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Medicaid Analytic eXtract (MAX) General Information

What’s New in October 2013!

  • Beta-MAX 2012 data are now available for 5 states:  Alabama, Iowa, Mississippi, South Dakota and Wyoming.  Please go to the Beta-MAX page for additional information.  

What’s New in September 2013!

  • A new issue brief is now available titled “Home- and Community-Based Service Use Among Medicare-Medicaid Enrollees with Functional Limitations, 2007–2008.”  This issue brief presents the results of the first study conducted using data from MAX and the Medicare Current Beneficiary Survey (MCBS).  In the study, we assessed the use of home- and community-based services (HCBS) by the presence and level of functional limitations, as measured by limitations in activities of daily living (ADL).  We illustrated that these limitations appear to be common among Medicare-Medicaid enrollees and affect both the percentage of enrollees who use HCBS and the cost associated with that care.  This issue brief is available through the links in the “Downloads” section of the Issue Briefs page.
  • MAX 2011 data are now available for 9 states (Alabama, Alaska, Arkansas, Iowa, Kentucky, Michigan, South Dakota, Virginia, and Wyoming).  The remaining 41 states and the District of Columbia were excluded because they did not have the requisite seven quarters of MSIS files approved by CMS by June 1, 2013.  The MAX data and supporting documentation (SAS load statements, data dictionaries, record counts, anomaly tables, managed care crosswalks, waiver crosswalks, and HCBS taxonomy crosswalks) are available through the links in the “Downloads” section below.  The validation tables are available through the MAX Validation Reports/Tables page.
  • Beta-MAX 2011 data are now available for 23 states:  Alabama, Alaska, Arkansas, Connecticut, Delaware, Georgia, Illinois, Indiana, Kentucky, Louisiana, Maryland, Michigan, Minnesota, Mississippi, Montana, Oregon, Rhode Island, South Carolina, South Dakota, Tennessee, Vermont, Virginia, and Wyoming.  Please go to the Beta-MAX page.  
  • Beta-MAX 2012 data are now available for 2 states:  South Dakota and Wyoming.  Please go to the Beta-MAX page.  

What’s New in August 2013!

  • MAX 2010 data are now available for 36 states; all states except for the District of Columbia, Idaho, Kansas, Maine, Massachusetts, Mississippi, Missouri, Nebraska, Nevada, New Jersey, North Dakota, Ohio, Texas, Utah, and Wisconsin.  New in MAX 2010 is the implementation of the home- and community-based services (HCBS) Taxonomy, which provides a uniform classification system of 18 categories and over 60 services for HCBS.  The MAX data and supporting documentation (SAS load statements, data dictionaries, record counts, anomaly tables, managed care crosswalks, waiver crosswalks, and HCBS taxonomy crosswalks) are available through the links in the “Downloads” section below.  The validation tables are available through the MAX Validation Reports/Tables page.  
  • A researcher notified us about two undocumented values in the monthly dual codes (EL_MDCR_DUAL_MO_x, where x = 1–12) in North Carolina’s MAX 2008 Person Summary (PS) file.  The undocumented values were "5 " (5 space) and "   " (space space).  We researched the issue and determined that the correct values should be "50" and "00", respectively.  The annual dual code (EL_MDCR_DUAL_ANN), the validation tables, and the claims files (which use the annual dual code) are unaffected by the error.  We regret the inconvenience this may have on the user community, but the good news is that you can easily fix the error yourself, by recoding "5 " (5 space) to "50" (5 zero) and recoding "  " (space space) to "00" (zero zero).  For future data users, we fixed the error in the PS file; you do not need to do anything further.  
  • A new issue brief is now available titled “The HCBS Taxonomy:  A New Language for Classifying Home and Community-Based Services.”  Because state Medicaid programs differ in the types of services they offer and in how they report these services in their data, analyzing HCBS at the national level has been challenging.  With the development of the HCBS taxonomy—a uniform classification system composed of 18 categories and over 60 services—states and CMS now have a common language for describing and categorizing community-based long-term care services.  This issue brief describes the HCBS taxonomy and presents findings on HCBS expenditures and service use for the 28 states in MAX 2010 that were approved for this analysis.  The issue brief is available through the links in the “Downloads” section of the MAX Issue Briefs page. The HCBS taxonomy and the detailed HCBS crosswalk, which maps services into the HCBS taxonomy, are available through the MAX 2010 link in the “Downloads” section below.

