Frequently Asked Questions

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Are CHIP program enrollees included in MSIS and Medicaid Analytic eXtract (MAX) and what data are available for these enrollees?

Current MSIS specifications require States to report CHIP enrollment and services for all Medicaid expansion CHIP (M-CHIP) enrollees.  The capture of these data is comparable to that of non-CHIP Medicaid enrollees.  By this, we mean that reporting of M-CHIP enrollment and any services provided to M-CHIP enrollees on a fee-for-service basis should be relatively complete and accurate.  However, other FAQs discuss limitations and inconsistencies of State reporting of encounter records for persons in prepaid managed care plans.  These same limitations and inconsistencies apply to encounter records for M-CHIP enrollees in prepaid managed care plans.  Currently, data for separate stand-alone CHIP (S-CHIP) enrollees is limited in MSIS and MAX.  States have the option of reporting enrollment for S-CHIP enrollees.  Some states report for all S-CHIP enrollees, others for some S-CHIP enrollees and others for none of their S-CHIP enrollees.  Previously, states have been told not to report utilization data for S-CHIP enrollees.  There are current efforts under way in the MAX-PDQ contract and through the release of an updated MSIS Data Dictionary to improve S-CHIP reporting.     

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