Separate CHIP Enrollment by Month and State – Historic CAA/Unwinding Period
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,This historic dataset with total enrollment in separate CHIP programs by month and state was created to fulfill reporting requirements under section 1902(tt)(1) of the Social Security Act, which was added by section 5131(b) of subtitle D of title V of division FF of the Consolidated Appropriations Act, 2023 (P.L. 117-328) (CAA, 2023). For each month from April 1, 2023, through June 30, 2024, states were required to submit to CMS (on a timely basis), and CMS was required to make public, certain monthly data, including the total number of beneficiaries who were enrolled in a separate CHIP program. Accordingly, this historic dataset contains separate CHIP enrollment by month and state between April 2023 and June 2024.,CMS will continue to publicly report separate CHIP enrollment by month and state (beyond the historic CAA/Unwinding period) in a new dataset, which is available at [link]. Please note that the methods used to count separate CHIP enrollees differ slightly between the two datasets; as a result, data users should exercise caution if comparing separate CHIP enrollment across the two datasets.,Sources: T-MSIS Analytic Files (TAF) and state-submitted enrollment totals. The data notes indicate when a state’s monthly total was a state-submitted value, rather than from T-MSIS. TAF data were pulled as follows: April 2023 enrollment - TAF as of August 2023 May 2023 enrollment - TAF as of August 2023 June 2023 enrollment - TAF as of September 2023 July 2023 enrollment - TAF as of October 2023 August 2023 enrollment - TAF as of November 2023 September 2023 enrollment - TAF as of December 2023 October 2023 enrollment - TAF as of January 2024 November 2023 enrollment - TAF as of February 2024 December 2023 enrollment - TAF as of March 2024 January 2024 enrollment - TAF as of April 2024 February 2024 enrollment - TAF as of May 2024 March 2024 enrollment - TAF as of June 2024 April 2024 enrollment – TAF as of July 2024 May 2024 enrollment – TAF as of August 2024 June 2024 enrollment – TAF as of September 2024,TAF are produced one month after the T-MSIS submission month. For example, TAF as of August 2023 is based on July T-MSIS submissions.,Notes: The separate CHIP enrollment in this report is not inclusive of enrollees covered by Medicaid expansion CHIP. Enrollment includes individuals enrolled in separate CHIP at any point during the month but excludes those enrolled in both Medicaid and separate CHIP during the month. See the Data Sources and Metrics Definitions Overview document for a full description of the data sources, metric definitions, and general data limitations. Alaska, District of Columbia, Hawaii, New Hampshire, New Mexico, North Carolina, North Dakota, Ohio, South Carolina, Vermont, and Wyoming do not have separate CHIP Programs. Maryland has a separate CHIP program that began in July 2023; April 2023 - June 2023 data for Maryland represents retroactive coverage. This document includes separate CHIP data submitted to CMS by states via T-MSIS or a separate collection form. These data include reporting metrics consistent with section 1902(tt)(1) of the Social Security Act. CHIP: Children's Health Insurance Program,Data notes: (a) State-submitted value; data not from T-MSIS (b1) May 2023 enrollment pulled from TAF as of September 2023 (b2) Data was restated using TAF as of October 2023 (b3) Data was restated using TAF as of April 2024 (b4) Data was restated using TAF as of July 2024 (b5) Data was restated using TAF as of August 2024 (c) Enrollment counts include postpartum women with coverage funded via a Health Services Initiative,
Medicaid and CHIP enrollees who received a well-child visit
