Archived as of 6/26/2025: The datasets will no longer receive updates but the historical data will continue to be available for download. This dataset provides information related to the claims of recipients enrolled in Medicaid. It contains information about the total number of patients, total number of claims, and total dollar amount, grouped by recipient race and gender. Restricted to claims with service date between 01/2012 to 12/2017. Restricted to patients with a Medicaid claim during this period. This data is for research purposes and is not intended to be used for reporting. Due to differences in geographic aggregation, time period considerations, and units of analysis, these numbers may differ from those reported by FSSA.

This dataset contains aggregate Medicaid payments, and counts for eligible recipients and recipients served by month and county in Iowa, starting with month ending 1/31/2011.

Eligibility groups are a category of people who meet certain common eligibility requirements. Some Medicaid eligibility groups cover additional services, such as nursing facility care and care received in the home. Others have higher income and resource limits, charge a premium, only pay the Medicare premium or cover only expenses also paid by Medicare, or require the recipient to pay a specific dollar amount of their medical expenses. Eligible Medicaid recipients may be considered medically needy if their medical costs are so high that they use up most of their income. Those considered medically needy are responsible for paying some of their medical expenses. This is called meeting a spend down. Then Medicaid would start to pay for the rest. Think of the spend down like a deductible that people pay as part of a private insurance plan.

Major Eligibility Group Information for Medicaid and CHIP Beneficiaries by Year

  Description

This data set presents annual enrollment counts of Medicaid and CHIP beneficiaries by major eligibility group (children, adult expansion group, adult, aged, persons with disabilities, or COVID newly-eligible). There are three metrics presented: (1) the number of beneficiaries ever enrolled in each major eligibility group over the year (duplicated count); (2) the number of… See the full description on the dataset page: https://huggingface.co/datasets/HHS-Official/major-eligibility-group-information-for-medicaid-a.

Archived as of 6/26/2025: The datasets will no longer receive updates but the historical data will continue to be available for download. This dataset provides information related to the services related to recipients enrolled in Medicaid. It contains information about the total number of recipients, total number of claims, and total dollar amount, by recipient zip code. Restricted to claims with service date between 01/2012 to 12/2017. Restricted to patients with a Medicaid claim during this period. This data is for research purposes and is not intended to be used for reporting. Due to differences in geographic aggregation, time period considerations, and units of analysis, these numbers may differ from those reported by FSSA.

Managed Care Information for Medicaid and CHIP Beneficiaries by Month

  Description

This data set includes monthly enrollment counts of Medicaid and CHIP beneficiaries by managed care participation (comprehensive managed care, primary care case management, MLTSS, including PACE, behavioral health organizations, nonmedical prepaid health plans, medical-only prepaid health plans, and other). These metrics are based on data in the T-MSIS Analytic Files (TAF). Some states have… See the full description on the dataset page: https://huggingface.co/datasets/HHS-Official/managed-care-information-for-medicaid-and-chip-ben.

