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

Source Category

COVERAGE

Arkansas Works Data

Jan 2014 – Dec 2022

Commercial, Fully Insured Data

Jan 2013 – Dec 2022

Arkansas Employee Benefits Division Data

Jan 2013 – Dec 2022

Arkansas Medicaid Data

Jan 2013 – Dec 2022

Arkansas Qualified Health Plan Data

Jan 2014 – Dec 2022

Arkansas Medicare Data

Jan 2013 - Dec 2020

Vital Statistics Data - Arkansas Birth Certificate Data

Jan 2013 - Dec 2021

Vital Statistics Data - Arkansas Death Certificate Data

Jan 2013 - Dec 2021

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

Jan 2013 - Dec 2021

Emergency Department Data (uninsured or self-pay patients)

Jan 2013 - Dec 2021

Cancer Registry Data

Jan 2013 - Dec 2019

Medical Marijuana Cardholders Data

Jan 2013 – Sept 2020

Arkansas Workers' Compensation Data

Jan 2013 – Dec 2022

SE_ID

Submitting Entity

Release Notes

Release Status

47155

Delta Dental

An internal system change at Delta Dental resulted in a data submission gap in which updated records were not received when an enrollment segment closed. 

Replacement data has been received and applied to years 2015 forward, correcting disenrollment dates (ME163A) to close segments appropriately.

NOTE:  Years 2013 and 2014 are still problematic and cannot be corrected.  This workaround is suggested:  Pull the available claims for members and assess the latest paid date to understand when the members were last active.  Determine if the time since the last paid date represents what could be an inactive member. 

Updated status:  Segments are still being received as open that should be closed.  Use with caution until final resolution is in place.  The referenced data tip provides suggested workaround.

See Data Tip 0080.

Informational

All Submitters

New Data Field - ME001_CAT - Type of Coverage

A new data point - Type of Coverage - has been added to the Member data that categorizes the type of coverage represented by the carrier and plan. This information can help the data users group data in high level coverage types. See the table below.

This categorization is found on member data only. To associate claims with members based on type of coverage categorization, join the member data to claims data using the SE_ID and member number and select the claims where the service date is within the enrollment date.

For example:

Enrollment Submitting Entity ID (ME001) = Medical Claim Submitting Entity ID (MC001) and Enrollment Member ID (ME107) = Medical Claims Member ID (MC137) and Service From Date (MC059) is between enrollment date (ME162A) and disenrollment date (ME163A).

Enrollment Submitting Entity ID (ME001) = Pharmacy Claim Submitting Entity ID (PC001) and Enrollment Member ID (ME107) = Pharmacy Claims Member ID (PC107) and Fill Date (PC032) is between enrollment date (ME162A) and disenrollment date (ME163A).

Enrollment Submitting Entity ID (ME001) = Dental Claim Submitting Entity ID (DC001) and Enrollment Member ID (ME107) = Dental Claims Member ID (DC056) and Service From Date (DC035) is between enrollment date (ME162A) and disenrollment date (ME163A).

Informational

67369A

67369

67369F

67369B

99CIG2

Cigna

Values in the APCD_Unique_ID (ME998) are formatted incorrectly on all Cigna member records preventing matching members from other submitting entities. See Data Tip https://achiapcd.atlassian.net/wiki/spaces/ADRS/pages/3154051093

Issue

60054M

Aetna

Aetna 60054M has been sunsetted and will no longer submit data. Any remaining open segments have been closed.

Informational

Arkansas Employee Benefits Division (EBD)

EBD data is managed by several entities. It is recommended that EBD data be grouped using ME001_CAT values representing EBD in the Type of Coverage table below.

This issue can still be applied if ME001_CAT is not available. https://achiapcd.atlassian.net/wiki/spaces/ADRS/pages/544276491

Informational

83472

Arkansas Blue Cross and Blue Shield

Less than 1% of medical claim records contain the value 9999-12-31 in Service date (MC059) and paid date (MC017). These are considered invalid and the submitting entity will resubmit to correct them in the future.

