Tip: TPA and PBM Replacement Data for EBD - REVISED

Number	0124 (2)
Submitting Entity (SE)	99EBD1, 95442, 95448B, 99MDI4, 99MDI5
Add Date	Sep 18, 2023
Update Date
Update
Description	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: https://achiapcd.atlassian.net/wiki/spaces/ADRS/pages/3054501929 IMPORTANT DATA POINT: The official date EBD data submission ended was 2022-05-31. However, several segments remained open where ME163A > 2022-05-31. These have been closed to reflect 2022-06-01. Note, this date was selected because no enrollment dates ended on this date. This will help the data user know that these segments were open after the system closed.
Active/Resolved	Active
Action / Resolution	Use with data requests fulfilled after March 2023.
Category 1	EBD
Category 2	TPA
Tip / Issue	Tip

ME001	ME001_CAT	Enrollment Date (ME162A)	Disenrollment Date (ME163A)	Description	Notes
99EBD1	EBD	1/1/2013	6/1/2022	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 find 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 find 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 find 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 find 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 find members between 95448B and 99EBD1.