Medicaid Managed Care Encounter Data Validation Toolkit

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.

• Medicaid Managed Care Encounter Data Validation Toolkit