OIG: Implementation challenges hinder Medicaid data flow

A number of technological problems continue to delay nationwide deployment of the Transformed Medicaid Statistical Information System, a program meant to improve Medicaid oversight, an HHS Office of Inspector General report found.

For the report, the office analyzed the implementation status of T-MSIS as of December 2016 and interviewed CMS staff and 16 states about their implementation experiences. The OIG determined 21 of 53 state programs were submitting data to T-MSIS, but, on average, they provided only 82 percent of T-MSIS data elements.

T-MSIS' goal is to improve the completeness, accuracy and timeliness of national Medicaid data to root out waste, fraud and abuse, the report states. CMS set its initial target deadline for nationwide T-MSIS implementation for 2014, but the deadline has repeatedly been pushed back due to numerous challenges.

In the report, states and CMS expressed concerns about early technological problems during data testing, which delayed initial T-MSIS implementation. They also noted issues with the completeness and reliability of the data, similar to concerns presented in the OIG's 2013 review of the T-MSIS pilot. States also said competing IT initiatives limited their ability to focus on T-MSIS implementation.

CMS set its most recent T-MSIS implementation goal for the end of 2017, but the OIG said it is not confident in the deadline. The OIG continues to support its 2013 recommendation for CMS to establish a fixed deadline for when T-MSIS data must be available for analysis. The office said a fixed deadline will ensure CMS and states consider the program a "management priority."

"Successfully getting all States' data into T-MSIS requires States and CMS to prioritize T-MSIS implementation. Because of CMS's history of delaying target dates for implementation, OIG is concerned that CMS and States will delay further rather than assign the resources needed to address the outstanding challenges," the report reads.

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