This dataset includes the number of people enrolled in DSS services by town and by program from CY 2015-2024. To view the full dataset and filter the data, click the "View Data" button at the top right of the screen. More data on people served by DSS can be found here. About this data For privacy considerations, a count of zero is used for counts less than five. A recipient is counted in all towns where that recipient resided in that year. Due to eligibility policies and operational processes, enrollment can vary slightly after publication. Please be aware of the point-in-time nature of the published data when comparing to other data published or shared by the Department of Social Services, as this data may vary slightly. Notes by year 2021 In March 2020, Connecticut opted to add a new Medicaid coverage group: the COVID-19 Testing Coverage for the Uninsured. Enrollment data on this limited-benefit Medicaid coverage group is being incorporated into Medicaid data effective January 1, 2021. Enrollment data for this coverage group prior to January 1, 2021, was listed under State Funded Medical. An historical accounting of enrollment of the specific coverage group starting in calendar year 2020 will also be published separately. 2018 On April 22, 2019 the methodology for determining HUSKY A Newborn recipients changed, which caused an increase of recipients for that benefit starting in October 2016. We now count recipients recorded in the ImpaCT system as well as in the HIX system for that assistance type, instead using HIX exclusively. Also, the methodology for determining the address of the recipients changed: 1. The address of a recipient in the ImpaCT system is now correctly determined specific to that month instead of using the address of the most recent month. This resulted in some shuffling of the recipients among townships starting in October 2016. If, in a given month, a recipient has benefit records in both the HIX system and in the ImpaCT system, the address of the recipient is now calculated as follows to resolve conflicts: Use the residential address in ImpaCT if it exists, else use the mailing address in ImpaCT if it exists, else use the address in HIX. This resulted in a reduction in counts for most townships starting in March 2017 because a single address is now used instead of two when the systems do not agree. On February 14, 2019 the enrollment counts for 2012-2015 across all programs were updated to account for an error in the data integration process. As a result, the count of the number of people served increased by 13% for 2012, 10% for 2013, 8% for 2014 and 4% for 2015. Counts for 2016, 2017 and 2018 remain unchanged. On January 16, 2019 these counts were revised to count a recipient in all locations that recipient resided in that year. On January 1, 2019 the counts were revised to count a recipient in only one town per year even when the recipient moved within the year. The most recent address is used.

Program Information for Medicaid and CHIP Beneficiaries by Month

  Description

This data set includes monthly enrollment counts of Medicaid and CHIP beneficiaries by program type (Medicaid or CHIP). These metrics are based on data in the T-MSIS Analytic Files (TAF). Some states have serious data quality issues for one or more months, making the data unusable for calculating these measures. To assess data quality, analysts adapted measures featured in the DQ Atlas. Data for… See the full description on the dataset page: https://huggingface.co/datasets/HHS-Official/program-information-for-medicaid-and-chip-benefici.

Dual Status Information for Medicaid and CHIP Beneficiaries by Month

  Description

This data set includes monthly enrollment counts of Medicaid and CHIP beneficiaries by dual eligibility status for Medicaid and Medicare (full dual eligibility, partial dual eligibility, or not dually eligible). These metrics are based on data in the T-MSIS Analytic Files (TAF). Some states have serious data quality issues for one or more months, making the data unusable for calculating these… See the full description on the dataset page: https://huggingface.co/datasets/HHS-Official/dual-status-information-for-medicaid-and-chip-bene.

Archived as of 6/26/2025: The datasets will no longer receive updates but the historical data will continue to be available for download. This dataset provides information related to the claims of recipients enrolled in Medicaid. It contains information about the total number of patients, total number of claims, and total dollar amount, grouped by funding subprogram code. Restricted to claims with service date between 01/2012 to 12/2017. Restricted to patients with a Medicaid claim during this period. This data is for research purposes and is not intended to be used for reporting. Due to differences in geographic aggregation, time period considerations, and units of analysis, these numbers may differ from those reported by FSSA.

