How can the dually eligible for Medicare and Medicaid be studied using CMS Medicaid claims and enrollment data?
Beginning with 1999, information is available in the MAX files on Medicare eligibility, including the details of Medicaid program payment of Medicare co-insurance, premiums and deductibles. Eg: QMB or SLMB programs. In terms of utilization data, the MAX files contain little information regarding claims for Medicare-covered services. Most states would treat the Medicare payment as payment-in-full. Claims will exist in the Medicaid files for services not covered by Medicare, eg: prescription drug claims.
