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

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

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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

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State Research Request Process

Faith Asper, MHS Director, ResDAC Assistance Desk

8/7/2013

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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

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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

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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)

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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).

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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)

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“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

  • f CMS data to DUA
  • States that choose to “opt out” of data sharing would

follow the standard request process (one DUA per project).

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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)

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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

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Request Process

  • State research request will be approved by CMS

Privacy Board.

  • ResDAC assists the State and CMS with the review
  • f 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.

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Request Process

  • 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
  • r Medicaid program
  • Description of how the study findings will be

disseminated

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Research Requests need to include

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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.

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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.

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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

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State Research Request Process

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Step 1: Obtain the request materials

  • Start at the ResDAC home page

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Step 1: Obtain the request materials

  • The State request materials are at the bottom of

the State Agency Data Request page.

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Step 1: Obtain request materials

  • Download request

materials

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Step 2: Prepare a draft

  • Prepare a draft of all the documents (before

signing them)

  • Next, we’ll walk through the request documents.

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State Request Letter

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  • Request letter template provided as a guide.
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State Executive Summary

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  • Includes data sharing, log of users, overview of

projects, dissemination of findings, and data management plan.

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State Executive Summary

  • 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.

Requests involving Part D data

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Data Use Agreement

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Data Use Agreement

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CMS will assign after submission This should be the State

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Data Use Agreement

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

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Data Use Agreement

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

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Data Use Agreement

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

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Data Use Agreement

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#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.

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Data Use Agreement

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Page 6 can be left blank.

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Data Use Attachment for State Research

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User that signed under #16 signs here.

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Specifications Worksheet

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Specifications Worksheet

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Specifications Worksheet

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Signature Addendum

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  • 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).

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File Specific Variable Justification

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  • 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

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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.

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Cost Invoice

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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.

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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.

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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

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