Medicaid Information System Needs Improvement, Feds Say

The Medicaid information system needs improvement says the GAO, (U.S. Government Accountability Office). They recommend that the Centers for Medicare & Medicaid Services (CMS) take steps to improve its system of tracking national Medicaid data, also known as 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.


Medicaid: What Reports Are Missing?

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 this 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 program. Further, states did not always specify in their documentation if, and when, they planned to report elements in the future.

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. Such steps should include efforts to obtain complete information from all states and to identify information to improve data comparability. GAO also recommends that CMS develop a specific oversight plan for the system.

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