What’s New in July 2013!

  • A new report is now available titled, “Medicaid Analytic Extract Provider Characteristics (MAXPC) Evaluation Report, 2010.”  In the report we describe the motivation for creating the MAXPC file.  We also describe its design and content, and examine the quality and completeness of each of the six types of provider IDs (inpatient billing provider, long-term care billing provider, other services billing and servicing providers, and prescription drug billing and prescribing providers).  Our analysis focuses on the 45 states that had the requisite MSIS files available for calendar year 2010 services (Idaho, Kansas, Maine, New Jersey, North Dakota, and Utah are excluded).  The quality and completeness varies substantially by state and by type of provider ID.  The report is available through the links in the “Downloads” section of the MAX Provider Characteristics page.

What’s New in June 2013!

  • A new issue brief is now available titled, “Implications of State Methods for Offering Personal Assistance Services.”  This article examines the differences in the use and cost of personal assistance services in states that do and do not provide these services through their state plans. States that offer these services through their state plans appear to provide them to a greater number of beneficiaries at a lower cost per beneficiary than states that do not. These states also have long-term care systems that are more balanced toward home- and community-based rather than institutional long-term care services.  The issue brief is available through the links in the “Downloads” section of the Issue Briefs page.
  • A new report is now available titled, “Medicaid Analytic Extract Date of Death (MAX DOD) Master File, 2009 Update.”  In the report, we describe the creation of the MAX DOD 2009 update file and the MAX DOD 1999–2009 master file.  We provide a brief synopsis of the data sources used in this process and present quality control statistics about both files.  In the appendices, we include the file layout, data dictionary, data processing steps, and some frequently asked questions about the DOD information.  The report is available through the links in the “Downloads” section of the MAX DOD page.
  • MAXPC 2011 data are now available for 35 states (all states and the District of Columbia except Arizona, California, Colorado, Florida, Idaho, Kansas, Maine, Massachusetts, Nebraska, New Hampshire, New Jersey, New Mexico, North Dakota, Ohio, Rhode Island, and Utah).  These data files contain useful provider information from the National Plan and Provider Enumeration System (NPPES) and state-specific provider files (when available).  They can be easily linked to the provider identification numbers (provider IDs) in MAX 2011.  The data files, SAS load statements, data dictionary, state-specific and cross-state validation tables, specifications about the measures in the validation tables, and anomaly tables are available through the links in the “Downloads” section of the MAX Provider Characteristics page.

What’s New in May 2013!

  • MAX 2009 data are now available for all 50 states and the District of Columbia.  The data and supporting documentation (SAS load statements, data dictionaries, record counts, anomaly tables, managed care crosswalks, and waiver crosswalks) are available through the links in the “Downloads” section below and the validation tables are available through the MAX Validation Reports/Tables page.
  • MAXPC 2010 data are now available for 45 states (all states and the District of Columbia except Idaho, Kansas, Maine, New Jersey, North Dakota, and Utah).  These data files contain useful provider information from the National Plan and Provider Enumeration System (NPPES) and state-specific provider files (when available).  They can be easily linked to the provider identification numbers (provider IDs) in MAX 2010.  The data files, SAS load statements, data dictionary, state-specific and cross-state validation tables, specifications about the measures in the validation tables, and anomaly tables are available through the links in the “Downloads” section of the MAX Provider Characteristics page.

What’s New in April 2013!