In order to facilitate public review and access, enrollment data published on the Open Data Portal is provided as promptly as possible after the end of each month or year, as applicable to the data set. Due to eligibility policies and operational processes, enrollment can vary slightly after publication. Please be aware of the point-in-time nature of the published data when comparing to other data published or shared by the Department of Social Services, as this data may vary slightly. As a general practice, for monthly data sets published on the Open Data Portal, DSS will continue to refresh the monthly enrollment data for three months, after which time it will remain static. For example, when March data is published the data in January and February will be refreshed. When April data is published, February and March data will be refreshed, but January will not change. This allows the Department to account for the most common enrollment variations in published data while also ensuring that data remains as stable as possible over time. In the event of a significant change in enrollment data, the Department may republish reports and will notate such republication dates and reasons accordingly. In March 2020, Connecticut opted to add a new Medicaid coverage group: the COVID-19 Testing Coverage for the Uninsured. Enrollment data on this limited-benefit Medicaid coverage group is being incorporated into Medicaid data effective January 1, 2021. Enrollment data for this coverage group prior to January 1, 2021, was listed under State Funded Medical. Effective January 1, 2021, this coverage group have been separated: (1) the COVID-19 Testing Coverage for the Uninsured is now G06-I and is now listed as a limited benefit plan that rolls up into “Program Name” of Medicaid and “Medical Benefit Plan” of HUSKY Limited Benefit; (2) the emergency medical coverage has been separated into G06-II as a limited benefit plan that rolls up into “Program Name” of Emergency Medical and “Medical Benefit Plan” of Other Medical. An historical accounting of enrollment of the specific coverage group starting in calendar year 2020 will also be published separately. This data represents number of active recipients who received benefits under a medical benefit plan in that calendar year and month. A recipient may have received benefits from multiple plans in the same month; if so that recipient will be included in multiple categories in this dataset (counted more than once.) 2021 is a partial year. For privacy considerations, a count of zero is used for counts less than five. NOTE: On April 22, 2019 the methodology for determining HUSKY A Newborn recipients changed, which caused an increase of recipients for that benefit starting in October 2016. We now count recipients recorded in the ImpaCT system as well as in the HIX system for that assistance type, instead using HIX exclusively. Also, corrections in the ImpaCT system for January and February 2019 caused the addition of around 2000 and 3000 recipients respectively, and the counts for many types of assistance (e.g. SNAP) were adjusted upward for those 2 months. Also, the methodology for determining the address of the recipients changed: 1. The address of a recipient in the ImpaCT system is now correctly determined specific to that month instead of using the address of the most recent month. This resulted in some shuffling of the recipients among townships starting in October 2016. 2. If, in a given month, a recipient has benefit records in both the HIX system and in the ImpaCT system, the address of the recipient is now calculated as follows to resolve conflicts: Use the residential address in ImpaCT if it exists, else use the mailing address in ImpaCT if it exists, else use the address in HIX. This resulted in a reduction in counts for most townships starting in March 2017 because a single address is now used instead of two when the systems do not agree.\ NOTE: On February 14 2019, the enrollment

Medicaid reports the number and rate (per 1,000) of Medicaid cases and recipients.

Analysis of ‘Managed Care Enrollment Summary’ provided by Analyst-2 (analyst-2.ai), based on source dataset retrieved from https://catalog.data.gov/dataset/730ae026-2760-41fb-b423-6a55a1eb54c3 on 26 January 2022.

--- Dataset description provided by original source is as follows ---

The Medicaid Managed Care Enrollment Report profiles enrollment statistics on Medicaid managed care programs on a plan-specific level. The managed care enrollment statistics include enrollees receiving comprehensive benefits and limited benefits and are point-in-time counts.

1. Total Medicaid Enrollees represents an unduplicated count of all beneficiaries in FFS and any type of managed care, including Medicaid-only and Medicare-Medicaid ("dual") enrollees.
2. Total Medicaid enrollment in Any Type of Managed Care represents an unduplicated count of beneficiaries enrolled in any Medicaid managed care program, including comprehensive MCOs, limited benefit MCOs, and PCCMs.
3. Medicaid Enrollment in Comprehensive Managed Care represents an unduplicated count of Medicaid beneficiaries enrolled in a managed care plan that provides comprehensive benefits (acute, primary care, specialty, and any other), as well as PACE programs. It excludes beneficiaries who are enrolled in a Financial Alignment Initiative Medicare-Medicaid Plan as their only form of managed care.
4. Medicaid Newly Eligible Adults Enrolled in Comprehensive MCOs represents individuals who are enrolled in comprehensive MCOs and are low-income adults, with or without dependent children, newly eligible for Medicaid under ACA Section VIII, and not covered under a waiver or other authority prior to 2014.

--- Original source retains full ownership of the source dataset ---

In order to facilitate public review and access, enrollment data published on the Open Data Portal is provided as promptly as possible after the end of each month or year, as applicable to the data set. Due to eligibility policies and operational processes, enrollment can vary slightly after publication. Please be aware of the point-in-time nature of the published data when comparing to other data published or shared by the Department of Social Services, as this data may vary slightly.

