Process 8/7/2013 Faith Asper, MHS Director, ResDAC Assistance Desk - PowerPoint PPT Presentation

State Research Request Process 8/7/2013 Faith Asper, MHS Director, ResDAC Assistance Desk

About ResDAC  Centers for Medicare and Medicaid (CMS) contractor  Offer free assistance to researchers interested in using Medicare and Medicaid data for research  Staffed by a team of public health and health services research specialists  Provide a range of services related to CMS data ˗ Assistance Desk ˗ Workshops and Outreach 2

Overview of Webinar  Review the State research request memo  Examine differences between the State research and Qualified Entity DUA  Examine reuse considerations  Provide step by step instructions on how to request CMS data under State research ˗ Materials needed ˗ Process to request ˗ Resources 3

State Data Request Memo  Review unique features of State research requests  Explain what “Opting in” to data sharing means  Review the data files and populations available  Review file availability, frequency, and cost  Provide general overview of the request process (details to follow) 4

State Data Request Memo  Definition of research is broader than typical research requests  State operations and demo projects will need to make separate request for data.  State can choose whether or not to “Opt in” to data sharing ˗ State must submit quarterly log of projects to CMS ˗ Allows State to reuse data for a variety of research projects under single DUA. ˗ States that choose to “opt out” of data sharing would follow the standard request process (one DUA per project). 5

Privacy Level of the Data  Research Identifiable Files (RIF) ˗ No direct identifiers (SSNs or Medicare numbers) contained in the files ˗ However, enough information is provided that beneficiaries could potentially be identified (e.g. date of birth, zip code, real physician identifiers) ˗ States can receive “identifier” files containing SSN, HIC, Name, MSIS id ˗ Requires a Data Use Agreement (DUA) 6

“Opting In” to Data Sharing  State can choose whether or not to “Opt in” to data sharing ˗ One agency signs CMS DUA as User and signs Attachment A ˗ Allows State to reuse data for a variety of research projects under single DUA ˗ State must submit quarterly log of projects to CMS ˗ State agrees to contractually bind other agencies and users of CMS data to DUA  States that choose to “opt out” of data sharing would follow the standard request process (one DUA per project). 7

Data Files and Populations Available  States can request Medicare beneficiaries for their state and a 5% national sample  States may choose the years and files ˗ Annual files available for historical years ˗ Current year files can be requested as frequently as quarterly  States can request enrollment, utilization (A/B/D), assessments, summary, and identifier files (SSN, HIC, Name, etc) 8

Data Availability, Frequency, & Cost  Historical data available as annual files back to 2008  Current year can be requested on a quarterly, bi- annual, or annual basis  Current year data requested quarterly or bi- annually will have a 6-9 month run off of claims  Pricing will depend on the files requested, but reflects a special price developed for States 9

Request Process  State research request will be approved by CMS Privacy Board.  ResDAC assists the State and CMS with the review of materials and answering any questions about the contents of data files, cost, and process.  State will provide an overview of the work being performed under research, Data management plan, DUA, and any other file specific documents.  See the ResDAC State Agency Data Requests website for list of materials. 10

Request Process Research Requests need to include  Description of the study, including objectives and design  Justification for why the data requested is the minimum amount of data needed to answer the study question  Explanation of how this study will benefit the Medicare or Medicaid program  Description of how the study findings will be disseminated 11

CMS Research Policies  Cell suppression policy ˗ Allowed to publish findings as long as no cell (admissions, discharges, patients, services) 10 or less may be displayed. This includes the use of percentages. 12

Difference between State research and QE DUA  State research request process allows a State to have a broader definition of “research” Exception to this is for requests involving Part D data where ˗ an example of a specific study will need to be provided and used as the basis for the justification for the data.  State research request will be reviewed by CMS Privacy Board  Provider level reports can ONLY be performed under the Qualified Entity DUA.  Data received under either request process can be reused for the other. Pricing and availability of the data are consistent across the ˗ State and QE request process. 13

Reuse considerations  Data received under State research process can be reused for the QE program. Likewise, data received under QE program can be reused for State research activities.  Reuse fee of $2,000/request is applied if no new data are requested 14

State Research Request Process 15

Step 1: Obtain the request materials  Start at the ResDAC home page 16

Step 1: Obtain the request materials  The State request materials are at the bottom of the State Agency Data Request page. 17

Step 1: Obtain request materials  Download request materials 18

Step 2: Prepare a draft  Prepare a draft of all the documents (before signing them)  Next, we’ll walk through the request documents. 19

State Request Letter  Request letter template provided as a guide. 20

State Executive Summary  Includes data sharing, log of users, overview of projects, dissemination of findings, and data management plan. 21

State Executive Summary Requests involving Part D data  The request of Part D data for a state research routine use request will require the following: ˗ Descriptions of the distinct lines of research which include specific examples of the kinds of issues to be explored. ˗ Information regarding how the Part D data will be used to address the research topic(s). ˗ Information regarding how each specific Part D data variable requested will be used in the research. 22

Data Use Agreement 23

Data Use Agreement CMS will assign after submission This should be the State 24

Data Use Agreement Insert the title of the Study. This will only be filled in if it involves a CMS contract. 25

Data Use Agreement List specific files and years requested. Leave SOR blank. Notice how Carrier and DME files are being reused from (DUA 12345) Year for the Identifier files will be crosswalk file should needed if reusing for be the year that it QE program. was provided. (i.e. 2013) CMS has an automatic 1 yr retention period. 26

Data Use Agreement #12 can include Attachment A (Opt-in to data sharing) and/or Signature addendum to the DUA 27

Data Use Agreement #16 is the individual that is authorized to sign on behalf of the State. #17 is the individual that is responsible for the data security. 28

Data Use Agreement Page 6 can be left blank. 29

Data Use Attachment for State Research User that signed under #16 signs here. 30

Specifications Worksheet 31

Specifications Worksheet 32

Specifications Worksheet 33

Signature Addendum  A Signature Addendum to the DUA is for any organization that will access the individual data, but did not sign as requestor (#16 of DUA) or custodian (#17 of DUA). 34

File Specific Variable Justification  If any of the following files are requested, then CMS requires a variable selection and justification worksheet accompany the request. ˗ MDS Assessments (Swing Beds or Nursing Homes) ˗ IRF-PAI Assessments ˗ OASIS Assessments ˗ Part D data 35

Step 3: Email drafts to ResDAC  Email draft documents to resdac@umn.edu  ResDAC will review, obtain cost invoice, provide comment and email all documents back to the State for final revisions and signatures. 36

Cost Invoice 37

Step 4: Email final copies to ResDAC  Email final documents with signatures to resdac@umn.edu ˗ CMS can’t accept digital signatures.  ResDAC will forward all to CMS for processing. 38

Step 5: Submit Payment  After the CMS Privacy Board reviews and approves the request, CMS emails the State: ˗ DUA number with approval notice ˗ Instructions to submit payment  Once the State submits payment, CMS will notify CCW that the data can be processed. 39

Resources for Help  ResDAC Assistance Desk ˗ Email: resdac@umn.edu ˗ Phone: 1-888-973-7322 ˗ Web: http://www.resdac.org  ResDAC Website CMS Data Request Center: State Research request page ˗ ˗ ResConnect (Resource Library) » Tips for Completing the DUA » Request Documents for Research Identifiable Data Requests: Data Use Agreement 40