  • The MAX 2008 Medicaid Pharmacy Benefit Use and Reimbursement Chartbook and Compendium Tables are now available.  The Chartbook is available through the link in the “Downloads” section of the Medicaid Pharmacy Benefit Use and Reimbursement – Introduction and Chartbooks Page.  The Compendium Tables are available at the Medicaid Analytic Rx eXtract (MAX Rx) Table Listing page.
  • A new journal article is available titled “National and State Trends in Enrollment and Spending for Dual Eligibles Under Age 65 in Medicaid Managed Care.” This article uses 2005 and 2008 MAX data to present spending and enrollment trends for adults with disabilities who are dually eligible for Medicare and Medicaid – a group whose experience is not discernible in most national managed care statistics. Our analysis shows that, nationwide, the proportion of adult duals in managed care increased from 2005 to 2008, with the expansion of prepaid health plans (PHPs), particularly behavioral health PHPs, driving the increase. While overall use of managed care has increased, there has been little expansion in the use of comprehensive managed care among adult duals, particularly when compared to their Medicaid-only disabled adult peers. This imbalance suggests that there is room to remove barriers that are preventing adult duals from enrolling in comprehensive, integrated managed care. This article was published as part of a special issue on dual eligibles and is available through the Disability and Health Journal website (subscription required).
  • A new journal article is available titled “Assessing the Usability of MAX 2008 Encounter Data for Comprehensive Managed Care.”  As growing numbers of Medicaid enrollees receive comprehensive health benefits through managed care, the researchers and policy makers seeking to understand the service use of these enrollees must rely on encounter data—information that states receive from managed care plans. Although encounter data provide insight, not all states report it to CMS’ Medicaid Statistical Information System (MSIS), and little is known about the data’s usability. This issue brief summarizes the availability, completeness, quality, and usability of the encounter data in the Medicaid Analytic eXtract (MAX) File, derived from MSIS, for enrollees in comprehensive managed care plans. It also gives specific information by state. The results should be encouraging for researchers and policymakers. Most states that have comprehensive managed care plans reported data to the other services (OT), inpatient (IP), and prescription drug (RX) files in 2008. Of those data, the majority are usable.  This article was published in Medicare & Medicaid Research Review.

What’s New in March 2013!

  • A new issue brief is now available titled “Trends and Patterns in the Use of Prescription Drugs Among Medicaid Beneficiaries: 1999 to 2009.”  This issue brief highlights the changes in volume of drugs used per person, changes in drug costs per person, and changes in the use of generic drugs between 1999 and 2009.  The analysis focuses in particular on drug use and costs for beneficiaries with disabilities and chronic illnesses, whose drug use is much more extensive than that of children and nondisabled adults.  It also focuses on some specific types of drugs that are especially costly for Medicaid:  antipsychotics, antiasthmatics, ulcer drugs, antidiabetics, and antidepressants. The issue brief is available through the links in the “Downloads” section of the Medicaid Pharmacy Benefit Use and Reimbursement – Introduction and Chartbooks page or the MAX Issue Briefs page.

What’s New in February 2013!

  • Beta-MAX 2011 data are now available for nine states:  Alaska, Arkansas, Connecticut, Delaware, Indiana, Mississippi, South Dakota, Virginia, and Wyoming.  Also, Beta-MAX 2010 data are now available for 29 states:  Alaska, Alabama, Arizona, Arkansas, California, Connecticut, Delaware, Georgia, Iowa, Illinois, Indiana, Kentucky, Louisiana, Mississippi, Montana, Nebraska, New Mexico, Ohio, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Virginia, Vermont, West Virginia and Wyoming.  Please go to the  Beta-MAX page for additional information.

What’s New in January 2013!

  • A new MAX chartbook is now available titled “MAX 2008 Encounter Data Chartbook and Appendix Tables.”  This chartbook describes the service utilization of Medicaid enrollees in managed care plans in MAX 2008 data. The chartbook extends the analysis of the previous MAX chartbooks, which focused on the service utilization of Medicaid enrollees covered on a fee-for-service basis. This chartbook also supplements the recent issue briefs focusing on the quality and completeness of encounter data. It provides valuable information for CMS and researchers on the availability of and uses for encounter data in MAX data.  It is available through the links in the “Downloads” section of the MAX Chartbooks page.
  • A new report is now available titled “Social Security Numbers in Medicaid Records: Reporting and Validity, 2009.”  This report presents the results of a validation study of Social Security numbers (SSNs) in Medicaid Statistical Information System (MSIS) records for the fourth quarter of federal fiscal year 2009.  The study presents results for the nation and the states on how often SSNs were reported in MSIS records and how often the reported SSNs passed a validation test at the Census Bureau, based on data obtained from the Social Security Administration. This report is available through the links in the “Downloads” section of the MAX SSN Verification page. 
  • A new issue brief is now available titled “Using the MAX-NHANES Merged Data to Evaluate the Association of Obesity and Medicaid Costs.”  This issue brief presents the results of the first study conducted using the newly merged MAX-NHANES data. Using data from MAX-NHANES 1999-2004, we assessed the association of obesity on annual total fee-for-service Medicaid costs. While the estimated costs were higher for obese adults than non-obese adults, the differences in costs by obesity status were not significant at the 0.05 level. The results of the analysis demonstrate the hazard of using a small national survey (NHANES) with a state-based data system (MAX) to perform cost analyses, particularly when the range of realistic costs is large. This issue brief is available through the links in the “Downloads” section of the MAX and Survey Linkage page or the MAX Issue Briefs page.