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This data set includes annual counts and percentages of Medicaid and Children’s Health Insurance Program (CHIP) enrollees who received a well-child visit paid for by Medicaid or CHIP, overall and by five subpopulation topics: age group, race and ethnicity, urban or rural residence, program type, and primary language. These results were generated using Transformed Medicaid Statistical Information System (T-MSIS) Analytic Files (TAF) Release 1 data and the Race/Ethnicity Imputation Companion File. This data set includes Medicaid and CHIP enrollees in all 50 states, the District of Columbia, Puerto Rico, and the U.S. Virgin Islands, except where otherwise noted. Enrollees in Guam, American Samoa, and the Northern Mariana Islands are not included. Results include enrollees with comprehensive Medicaid or CHIP benefits for all 12 months of the year and who were younger than age 19 at the end of the calendar year. Results shown for the race and ethnicity subpopulation topic exclude enrollees in the U.S. Virgin Islands. Results shown for the primary language subpopulation topic exclude select states with data quality issues with the primary language variable in TAF. Some rows in the data set have a value of "DS," which indicates that data were suppressed according to the Centers for Medicare & Medicaid Services’ Cell Suppression Policy for values between 1 and 10. This data set is based on the brief: "Medicaid and CHIP enrollees who received a well-child visit in 2020." Enrollees are identified as receiving a well-child visit in the year according to the Line 6 criteria in the Form CMS-416 reporting instructions. Enrollees are assigned to an age group subpopulation using age as of December 31st of the calendar year. Enrollees are assigned to a race and ethnicity subpopulation using the state-reported race and ethnicity information in TAF when it is available and of good quality; if it is missing or unreliable, race and ethnicity is indirectly estimated using an enhanced version of Bayesian Improved Surname Geocoding (BISG) (Race and ethnicity of the national Medicaid and CHIP population in 2020). Enrollees are assigned to an urban or rural subpopulation based on the 2010 Rural-Urban Commuting Area (RUCA) code associated with their home or mailing address ZIP code in TAF (Rural Medicaid and CHIP enrollees in 2020). Enrollees are assigned to a program type subpopulation based on the CHIP code and eligibility group code that applies to the majority of their enrolled-months during the year (Medicaid-Only Enrollment; M-CHIP and S-CHIP Enrollment). Enrollees are assigned to a primary language subpopulation based on their reported ISO language code in TAF (English/missing, Spanish, and all other language codes) (Primary Language). Please refer to the full brief for additional context about the methodology and detailed findings. Future updates to this data set will include more recent data years as the TAF data become available.
CMS Program Statistics - Original Medicare Enrollment
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The CMS Program Statistics - Original Medicare Enrollment tables provide data on characteristics of the Original Medicare population. For additional information on enrollment, providers, and Medicare use and payment, visit the CMS Program Statistics page. Below is the list of tables: MDCR ENROLL AB 9. Original Medicare Enrollment: Part A and/or Part B Total, Aged, and Disabled Enrollees, Yearly Trend MDCR ENROLL AB 10. Original Medicare Enrollment: Part A and/or Part B Enrollees, by Age Group, Yearly Trend MDCR ENROLL AB 11. Original Medicare Enrollment: Part A and/or Part B Enrollees, by Demographic Characteristics MDCR ENROLL AB 12. Original Medicare Enrollment: Part A and/or Part B Enrollees, by Type of Entitlement and Demographic Characteristics MDCR ENROLL AB 13. Original Medicare Enrollment: Part A and/or Part B Total, Aged, and Disabled Enrollees, by Area of Residence MDCR ENROLL AB 14. Original Medicare Enrollment: Part A and/or Part B Enrollees, by Type of Entitlement and Area of Residence
Express Lane Eligibility for Medicaid and CHIP Coverage
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States may rely on eligibility information from "Express Lane" agency programs to streamline and simplify enrollment and renewal in Medicaid and CHIP. Express Lane agencies may include Supplemental Nutrition Assistance Program (SNAP), School Lunch programs, Temporary Assistance for Needy Families, Head Start, and the Women, infant, and children's program (WIC) , among others. States can also use state income tax data to determine Medicaid and CHIP eligibility for children.