Issue

10155

Wellcare

The value ‘HM’ in Insurance Product Code (ME003) was corrected to be ‘HN’

Issue

99CAR1

Caremark

Caremark member records with ME162A = '2017-03-01' and ME163A = '2017-01-31' were confirmed to be invalid have been removed.

Informational

99HSM1

HealthSmart

Member disenrollment date (ME163A) was updated with 9999-12-31 when the value was previously 1900-01-01 or 2099-12-31.

Informational

All SEs

An issue was found Provider Birth Year and Month (PV033) where this field was being replaced with NULLs incorrectly in some cases. This has been resolved and the data has been repopulated.

Informational

COM

Fully insured health plans that are a traditional type of insurance option sponsored by an employer. The employer pays monthly and yearly premiums to the insurance company, with fixed annual amounts based on how many employees are enrolled in the health plan.

DNT

Fully insured dental plans that are a traditional type of insurance option sponsored by an employer. The employer pays monthly and yearly premiums to the insurance company, with fixed annual amounts based on how many employees are enrolled in the health plan.

EBD

Medical and older pharmaceutical plans from for the largest self-insured entity in the state, the Arkansas Employee Benefits Division (EBD). EBD manages the health insurance plans for Arkansas public school teachers and state employees. Many of these plans are managed by TPAs. It is recommended that the following types of coverage be group together: EBD, EBD_NOHLTH, EBD_PBM, EBD_RET, EBD_TPA.

EBD_NOHLTH

Represents EBD members with no EBD coverage. These members are often covered by spouses or other non-EBD plans. It is recommended that the following types of coverage be group together: EBD, EBD_NOHLTH, EBD_PBM, EBD_RET, EBD_TPA.

EBD_PBM

New PBM managed pharmaceutical plans from for the largest self-insured entity in the state, the Arkansas Employee Benefits Division (EBD). EBD manages the health insurance plans for Arkansas public school teachers and state employees. It is recommended that the following types of coverage be group together: EBD, EBD_NOHLTH, EBD_PBM, EBD_RET, EBD_TPA.

EBD_RET

Represents plans for retired EBD members. These members could have EBD coverage. It is recommended that the following types of coverage be group together: EBD, EBD_NOHLTH, EBD_PBM, EBD_RET, EBD_TPA.

EBD_TPA

Older TPA managed medical plans from for the largest self-insured entity in the state, the Arkansas Employee Benefits Division (EBD). EBD manages the health insurance plans for Arkansas public school teachers and state employees. It is recommended that the following types of coverage be group together: EBD, EBD_NOHLTH, EBD_PBM, EBD_RET, EBD_TPA.

HCIP

Originally known as the Arkansas Private Option and then Arkansas Works, the Arkansas Health and Opportunity for Me (ARHOME) plans use Medicaid dollars to buy private health insurance through Arkansas Blue Cross or Ambetter for qualified beneficiaries. Member records with HCIP are sourced from Arkansas Medicaid. These member records are duplicated in the MCD_QHP category because they are managed by TPAs and should be excluded from ARHOME analysis.

MCD

Arkansas Medicaid plans that provide health coverage to children, pregnant women and individuals with disabilities.

MCD_QHP

Originally known as the Arkansas Private Option and then Arkansas Works, the Arkansas Health and Opportunity for Me (ARHOME) plans use Medicaid dollars to buy private health insurance through Arkansas Blue Cross or Ambetter for qualified beneficiaries. These member records are managed by TPAs. These member records are duplicated in the HCIP category. Members where ME001_CAT is MCD_QHP should be included in ARHOME analysis.

MCR_ADV

Medicare Advantage plans are private coverage alternatives to Medicare fee for service coverage for medical services.

MCRAdvPhrm

Medicare Advantage private coverage plans for Medicare Part D pharmacy coverage.

PASSE

PASSE plans serve Arkansas Medicaid clients with complex behavioral health, developmental, or intellectual disabilities. These plans are managed by TPAs.

PBM

Pharmacy benefit managers, or PBMs, manage prescription drug benefits on behalf of health insurers. They manage only pharmaceutical plans.

QHP

Qualified health plans (QHP), established by the Affordable Care Act (ACA), provide medical and pharmacy coverage to qualified members.