What’s New in December 2012!

  • A new report is now available titled “MAX and NCHS Survey Linkage, 1999-2009”.  This report focuses on the linking of an extract of National Center for Health Statistics (NCHS) survey data to the Medicaid Analytic eXtract (MAX) files.  It describes the data sources, presents the linkage algorithm, examines the linkage results, and offers advice to researchers interested in using the linked NCHS-MAX files.  The files were linked during the past few years and given to NCHS as they became available.  This report summarizes the various rounds of linkage in one document.  It is available through the links in the “Downloads” section of the MAX and Survey Linkage page.
  • A new report is now available titled “Medicaid Analytic Extract Provider Characteristics (MAXPC) Evaluation Report, 2009”.  This report describes the design, content, and motivation for creating the MAXPC file.  The report also examines the quality and completeness of each of the six types of provider IDs in each of the 51 states.  The quality and completeness vary substantially by state and by type of provider ID.  The report also identifies recommendations for CMS to help improve the quality of the provider IDs.   It is available through the the links in the “Downloads” section of the MAX Provider Characteristics page. 
  • A new issue brief is now available titled “Assessing the Usability of Encounter Data for Enrollees in Comprehensive Managed Care Across MAX 2007–2009”.  This issue brief assesses the availability, completeness, and quality of encounter data in MAX 2007–2009.  The analysis builds on our previous reviews of MAX 2007 and 2008 encounter data by evaluating MAX 2009 physician, outpatient, and clinic services (OT), inpatient hospital services (IP), and prescription drug services (RX), and by assessing trends in the availability and usability of encounter data across the three year period.  The analysis provides tools to assist researchers and policymakers in determining which states’ encounter data to analyze.  The increase in reporting and usability makes the inclusion of encounter data in research studies a more viable option than in the past.  This issue brief is available through the links in the “Downloads” section of the MAX Encounter Reporting Technical Assistance page or the MAX Issue Briefs page.
  • A new issue brief is now available titled “The Availability and Usability of Behavioral Health Organization (BHO) Encounter Data in MAX 2009”.  The purpose of this issue brief is to provide a detailed analysis of the behavioral health organization (BHO) encounter data in MAX 2009 and assess the viability of using these data for research and policy analysis.  This issue brief is available through the links in the “Downloads” section of the MAX Encounter Reporting Technical Assistance page or the MAX Issue Briefs page.

What’s New in November 2012!

  • A new issue brief is now available titled “CHIP Data in the Medicaid Statistical Information System (MSIS): Availability and Uses.”  This issue brief discusses the increasing availability of Children’s Health Insurance Program (CHIP) data in the Medicaid Statistical Information System (MSIS) and potential uses for that data, including to monitor program performance, evaluate policy options, and help implement provisions of the Affordable Care Act (ACA).  It is available through the links in the “Downloads” section of the CHIP Reporting Technical Assistance page or the Issue Briefs page.
  • A new issue brief is now available titled “Best Practices for Linking Medicaid and Separate CHIP Eligibility Records.”  This issue brief provides guidance to states that have distinct eligibility determination systems for Medicaid and separate CHIP on how to link enrollment records across systems and report a unique, permanent identifier to MSIS.  It is available through the links in the “Downloads” section of the CHIP Reporting Technical Assistance page or the Issue Briefs page.

Description

Each state’s Medicaid agency collects enrollment and claims data for persons enrolled in Medicaid and the Children’s Health Insurance Program (CHIP).  These data are collected in the state’s Medicaid Management Information System (MMIS).  Each state’s MMIS is tailored to the needs of that state’s Medicaid program.  In partnership with the states, the federal government seeks to manage the Medicaid program and monitor the progress of the health care delivery system nationally.  Because the Medicaid program varies by state, the data in the MMIS are converted into a national standard and submitted to CMS via the Medicaid and CHIP Statistical Information System (MSIS).

