This dataset includes total enrollment in separate CHIP (S-CHIP) programs by month and state from April 2023 forward. Sources: T-MSIS Analytic Files (TAF) and state-submitted enrollment totals. The data notes indicate when a state’s monthly total was a state-submitted value, rather than from T-MSIS. Methods: Enrollment includes individuals enrolled in S-CHIP at any point during the coverage month, excluding those enrolled in dental-only coverage. The S-CHIP enrollment in this report also excludes enrollees covered by Medicaid expansion CHIP, a program in which a state receives federal funding to expand Medicaid eligibility to optional targeted low-income children that meets the requirements of section 2103 of the Social Security Act. If an individual is enrolled in both Medicaid or Medicaid-expansion CHIP and S-CHIP in a given month, TAF picks the program in which they were last enrolled. Unless S-CHIP enrollment counts are replaced with a state-submitted value, each state's monthly S-CHIP enrollment is equal to the number of unique people in TAF with a CHIP_CODE = 3 (S-CHIP) and ELGBLTY_GRP_CD not equal to ‘66’ (Children Eligible for Dental Only Supplemental Coverage). More information about TAF is available at https://www.medicaid.gov/medicaid/data-systems/macbis/medicaid-chip-research-files/transformed-medicaid-statistical-information-system-t-msis-analytic-files-taf/index.html. Note: A historic dataset with S-CHIP enrollment by month and state from April 2023 to June 2024 is also available at: https://data.medicaid.gov/dataset/d30cfc7c-4b32-4df1-b2bf-e0a850befd77. This historic dataset was created to fulfill reporting requirements under section 1902(tt)(1) of the Social Security Act, which was added by section 5131(b) of subtitle D of title V of division FF of the Consolidated Appropriations Act, 2023 (P.L. 117-328) (CAA, 2023). Please note that the methods used to count S-CHIP enrollees differ slightly between the two datasets; as a result, data users should exercise caution if comparing S-CHIP enrollment across the two datasets. State notes: Alaska, District of Columbia, Hawaii, New Hampshire, New Mexico, North Carolina, North Dakota, Ohio, South Carolina, Vermont, and Wyoming do not have S-CHIP programs. Maryland has an S-CHIP program for the from conception to end of pregnancy group that began in July 2023; April 2023 - June 2023 data for Maryland represents retroactive coverage. Oregon moved all its S-CHIP enrollees, other than those in the from conception to the end of pregnancy group, to a Medicaid-expansion CHIP program effective January 1, 2024. CHIP: Children's Health Insurance Program

This data set accompanies the Profile of the California Medicare Population chartbook, published by the Office of Medicare Innovation and Integration in February 2022, and available at (https://www.dhcs.ca.gov/services/Documents/OMII-Medicare-Databook-February-18-2022.pdf). The three data files in this data set were analyzed from federal administrative data (the Medicare Master Beneficiary Summary File) for beneficiary characteristics as of March 2021. These datasets include: Medicare enrollment, Medicare Advantage enrollment (and its converse fee-for-service Medicare enrollment), dual Medi-Cal eligibility and enrollment (and its converse Medicare-only enrollment), by county. Medicare Savings Program enrollees were considered Medicare-only and not dually enrolled in Medi-Cal. All Medicare Part C beneficiaries, including PACE, Cal MediConnect and Special Needs Plans, were considered to have Medicare Advantage.

DHCS partnered with The SCAN Foundation and ATI Advisory in 2021 and 2022 to develop a series of chartbooks that provide information about Medicare beneficiaries in California. This work is supported by a grant from The SCAN Foundation to advance a coordinated and easily navigated system of high-quality services for older adults that preserve dignity and independence. For more information, visit www.TheSCANFoundation.org.

Centers for Medicare & Medicaid Services - Nursing HomesThis feature layer, utilizing data from the Centers for Medicare & Medicaid Services (CMS), displays the locations of nursing homes in the U.S. Nursing homes provide a type of residential care. They are a place of residence for people who require constant nursing care and have significant deficiencies with activities of daily living. Per CMS, "Nursing homes, which include Skilled Nursing Facilities (SNFs) and Nursing Facilities (NFs), are required to be in compliance with Federal requirements to receive payment under the Medicare or Medicaid programs. The Secretary of the United States Department of Health & Human Services has delegated to the CMS and the State Medicaid Agency the authority to impose enforcement remedies against a nursing home that does not meet Federal requirements." This layer includes currently active nursing homes, including number of certified beds, address, and other information.Bridgepoint Sub-Acute and Rehab Capitol HillData downloaded: August 1, 2024Data source: Provider InformationData modification: This dataset includes only those facilities with addresses that were appropriately geocoded.For more information: Nursing homes including rehab servicesFor feedback, please contact: ArcGIScomNationalMaps@esri.comCenters for Medicare & Medicaid ServicesPer USA.gov, "The Centers for Medicare and Medicaid Services (CMS) provides health coverage to more than 100 million people through Medicare, Medicaid, the Children’s Health Insurance Program, and the Health Insurance Marketplace. The CMS seeks to strengthen and modernize the Nation’s health care system, to provide access to high quality care and improved health at lower costs."