As a general practice, for monthly data sets published on the Open Data Portal, DSS will continue to refresh the monthly enrollment data for three months, after which time it will remain static. For example, when March data is published the data in January and February will be refreshed. When April data is published, February and March data will be refreshed, but January will not change. This allows the Department to account for the most common enrollment variations in published data while also ensuring that data remains as stable as possible over time. In the event of a significant change in enrollment data, the Department may republish reports and will notate such republication dates and reasons accordingly. In March 2020, Connecticut opted to add a new Medicaid coverage group: the COVID-19 Testing Coverage for the Uninsured. Enrollment data on this limited-benefit Medicaid coverage group is being incorporated into Medicaid data effective January 1, 2021. Enrollment data for this coverage group prior to January 1, 2021, was listed under State Funded Medical. Effective January 1, 2021, this coverage group have been separated: (1) the COVID-19 Testing Coverage for the Uninsured is now G06-I and is now listed as a limited benefit plan that rolls up into “Program Name” of Medicaid and “Medical Benefit Plan” of HUSKY Limited Benefit; (2) the emergency medical coverage has been separated into G06-II as a limited benefit plan that rolls up into “Program Name” of Emergency Medical and “Medical Benefit Plan” of Other Medical. An historical accounting of enrollment of the specific coverage group starting in calendar year 2020 will also be published separately. This data represents number of active recipients who received benefits under a program in that calendar year and month. A recipient may have received benefits from multiple programs in the same month; if so that recipient will be included in multiple categories in this dataset (counted more than once.) 2021 is a partial year. For privacy considerations, a count of zero is used for counts less than five. NOTE: On April 22, 2019 the methodology for determining HUSKY A Newborn recipients changed, which caused an increase of recipients for that benefit starting in October 2016. We now count recipients recorded in the ImpaCT system as well as in the HIX system for that assistance type, instead using HIX exclusively. Also, corrections in the ImpaCT system for January and February 2019 caused the addition of around 2000 and 3000 recipients respectively, and the counts for many types of assistance (e.g. SNAP) were adjusted upward for those 2 months. Also, the methodology for determining the address of the recipients changed: 1. The address of a recipient in the ImpaCT system is now correctly determined specific to that month instead of using the address of the most recent month. This resulted in some shuffling of the recipients among townships starting in October 2016. 2. If, in a given month, a recipient has benefit records in both the HIX system and in the ImpaCT system, the address of the recipient is now calculated as follows to resolve conflicts: Use the residential address in ImpaCT if it exists, else use the mailing address in ImpaCT if it exists, else use the address in HIX. This resulted in a reduction in counts for most townships starting in March 2017 because a single address is now used instead of two when the systems do not agree. NOTE: On February 14 2019, the enrollment counts for 2012-2015 across all programs were updated to account for an error in the data integration process. As a result, the count of the number of people served increased by 13% for 2012, 10% for 2013, 8% for 2014 and 4% for 2015. Counts for 2016, 2017 and 2018 remain unchanged. NOTE: On 11/30/2018 the counts were revised because of a change in the way active recipients were counted in one source system.

Archived as of 5/30/2025: The datasets will no longer receive updates but the historical data will continue to be available for download. This dataset provides information related to returning citizens released from a Department of Corrections facility and enrolled in Medicaid during the time period 01/2019 to 03/2022. It contains information about the total number of recipients by county of residence at the time of the Medicaid application, gender, ethnicity, and race. This data is for research purposes and is not intended to be used for reporting. Due to differences in geographic aggregation, time period considerations, and units of analysis, these numbers may differ from those reported by FSSA.

This data set includes monthly counts and rates (per 1,000 beneficiaries) of contraceptives, including any contraceptives and long-acting reversible contraceptives, provided to female Medicaid and CHIP beneficiaries ages 15 to 44 (as of the first day of the month), by state.

These metrics are based on data in the T-MSIS Analytic Files (TAF). Some states have serious data quality issues for one or more months, making the data unusable for calculating contraceptive care services measures. To assess data quality, analysts adapted measures featured in the DQ Atlas. Data for a state and month are considered unusable if at least one of the following topics meets the DQ Atlas threshold for unusable: Total Medicaid and CHIP Enrollment, Procedure Codes - OT Professional, Claims Volume - OT. Please refer to the DQ Atlas at http://medicaid.gov/dq-atlas for more information about data quality assessment methods. Cells with a value of “DQ” indicate that data were suppressed due to unusable data.