The MSIS data (enrollment and claims data) are reported to CMS on a quarterly basis.  The enrollment data identify Medicaid and CHIP enrollees in each month of that quarter and whose enrollment in a prior period should be revised (due to a correction or retroactive enrollment).  The fee-for-service (FFS) claims data identify who received what service from which provider at what cost.  The FFS claims data are submitted based on the quarter in which the claim was adjudicated, not when the service was performed.  The managed care encounter records (also known as encounter claims) identify who received what service under which managed care organization and from which provider.  The encounter records are submitted based on the quarter in which the encounter was processed, not when the service was performed.  The MSIS data are challenging to use for research because the data represent a mixture of time periods.  Consequently, CMS developed the Medicaid Analytic Extract (MAX) files, a more research-friendly set of Medicaid administrative files.  

The enrollment information in MAX identifies monthly enrollment after the retroactive/correction records have been applied and after certain state-specific data elements are transformed into a consistent, national format.  The claims in MAX identify the services rendered and the cost of those services after the adjustments have been applied.  The enrollment pertains to people enrolled in the given calendar year (CY), and claims pertain to the services rendered in that same time period, thereby making a consistent—and more meaningful—time period for analyses of enrollment, service utilization, and expenditures.

A Powerpoint presentation entitled "Introduction to Medicaid Analytic eXtract (MAX) Data" is available in the “Downloads Section.” Researchers might find this presentation helpful because it:

  • Describes the source data,
  • Provides an overview of MAX data,
  • Describes the types of MAX data,
  • Lists a number of the MAX data enhancements,
  • Explains the linkages to other data sources,
  • Describes related MAX data products, and
  • Identifies Medicaid data limitations.

General Information

In the “Downloads” section, we provide a number of zip files, which contain the following supporting documents about MAX:

1. SAS Load Statements - For users of the Statistical Analysis System (SAS), we provide the SAS load statements that can be used for each MAX file.

2. Data Dictionaries – We include the data dictionaries for the Inpatient Hospital (IP), Long-Term Care (LT), Other Services (OT), Prescription Drug (RX), and Person Summary (PS) MAX files. From 1999-2004, the data dictionaries did not change.  Beginning in 2005, however, the record lengths, variable locations, and data element descriptions changed from year to year.  We listed the changes at the beginning of each data dictionary.

3. Variable Crosswalk – Over time, data elements have been added or removed from the MAX files.  We recommend that you review the variable crosswalk to get a better understanding of when the changes occurred.

4. Record Counts – We include a table showing the number of records in each MAX file.  We recommend that you use this table to confirm that you received the correct number of records in your files.

5. Data Anomalies Reports and Tables – We review the validation tables (described below) looking for outliers and unexpected changes.  We record salient anomalies about the eligibility and the claims data in the data anomalies reports and tables.  We recommend that you read the anomalies to determine if the data should be included in your analysis.

6. Waiver Crosswalk – Beginning in MAX 2005, we created the waiver crosswalk, which describes each state’s Section 1915(b) managed care/freedom of choice waiver, Section 1915(c) Home and Community-Based Services (HCBS) waiver, Section 1915(b)(c) managed care HCBS waiver, Section 1115 demonstration waiver, and Health Insurance Flexibility and Accountability (HIFA) waiver.  For each waiver, we identify the waiver type, waiver identification number in MAX, waiver name from both CMS’s and the state’s perspective, original CMS approval date, most recent CMS renewal date, expiration date, and whether reporting of the waiver is still ongoing in MAX data.  This crosswalk is invaluable to researchers wanting to understand the various waiver authorities active in the state and whom the authorities serve.  

7. Managed Care Crosswalk – Beginning in MAX 2009, we created the managed care crosswalk, which identifies each state’s managed care plan identification number, plan name, plan type (comprehensive care or prepaid health plan), and whether the plan reported enrollment, capitation payments, and managed care encounter records (claim-like records for managed care services).  This crosswalk is invaluable to researchers wanting to understand more about managed care plans and the completeness of their data.  

