With the on-going changes to the national health care environment, the Centers for Medicare & Medicaid Services (CMS) has made significant investments to meet the organizational and information technology (IT) infrastructure to adequately represent CMS’ role in the healthcare marketplace. The Transformed Medicaid Statistical Information System (T-MSIS) is a critical data and systems component of the CMS Medicaid and CHIP Business Information Solution (MACBIS).
CMS has been working with states to transform our MSIS system, which was used to collect utilization and claims data as well as other key Medicaid and CHIP program information, to keep pace with the data needed to improve beneficiary quality of care, assess beneficiary to care and enrollment, improve program integrity, and support our states, the private market, and stakeholders with key information.
The T-MSIS data set contains:
- Enhanced information about beneficiary eligibility
- Beneficiary and provider enrollment
- Service utilization
- Claims and managed care data
- Expenditure data for Medicaid and CHIP
Learn more in the T-MSIS Informational Bulletin (PDF, 134.56 KB), T-MSIS State Health Official (PDF, 136.4 KB) and T-MSIS State Medicaid Director (PDF, 159.18 KB) letters, as well as the T-MSIS Data Dictionary (ZIP, 1.73 MB).
The following factors influence the T-MSIS file submission status:
- Currency of state data – Files for a reporting period are submitted before the end of the subsequent month.
- Completeness of state data – Current or historical resubmissions contain all data for those reporting months, and the data is complete and usable.
- States completing Large System Enhancements (LSE) remain compliant, with no gaps in reporting
T-MSIS State File Submission Status
T-MSIS State Overall Progress as of 11/16/2020
51 states (includes DC), 4 entities (IA CHIP, PA CHIP, WY CHIP, and Montana TPA) and 2 territories (Virgin Islands and Puerto Rico) are in production and submitting monthly (100%)
0 states in production and no longer current by 2 -6 months
0 states in production and no longer current by 6+ months
1 territory (Guam) working towards production
2 territories (American Samoa and Northern Mariana Islands) do not participate in T-MSIS
T-MSIS Priority Items (TPIs) 1 – 23 Status
(2020 T-MSIS DQ Assessment)
T-MSIS Data Quality Progress for T-MSIS Priority Items (TPI) 1-23 as of 11/16/2020
13 states and 1 territory (Virgin Islands) have data quality issues in 2 or fewer TPIs
26 states have data quality issues in 3 to 5 TPIs
12 states and 1 territory (Puerto Rico) have data quality issues in 6 or more TPIs
3 territories do not yet submit T-MSIS data
Notes on Map for T-MSIS Priority Items (TPI) 1 – 23
- TPI categories are identified on the T-MSIS Coding Blog.
- If a state has one or more data quality issues in TPIs 1 - 23, then that category will be included in the count of total TPIs reflected on the map.
- Pennsylvania and Wyoming submit Medicaid and CHIP program data to T-MSIS separately. The count of TPIs on the map reflect only those TPIs identified for the Medicaid T-MSIS file submission.
- The TPI map identifies the status of state activities in addressing T-MSIS data quality areas currently prioritized by CMCS. The map indicates the measures related to the TPIs that identify potential data quality issues. This map is not a representation of all T-MSIS data quality issues
- The number of TPIs are increased annually as states continue to improve their data.
- TPIs 1 – 23 will be used as the T-MSIS data quality criteria for the 2020 assessment.
- While states are strongly encouraged to continue to improve on TPIs 1 – 23, CMS does not plan to use State Data Quality Assessment results as the basis to initiate state compliance actions during or immediately following the COVID-19 public health emergency (PHE).
T-MSIS Priority Items (TPIs) 1 – 12 Status
T-MSIS Data Quality Progress for T-MSIS Priority Items (TPI) 1-12 as of 11/16/2020
46 states and 2 territories (Puerto Rico and Virgin Islands) have data quality issues in 2 or fewer TPIs
5 states have data quality issues in 3 to 5 TPIs
0 states have data quality issues in 6 or more TPIs
3 territories do not yet submit T-MSIS data
Notes on Map for T-MSIS Priority Items (TPI) 1 – 12
- TPI categories are identified on the T-MSIS Coding Blog.
- If a state has one or more data quality issues in TPIs 1 - 12, then that category will be included in the count of total TPIs reflected on the map.
- Pennsylvania and Wyoming submit Medicaid and CHIP program data to T-MSIS separately. The count of TPIs on the map reflect only those TPIs identified for the Medicaid T-MSIS file submission.
- The TPI map identifies the status of state activities in addressing T-MSIS data quality areas currently prioritized by CMCS. The map indicates the measures related to the TPIs that identify potential data quality issues. This map is not a representation of all T-MSIS data quality issues.
- The number of TPIs are increased annually as states continue to improve their data.
- The T-MSIS DQ Map will be updated on the last week of the month.
T-MSIS Coding Guidance Updates
Receive announcements as well as new and updated CMS guidance about coding information related to the Transformed Medicaid Statistical Information System (T-MSIS).
- Subscribe to T-MSIS updates
- See previous T-MSIS Coding Memos
MSIS Information
The Medicaid and Statistical Information System (MSIS) used by the Centers for Medicare and Medicaid Services (CMS) to gather key eligibility, enrollment, program, utilization and expenditure data for the Medicaid and Children's Health Insurance Program (CHIP) has been decommissioned and replaced by T-MSIS.