Arkansas APCD 21B Release Notes - September 2021

The Arkansas Healthcare Transparency Initiative (HTI) Arkansas APCD 21B database is now available.  The Arkansas APCD 21B release includes data through December 2020.  The Data Coverage table provides overall coverage periods.  Some submitters within these categories have exemptions affecting their coverage.  Refer to the Arkansas APCD 21B Universe Counts spreadsheet for submitter specific coverage information. 

Note, hereafter, the release number will be included with database name, e.g. 20B.  The Arkansas APCD is updated quarterly though only the second and fourth updates annually are available for release.

The Arkansas APCD quarterly releases can be identified using the following naming convention:

 

Quarter

Coverage Period

Release

Example

Available

Q1

January 1, 2013 – September 30, [previous year]

[Year][A]

20A

n/a

Q2

January 1, 2013 – December 31, [previous year]

[Year][B]

20B*

July/August

Q3

January 1, 2013 – March 31, [current year]

[Year][C]

20C

n/a

Q4

January 1, 2013 – June 30, [current year]

[Year][D]

20D*

January/February

*Arkansas APCD releases available for data request fulfillment. 

DATA COVERAGE

Source Category

COVERAGE

Arkansas Works Data

Jan 2014 – Dec 2020

Commercial, Fully Insured Data

Jan 2013 – Dec 2020

Arkansas Employee Benefits Division Data

Jan 2013 – Dec 2020

Arkansas Medicaid Data

Jan 2013 – Dec 2020

Arkansas Qualified Health Plan Data

Jan 2014 – Dec 2020

Arkansas Medicare Data

Jan 2013 - Dec 2018

Vital Statistics Data - Arkansas Birth Certificate Data

Jan 2013 - Dec 2020

Vital Statistics Data - Arkansas Death Certificate Data

Jan 2013 - Dec 2020

Inpatient Hospital Discharge Data (uninsured or self-pay patients)

Jan 2013 - Dec 2019

Emergency Department Data (uninsured or self-pay patients)

Jan 2013 - Dec 2019

Cancer Registry Data

Jan 2013 - Dec 2018

Medical Marijuana Cardholders Data

Jan 2013 – Sept 2020

Arkansas Workers' Compensation Data

Jan 2013 – Dec 2020

With a few exceptions, all required submitting entities have submitted data in the ranges indicated in the Data Coverage table above.  Refer to the Source Specific Release Notes section for more information.

Source Specific Release Notes

Certain submitting entities have been added or omitted from the Arkansas APCD for this release.  Those omitted have data quality issues that are being resolved.  These issues are significant, resulting in their omission from the database release until resolution.  Once resolved, previously excluded submitting entities are included in subsequent builds.  The table below lists the problematic entities and their current status.

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.

 

 

 

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.

 

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.

 

 

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.

 

 

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. https://achiapcd.atlassian.net/wiki/spaces/ADRS/pages/554729531

Refer to this data top be able to locate and manage duplicate claims created from the circumstance described. https://achiapcd.atlassian.net/wiki/spaces/ADRS/pages/2571763827

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. https://achiapcd.atlassian.net/wiki/spaces/ADRS/pages/2571763827

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. https://achiapcd.atlassian.net/wiki/spaces/ADRS/pages/2571829335 This count increase is visible in the APCD Universe counts. This increase does not include PASSE data as referenced above.

 

Important Information

  • 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.