CMS Program Statistics - Medicare Premiums
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The CMS Program Statistics - Medicare Premium tables provide information on counts of Medicare Part A (Hospital Insurance) and Part B (Medical Insurance) total premium, standard base premium, reduced base premium, and penalty beneficiaries. In addition, these tables include premium amounts and penalty amounts. For the Part B premium tables, information on Income Related Monthly Adjustment Amount (IRMAA) beneficiaries, IRMAA amounts, Managed Care Reduction beneficiaries and Managed Care Reduction amounts are also included. For additional information on enrollment, providers, and Medicare use and payment, visit the CMS Program Statistics page. These data do not exist in a machine-readable format, so the view data and API options are not available. Please use the download function to access the data. Below is the list of tables: MDCR PREMIUMS 1. Medicare Premiums: Medicare Part A Premium Beneficiaries and Amounts, Yearly Trend MDCR PREMIUMS 2. Medicare Premiums: Medicare Part A Premium Beneficiaries and Amounts by Demographic Characteristics and Medicare-Medicaid Enrollment Status MDCR PREMIUMS 3. Medicare Premiums: Medicare Part A Premium Beneficiaries and Amounts, by Area of Residence MDCR PREMIUMS 4. Medicare Premiums: Medicare Part B Premium Beneficiaries and Amounts, Yearly Trend MDCR PREMIUMS 5. Medicare Premiums: Medicare Part B Premium Beneficiaries and Amounts by Demographic Characteristics and Medicare-Medicaid Enrollment Status MDCR PREMIUMS 6. Medicare Premiums: Medicare Part B Premium Beneficiaries and Amounts, by Area of Residence
CMS Program Statistics - Medicare Part A & Part B - All Types of Service
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The CMS Program Statistics - Medicare Part A & Part B - All Types of Service tables provide use and payment data by type of coverage and type of service. For additional information on enrollment, providers, and Medicare use and payment, visit the CMS Program Statistics page. These data do not exist in a machine-readable format, so the view data and API options are not available. Please use the download function to access the data. Below is the list of tables: MDCR SUMMARY AB 1. Medicare Part A and Part B Summary: Utilization, Program Payments, and Cost Sharing for All Original Medicare Beneficiaries, by Type of Coverage and Type of Service, Yearly Trend MDCR SUMMARY AB 2. Medicare Part A and Part B Summary: Utilization, Program Payments, and Cost Sharing for Aged Original Medicare Beneficiaries, by Type of Coverage and Type of Service, Yearly Trend MDCR SUMMARY AB 3. Medicare Part A and Part B Summary: Utilization, Program Payments, and Cost Sharing for Disabled Original Medicare Beneficiaries by Type of Coverage and Type of Service, Yearly Trend MDCR SUMMARY AB 4. Medicare Part A and Part B Summary: Utilization, Program Payments, and Cost Sharing for Original Medicare Beneficiaries, by Type of Coverage, Demographic Characteristics, and Medicare-Medicaid Enrollment Status MDCR SUMMARY AB 5. Medicare Part A and Part B Summary: Utilization, Program Payments, and Cost Sharing for Original Medicare Beneficiaries, by Type of Coverage and by Area of Residence MDCR SUMMARY AB 6. Medicare Part A and Part B Summary: Utilization and Program Payments for Original Medicare Beneficiaries, by Type of Entitlement, Amount of Program Payments, Type of Coverage, and Type of Service
Medicaid enrollees who qualify for benefits based on disability
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This data set includes annual counts and percentages of Medicaid enrollees who are eligible for benefits based on disability, overall; by reason for qualification of disability benefits; and by four subpopulation topics: age group, dual eligibility status, race and ethnicity, and managed care participation. These results were generated using Transformed Medicaid Statistical Information System (T-MSIS) Analytic Files (TAF) Release 1 data and the Race/Ethnicity Imputation Companion File. This data set includes Medicaid enrollees in all 50 states, the District of Columbia, Puerto Rico, and the U.S. Virgin Islands who were enrolled for at least one day in the calendar year, except where otherwise noted. Enrollees in Guam, American Samoa, and the Northern Mariana Islands are not included. The Children’s Health Insurance Program (CHIP) does not confer eligibility based on disability, so Medicaid expansion CHIP (M-CHIP) and separate CHIP (S-CHIP) enrollees are not included. Results shown for the race and ethnicity subpopulation topic exclude enrollees in the U.S. Virgin Islands. Results shown for the dual eligibility, race and ethnicity, and managed care participation subpopulation topics are restricted to working-age adults (ages 19 to 64) with comprehensive Medicaid benefits. Some rows in the data set have a value of "DS," which indicates that data were suppressed according to the Centers for Medicare & Medicaid Services’ Cell Suppression Policy for values between 1 and 10. This data set is based on the brief: "Medicaid enrollees who qualify for benefits based on disability in 2020." Enrollees are assigned to a disability category based on their latest reported eligibility group code and age in the calendar year. Enrollees are assigned to an age group subpopulation using age as of December 31st of the calendar year. Enrollees are assigned to a dual eligibility status subpopulation based on the dual eligibility code that applies to the majority of their enrolled-months during the year (Dual Eligibility Code). Enrollees are assigned to a race and ethnicity subpopulation using the state-reported race and ethnicity information in TAF when it is available and of good quality; if it is missing or unreliable, race and ethnicity is indirectly estimated using an enhanced version of Bayesian Improved Surname Geocoding (BISG) (Race and ethnicity of the national Medicaid and CHIP population in 2020). Enrollees are assigned to a managed care participation subpopulation based on the managed care plan type code that applies to the majority of their enrolled-months during the year (Enrollment in CMC Plans). Please refer to the full brief for additional context about the methodology and detailed findings. Future updates to this data set will include more recent data years as the TAF data become available.