8. HCBS Taxonomy – As states have sought to make home- and community-based services (HCBS) more accessible, researchers have become more interested in understanding service use by, and spending for, those Medicaid beneficiaries who need long-term services and supports (LTSS).  Because state Medicaid programs differ in the types of services they offer, and in how they report these services in their data, analyzing HCBS at the national level has been challenging.  To enable CMS to monitor the wide range of Section 1915(c) HCBS waiver services and to help researchers approach the study and analysis of waivers in a uniform manner, Truven Health Analytics, formerly known as Thomson Reuters, led the development of an HCBS waiver services taxonomy.   The first version of the taxonomy was constructed from literature reviews, expert interviews, and an analysis of service definition information provided by 176 HCBS waivers and nine demonstration grants for community alternatives to Psychiatric Residential Treatment Facilities.  This draft taxonomy was tested by a working group of state associations and staff from 10 states and one Area Agency on Aging.  Mathematica then conducted a pilot test in which the taxonomy was applied to 2008 MSIS HCBS waiver claims.  Through these tests, Mathematica and Truven worked jointly to refine the taxonomy into its current version.  The taxonomy includes 18 categories and over 60 services.

9. HCBS Taxonomy Crosswalk – Beginning in MAX 2010, we created the HCBS taxonomy crosswalk, which maps Section 1915 (c) waiver services (program type = 6, 7) in the MAX OT file into the HCBS taxonomy.  The crosswalk uses national Healthcare Common Procedure Coding System (HCPCS) procedure codes, Current Procedural Terminology (CPT) procedure codes, state-specific procedure codes, procedure code modifiers, place-of-service codes, and type-of-service codes to map the services into the new OT data element called HCBS Taxonomy Code for Waivers.  The first two characters of the data element correspond to the 18 taxonomy categories and the full five characters uniquely identify each taxonomy service.  

10. Validation Specifications (for the Validation Reports) – The validation tables (described below) contain many measures that researchers could find useful for their analysis.  In the validation specification document, we defined how each measure in the validation table was created. We recommend that you use this document to better understand the subpopulation and the data element(s) used in the construction of each measure.

MAX Validation Reports - These reports are prepared for each of the 50 states and the District of Columbia. The reports provide a lot of statistics on the data contained in the MAX files, including enrollment, utilization and Medicaid payments. Due to the volume of these reports, they are not included in the “Downloads” section; instead they are available through the MAX Validation Reports/Tables page.  

Availability

Because MAX production requires seven quarters of MSIS data (four quarters for the calendar year plus three additional quarters for the adjustment records), there can be a considerable delay between the end of a calendar year and the availability of the corresponding MAX files.  We produce the files as quickly as possible and release them on a scheduled basis.  New releases are announced at the top of this webpage.

Since the MAX data contain protected health information (PHI) and personally identifiable information (PII), they are protected under the Privacy Act. The data are available for approved research activities only through a Data Use Agreement (DUA) or Interagency Agreement (IA) with CMS.  Note that only approved academic research projects and certain government agencies are entitled to a DUA or IA to obtain MAX data. The DUA form is below in the “Downloads Section”.  For help in preparing data requests (including DUAs), technical assistance with the data, or to report data problems, please contact the Research Data Assistance Center (ResDAC) via the link in the "Related Links" section.

MAX Data Prior to 1999

Before 1999, states had the option to submit either MSIS data or aggregate summary statistics, using the HCFA-2082 reporting format.  CMS began producing State Medicaid Research File (SMRF) data from MSIS in the late 1980s for a small group of participating states.  The number of states for which SMRF were produced increased greatly in 1992 and continued to increase through 1998 as participation in MSIS grew.  The Balanced Budget Act (BBA) of 1997 mandated that all states report MSIS data beginning in 1999.  Along with the BBA mandate, data collection in MSIS expanded and SMRF was given a new name – MAX.  CMS does not provide SMRF files to outside parties.

MAX Data for 1999–2004

The file layouts for MAX 1999–2004 are exactly the same.  

After production was completed for MAX 2004, we reprocessed the following files:

  • In Tennessee’s MAX data, we determined there was a substantial shortfall of records in the IP file. It was possible to correct this shortfall by reprocessing the Tennessee IP file. It was also necessary to reprocess the PS file because some data elements in the PS file are summary statistics about inpatient hospital utilization and expenditures. The IP file was reprocessed on November 5, 2008 and the PS file was reprocessed on November 7, 2008.
  • In Arizona’s MAX data, we identified a problem with the Medicaid identification numbers (MSIS ID) provided to CMS. The data for all MAX files (IP, LT, OT, RX, and PS) were reprocessed on February 26, 2009.

Users that received these files prior to the indicated dates may want to request copies of the reprocessed files.

