Incomplete Medicaid Data Harms Opioid Monitoring, HHS IG Says

Limited collection of Medicaid data by states is standing in the way of a complete analysis of opioid misuse and abuse within the program, according to an August 15 report from the Department of Health and Human Services’ (HHS’) Office of Inspector General (OIG).

The report finds that 32 states were missing some data, preventing a full analysis at the Federal level. Some states did not require reporting of National Provider Identifiers, diagnosis codes, and the quantity of opioids prescribed.

This incomplete data feeds into the Center for Medicaid and Medicare Services’ (CMS’) Transformed Medicaid Statistical Information System (T-MSIS) database, which could serve as a source for national analysis, but is hampered by the data gaps.

“These data have not yet been adequate for national analysis and oversight, even though some states’ data have been sufficient for individual state analysis,” the report notes.

With the White House declaring opioid abuse a public health emergency, better understanding of existing data to prevent opioid abuse is a Federal priority. CMS has been working with states to improve data quality and added the categories identified by OIG to its data quality priorities, the report notes.

OIG recommended that CMS continue to work on improved data quality, including unique identifiers, submission of all data, and clarified guidance for states. CMS concurred with all recommendations, and in its comments on the report, CMS noted that it is developing a process to link related identifiers to one another, and is looking at its data dictionary guidance.

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