medical coverage beginning 6/1/2022.  

Data exists prior to this date.  If used, account for possible duplication with 99EBD1. Use Study ID (ME998+ME013) to fine members between 95442 and 99EBD1.

99MDI4

EBD_PBM

6/1/2022

12/31/9999

Enrollment for Arkansas State Employee (ASE) Pharmacy coverage beginning 6/1/2022

Data exists prior to this date.  If used, account for possible duplication with 99EBD1. Use Study ID (ME998+ME013) to fine members between 99MDI4 and 99EBD1.

99MDI5

EBD_PBM

6/1/2022

12/31/9999

Enrollment for Arkansas Public School Employee (PSE) Pharmacy coverage beginning 6/1/2022

Data exists prior to this date.  If used, account for possible duplication with 99EBD1. Use Study ID (ME998+ME013) to fine members between 99MDI5 and 99EBD1.

99EBD1

EBD_RET

1/1/2013

5/31/2022

Enrollment for EBD Retirees

Data exists after to this date however not from other submitting entities.  It will not be updated.

99EBD1

EBD_NOHLTH

1/1/2013

5/31/2022

Enrollment for EBD members with no coverage

Data exists after to this date however not from other submitting entities.  It will not be updated.

99EBD1

EBD_TPA

1/1/2013

12/31/2018

Enrollment for EBD members through QualChoice.  

Data exists after this date.  If used, account for possible duplication with 99EBD1. Use Study ID (ME998+ME013) to fine members between 95448B and 99EBD1.