MAX Data for 2005

We were unable to process the following state with the requisite seven quarters of MSIS data:

  • Maine was unable to accurately report its IP, LT, and OT claims because it did not have a fully functional MMIS.  Consequently, the state’s MAX 2005 files only include the PS and RX files.  Summary statistics that would normally appear in the PS file for IP, LT, and OT services were not populated.

We made the following revisions to the PS file:

  • Added a variable that gauges the validity of the Social Security numbers (SSNs)
  • Added the SSN obtained from the Medicare enrollment database (EDB)
  • Added new race and ethnicity variables
  • Added monthly dual Medicare and Medicaid enrollment
  • Added monthly waiver enrollment information (waiver identification number and waiver type) for up to three waivers per month
  • Added annual enrollment in Section 1915(c) waivers using a national, uniform classification
  • Added expenditure variables for each of the 21 Community-Based Long-Term Care categories
  • Removed the quarterly and annual dual Medicare and Medicaid enrollment flags that used an old (pre-1999) definition

We made the following revisions to the claims files:

  • Added new race and ethnicity variables
  • Added an indicator variable for whether the claim linked to an enrollment record and the person was enrolled in Medicaid or CHIP for at least one month
  • Added National Provider Identifier (but it was set to missing for all records; the data became available beginning in 2009)
  • Added Provider Taxonomy (but it was set to missing for all records; the data became available beginning in 2009)
  • Increased the length of the diagnosis and procedure codes
  • Removed the annual dual Medicare and Medicaid enrollment flags that used an old (pre-1999) definition

In the OT file, we also:

  • Added a new Community-Based Long-Term Care Flag

In the RX file, we also:

  • Removed the claims-based Medicare Crossover Flag

Please see the MAX 2005 data dictionaries for more information about these and other minor revisions.

MAX Data for 2006

We were unable to process the following state with the requisite seven quarters of MSIS data:

  • Maine was unable to accurately report its IP, LT, and OT claims because it did not have a fully functional MMIS.  Consequently, the state’s MAX 2006 files only include the PS and RX files.  Summary statistics that would normally appear in the PS file for IP, LT, and OT services were not populated.

We made the following revisions to the PS file:

  • Added more values to the monthly and quarterly Medicare Dual Codes
  • Added more values to the monthly Restricted Benefits Flag
  • Added a new value to the monthly and annual Waiver Type
  • Added new values to the Recipient Indicator

We made the following revisions to the RX file:

  • Removed the Medicare Coinsurance Payment Amount
  • Removed the Medicare Deductible Payment Amount

Please see the MAX 2006 data dictionaries for more information about these and other minor revisions.

MAX Data for 2007

We were unable to process the following state with the requisite seven quarters of MSIS data:

  • Maine was unable to accurately report its IP, LT, and OT claims because it did not have a fully functional MMIS.  Consequently, the state’s MAX 2007 files only include the PS and RX files.  Summary statistics that would normally appear in the PS file for IP, LT, and OT services were not populated.

We made the following revisions to the PS file:

  • Added Date of Death from the Social Security Administration’s Death Master File (SSA DMF)
  • Deleted the quarterly Medicare Dual Code

We made the following revisions to the RX file:

  • Removed the Hierarchical Ingredient Code List
  • Removed the American Hospital Formulary System Class Code
  • Replaced the Specific Therapeutic Class Code with the Hierarchical Specific Therapeutic Class Code (a new variable)
  • Replaced the Smart Key with these four variables:
        o Clinical Formulation Identification Number
        o Ingredient List Identifier
        o Hierarchical Specific Therapeutic Class Code Sequence Number
        o Filler

 Please see the MAX 2007 data dictionaries for more information about these and other minor revisions.

MAX Data for 2008

We were unable to process the following states with the requisite seven quarters of MSIS data:

  • Maine was unable to accurately report its IP, LT, and OT claims because it did not have a fully functional MMIS.  Consequently, the state’s MAX 2008 files only include the PS and RX files.  Summary statistics that would normally appear in the PS file for IP, LT, and OT services were not populated.
  • Massachusetts was unable to accurately report its claims because it did not have a fully functional MMIS. The MAX 2008 files only contain claims adjudicated through Q2 FY 2009.  Consequently, some claims representing services provided in CY 2008 will be missing and some claims may not be fully adjusted.
  • Utah was unable to report all of its claims by the prescribed deadline. The MAX 2008 files only contain claims adjudicated through Q1 FY 2009. Consequently, some claims representing services provided in CY 2008 will be missing and some claims may not be fully adjusted.
  • Wisconsin was unable to report all of its claims by the prescribed deadline. The MAX 2008 files only contain claims adjudicated through Q3 FY 2009. Consequently, some claims representing services provided in CY 2008 will be missing and some claims may not be fully adjusted.

