Today, the Centers
for Medicare & Medicaid Services (CMS) released the Encounter Data
Validation Toolkit, a new resource for states who oversee Medicaid managed
care programs. Medicaid managed care encounter data is essential for
measuring and monitoring the quality of managed care plans and for
evaluating plan compliance with contract requirements. Medicaid managed
care encounter data pass through multiple entities and systems before
reaching states and being available for Medicaid program administration.
Careful validation is critical to ensuring data quality at each stage. This
toolkit is designed to support the role that states play in validating
encounter data, and is intended to be a helpful resource for senior
managers and policymakers who oversee this function.
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