GAO recommends improvements to Transformed Medicaid Statistical Information System

The U.S. Government Accountability Office is recommending that the Centers for Medicare & Medicaid Services (CMS) take steps to improve its system of tracking national Medicaid data, the Transformed Medicaid Statistical Information System (T-MSIS).

CMS established T-MSIS in 2011 to improve the scope and quality of state-reported data. To date, 49 states had begun reporting data through T-MSIS.

GAO was asked to review some of the states experiences with T-MSIS. It found that while T-MSIS is a reliable national repository for Medicaid data, there have been challenges that have hindered states’ and CMS’s use of the T-MSIS data for oversight.

Of the states that GAO reviewed, none of them were reporting complete data. The states maintained that certain unreported elements were contingent on federal or state actions, and others were not applicable to the state’s Medicaid program. Further, states did not always specify in their documentation if, and when, they planned to report elements in the future.

Also, all states were interested in CMS facilitating information sharing among states. And while states expressed a desire to compare their T-MSIS data to other states’ T-MSIS data, several expressed concerns about the comparability of T-MSIS data across states.

GAO found that while CMS has taken steps for the initial use of T-MSIS data, it does not have a plan or for using these data for oversight. Consequently, some of the goals for T-MSIS, such as reducing states’ reporting burden and enhancing program integrity activities, are not being fully realized.

GAO recommends that CMS improve T-MSIS’s completeness and comparability to facilitate its use. Such steps should include efforts to obtain complete information from all states on unreported T-MSIS data; identify and share information across states to improve data comparability; and implement mechanisms, such as the Learning Collaborative, by which states can collaborate on to improve the completeness, comparability, and use of T-MSIS data. GAO also recommends that CMS develop a specific oversight plan for the system.