We made the following revision to the PS file:

  • Added a new value to the monthly Restricted Benefits Flag

Please see the MAX 2008 data dictionaries for more information about these and other minor revisions.

After production was completed for MAX 2008, we reprocessed the following file:

• In North Carolina’s PS file, a researcher noticed two undocumented values in the monthly dual codes (EL_MDCR_DUAL_MO_x, where x = 1–12).  The undocumented values were "5 " (5 space) and "   " (space space).  We researched the issue and determined that the correct values should be "50" and "00", respectively.  The annual dual code (EL_MDCR_DUAL_ANN), the validation tables, and the claims files (which use the annual dual code) are unaffected by the error.  We regret the inconvenience this may have on the user community, but the good news is that you can easily fix the error yourself, by recoding "5 " (5 space) to "50" (5 zero) and recoding "  " (space space) to "00" (zero zero).  We fixed the error in the PS file on August 27, 2013.  

Users that received the file prior to the indicated date will need to fix it themselves or request a copy of the corrected file.

MAX Data for 2009

We were unable to process the following states with the requisite seven quarters of MSIS data:

  • Idaho was unable to accurately report its claims following the implementation of a new MMIS.  As a result, the state’s MAX 2009 files only contain IP, LT, and RX claims reported to MSIS through Q2 FY 2010 and OT claims reported to MSIS through Q1 FY 2010.  Consequently, some claims representing services provided in CY 2009 will be missing and some claims may not be fully adjusted.
  • Maine was unable to accurately report its IP, LT, and OT claims because it did not have a fully functional MMIS.  Consequently, the state’s MAX 2008 files only include the PS and RX files.  Summary statistics that would normally appear in the PS file for IP, LT, and OT services were not populated.

We made the following revisions to the PS file:

  • Added new values to the monthly and annual Medicare Dual Codes

We made the following revisions to the claims file:

  • Added new values to the annual Medicare Dual Code
  • Began populating National Provider Identifier
  • Began populating Provider Taxonomy

In the IP and LT file, we also:

  • Added new values to Patient Status Code

In the OT file, we also:

  • Added new values to Place of Service

Please see the MAX 2009 data dictionaries for more information about these and other minor revisions.

MAX Data for 2010

We were unable to process the following states because they did not have the requisite seven quarters of MSIS files approved by CMS by June 1, 2013:  District of Columbia, Idaho, Kansas, Maine, Massachusetts, Mississippi, Missouri, Nebraska, Nevada, New Jersey, North Dakota, Ohio, Texas, Utah, and Wisconsin.

We made the following revisions to the PS file:

• Added expenditure variables for each of the 18 HCBS taxonomy categories

We made the following revisions to the OT file:

• Added HCBS taxonomy code

Please see the MAX 2010 data dictionaries for more information about these and other minor revisions.

MAX Data for 2011

We processed the following 9 states:  Alabama, Alaska, Arkansas, Iowa, Kentucky, Michigan, South Dakota, Virginia, and Wyoming.  The remaining 41 states and the District of Columbia were excluded because they did not have the requisite seven quarters of MSIS files approved by CMS by June 1, 2013.

We made the following revisions to the PS file:

• Expanded the PREMIUM PAYMENT GROUP (data element numbers 104-106) to include an occurrence for TOS = 23, Capitated Payments to Private Health Insurance (PHI).  The group now occurs four times, for TOS 20, 21, 22 and 23.  

• Added one new variable for Encounter Record Count for HCBS (Data Element 107).

• Replaced the HGT_FLAG (Data Element 5) with FILLER because the high group test is no longer applicable (SSNs are now randomized).

• Description for RBF= W updated (Data Element 55).

• The total record length is now 3058.

We made the following revisions to the OT file:

• Added TOS value = 23 to MSIS Type of Service (Data Element 21) and MAX Type of Service (Data Element 23).

Please see the MAX 2011 data dictionaries for more information about these and other minor revisions.