Frequently Asked Questions

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FAQ

How can dual Medicare and Medicaid enrollees with selected diagnoses, procedures and/or medical conditions be accurately identified in the Medicaid Analytic eXtract (MAX) data?

The answer to this question depends on the fact that Medicare is the first payer for covered Part A, B and D services for dual enrollees.  A user should link MAX enrollment data with Medicare enrollment data for these enrollees, then access Medicare and Medicaid service (claims) records for the enrollee from both systems to identify completely selected diagnoses, procedures and/or medical conditions for the enrollee.  For dual enrollees, data from MAX are not likely to identify fully all of the diagnoses, procedures and/or medical conditions for that enrollee.  For data housed in the Medicare Chronic Condition Warehouse, a number of chronic health conditions are identified.
 
(FAQ2919)

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