Some cells have a value of “DS”. This indicates that data were suppressed for confidentiality reasons because the group included fewer than 11 beneficiaries.

Pregnancy Outcomes for Medicaid and CHIP Beneficiaries ages 15 to 44

  Description

This data set includes monthly counts and rates (per 1,000 beneficiaries) of pregnancy outcomes, including (1) live births and (2) miscarriages, stillbirths, and terminations, for female Medicaid and CHIP beneficiaries ages 15 to 44 (as of the first day of the month), by state. These metrics are based on data in the T-MSIS Analytic Files (TAF). Some states have serious data quality issues… See the full description on the dataset page: https://huggingface.co/datasets/HHS-Official/pregnancy-outcomes-for-medicaid-and-chip-beneficia.

Health Screenings Provided to Medicaid and CHIP Beneficiaries Under Age 19

  Description

This data set includes monthly counts and rates (per 1,000 beneficiaries) of health screenings provided to Medicaid and CHIP beneficiaries under the age of 19 (as of the first day of the month) by state. These metrics are based on data in the T-MSIS Analytic Files (TAF). Some states have serious data quality issues for one or more months, making the data unusable for calculating… See the full description on the dataset page: https://huggingface.co/datasets/HHS-Official/health-screenings-provided-to-medicaid-and-chip-be.

Archived as of 5/30/2025: The datasets will no longer receive updates but the historical data will continue to be available for download. This dataset provides information related to returning citizens released from a Department of Corrections facility and enrolled in Medicaid during the time period 01/2019 to 03/2022 and diagnosed with with opioid dependence, alcohol dependence, nicotine dependence, hypertension, anxiety disorder, depression or Type II diabetes. It contains total number of paid Medicaid claims, cost, and median cost by recipient county. This data is for research purposes and is not intended to be used for reporting. Due to differences in geographic aggregation, time period considerations, and units of analysis, these numbers may differ from those reported by FSSA.

The Medicaid by Drug dataset presents information on spending for covered outpatient drugs prescribed to beneficiaries enrolled in Medicaid by physicians and other healthcare professionals.

The dataset focuses on average spending per dosage unit and change in average spending per dosage unit over time. Units refer to the drug unit in the lowest dispensable amount. It also includes spending information for manufacturer(s) of the drugs as well as consumer-friendly information of drug uses and clinical indications.

Drug spending metrics for Medicaid represent the total amount reimbursed by both Medicaid and non-Medicaid entities to pharmacies for the drug. Medicaid drug spending contains both the Federal and State reimbursement and is inclusive of any applicable dispensing fees. In addition, this total is not reduced or affected by Medicaid rebates paid to the states.

The Share of Medicaid Enrollees in any Managed Care and in Comprehensive Managed CaAre profiles state-level enrollment statistics (numbers and percentages) of total Medicaid enrollees in any type of managed care as well as those enrolled specifically in comprehensive managed care programs. The report provides managed care enrollment by state with all 50 states, the District of Columbia and the US territories are represented in these data.

1. Note: "n/a" indicates that a state or territory was not able to report data or does not have a managed care program.

2. The “Total Medicaid Enrollees” column represents an unduplicated count of all beneficiaries in FFS and any type of managed care, including Medicaid-only and dually eligible individuals receiving full Medicaid benefits or Medicaid cost sharing.

3. The “Total Medicaid Enrollment in Any Type of Managed Care” column represents an unduplicated count of beneficiaries enrolled in any Medicaid managed care program, including comprehensive MCOs, limited benefit MCOs, PCCMs, and PCCM entities.

4. The “Medicaid Enrollment in Comprehensive Managed Care” column represents an unduplicated count of Medicaid beneficiaries enrolled in a managed care plan that provides comprehensive benefits (acute, primary care, specialty, and any other), as well as PACE programs. It excludes beneficiaries who are enrolled in a Financial Alignment Initiative Medicare-Medicaid Plan as their only form of managed care.