Tip: Identifying Arkansas Medicaid Members in Health Care Independence Programs (HCIP)





Number

0031

Submitting Entities

99MCD1

Add Date

Jul 29, 2019

Update Date

 Dec 30, 2021 Aug 10, 2023

Update

A new field is available after March 2023 on Member/Enrollment records for HCIP plan identification. When ME001_CAT = HCIP, the record represents a Medicaid health care independence program as part of the Arkansas Private Option, Arkansas Works, or, more recently, AR HOME. The original process below still works but this label should make the selection easier for the data users. NOTE: These member/enrollment records are ALSO received from private carriers. When a non-Medicaid carrier (ME001 <> ‘99MCD1’) has the value MCD_QHP in ME001_CAT, a duplicate record is in the Medicaid data (ME001 = '99MCD1' and ME001_CAT = ‘HCIP’). These members can be found using Study_ID (ME998+ME013). No Medicaid claims exist for these members. Use the non-Medicaid member and claims data for analyses. Included in the August 2023 Data Tips email.

Description

How to identify Arkansas Medicaid member records associated with health care independence program (HCIP), i.e. Arkansas Private Option or Arkansas Works plans

Action / Resolution

When ME001_CAT = HCIP, the record represents a Medicaid health care independence program as part of the Arkansas Private Option, Arkansas Works, or, more recently, AR HOME. NOTE: These member/enrollment records are ALSO received from commercial entities. When a commercial entity (ME001 <> ‘99MCD1’) has the value 'MCD_QHP' in ME001_CAT, a duplicate enrollment record is in the Medicaid data (ME001 = '99MCD1' and ME001_CAT = ‘HCIP’). This member overlap can be found using Study_ID (ME998+ME013). No Medicaid claims exist for these members.

 It is recommended that the commercial entity enrollment records by used in analytic projects. The Arkansas Medicaid version of the enrollment record can be used for more focused enrollment analyses as Arkansas Medicaid carries more demographic information on its member records.

See data tip: https://achiapcd.atlassian.net/wiki/spaces/ADRS/pages/542081453

Category 1

Medicaid

Category 2

Medicaid Expansion Members

Tip / Issue

Tip