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. Because Medicaid beneficiaries may be enrolled concurrently in more than one type of managed care program (e.g., a Comprehensive MCO and a BHO), users should not sum enrollment across all program types, since the total would count individuals more than once and, in some states, exceed the actual number of Medicaid enrollees.
2. Comprehensive MCOs cover acute, primary, and specialty medical care services; they may also cover behavioral health, long-term services and supports, and other benefits in some states. Limited benefit managed care programs, including MLTSS only, BHO, Dental, Transportation, and Other cover a narrower set of services.
3. The indicated territory was not able to supply data for this report. The Northern Mariana Islands reported that they have no Medicaid managed care enrollment, but they did not report total Medicaid enrollees.
4. The “Total dually eligible individuals” column represents an unduplicated count of all beneficiaries in FFS and any type of managed care, including enrollees receiving full Medicaid benefits or Medicaid cost sharing.

"--" indicates states that do not operate programs of a given type. 0 signifies that a state operated a program of this type in 2014, but it ended before July 1, 2014, or began after that date.

The MMA legislation provides seniors and people with disabilities with the first comprehensive prescription drug benefit ever offered under the Medicare program, the most significant improvement to senior health care in nearly 40 years. This overview page provides links to important information on the new benefit.

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. Because Medicaid beneficiaries may be enrolled concurrently in more than one type of managed care program (e.g., a Comprehensive MCO and a BHO), users should not sum enrollment across all program types, since the total would count individuals more than once and, in some states, exceed the actual number of Medicaid enrollees. Comprehensive MCOs cover acute, primary, and specialty medical care services; they may also cover behavioral health, long-term services and supports, and other benefits in some states. Limited benefit managed care programs, including MLTSS only, BHO, Dental, Transportation, and Other cover a narrower set of services. The indicated territory was not able to supply data for this report. The Northern Mariana Islands reported that they have no Medicaid managed care enrollment, but they did not report total Medicaid enrollees. The “Total dually eligible individuals” column represents an unduplicated count of all beneficiaries in FFS and any type of managed care, including enrollees receiving full Medicaid benefits or Medicaid cost sharing. "--" indicates states that do not operate programs of a given type. 0 signifies that a state operated a program of this type in 2014, but it ended before July 1, 2014, or began after that date.

This dataset presents the estimates of the internal and overseas migration statistics of Australia by age by Statistical Area Level 2 (SA2) following the 2016 Australian Statistical Geography Standard (ASGS). The dataset spans from the 2016-17 financial year up to the 2019-20 financial year. Overseas migration is the movement of people from overseas to Australia's sub-state areas and vice-versa. It cannot be directly measured and is estimated by breaking down overseas migrant arrivals and departures at the state level to sub-state areas, using information from the most recent Census. The state-level overseas migration data is sourced from Department of Home Affairs processing systems, visa information, and incoming passenger cards, and is published in National, state and territory population. Internal migration is the movement of people across a specified boundary within Australia involving a change in place of usual residence. It cannot be directly measured and is instead estimated using administrative data. The movement of people between and within Australia's states and territories cannot be directly measured and is estimated using administrative data. Internal migration is estimated based on a combination of Census data (usual address one year ago), Medicare change of address data (provided by Services Australia), and Department of Defence records (for military personnel only). The Medicare source data is assigned to a state or territory and GCCSA for a person's departure and arrival locations, based on the postcodes of their residential addresses as registered with Medicare. Postcodes are assigned wholly to a state/territory and GCCSA based on best fit. Where a postcode is split across areas, it is assigned to the area that contains the majority of that postcode's population. For more information please visit the Regional population methodology. AURIN has spatially enabled the original data.

This dataset presents the estimates of the internal and overseas migration statistics of Australia by age by Greater Capital City Statistical Area (GCCSA) following the 2016 Australian Statistical Geography Standard (ASGS). The dataset spans from the 2016-17 financial year up to the 2019-20 financial year. Overseas migration is the movement of people from overseas to Australia's sub-state areas and vice-versa. It cannot be directly measured and is estimated by breaking down overseas migrant arrivals and departures at the state level to sub-state areas, using information from the most recent Census. The state-level overseas migration data is sourced from Department of Home Affairs processing systems, visa information, and incoming passenger cards, and is published in National, state and territory population. Internal migration is the movement of people across a specified boundary within Australia involving a change in place of usual residence. It cannot be directly measured and is instead estimated using administrative data. The movement of people between and within Australia's states and territories cannot be directly measured and is estimated using administrative data. Internal migration is estimated based on a combination of Census data (usual address one year ago), Medicare change of address data (provided by Services Australia), and Department of Defence records (for military personnel only). The Medicare source data is assigned to a state or territory and GCCSA for a person's departure and arrival locations, based on the postcodes of their residential addresses as registered with Medicare. Postcodes are assigned wholly to a state/territory and GCCSA based on best fit. Where a postcode is split across areas, it is assigned to the area that contains the majority of that postcode's population. For more information please visit the Regional population methodology. AURIN has spatially enabled the original data.

This dataset presents the estimates of the internal and overseas migration statistics of Australia by age by Statistical Area Level 4 (SA4) following the 2016 Australian Statistical Geography Standard (ASGS). The dataset spans from the 2016-17 financial year up to the 2019-20 financial year. Overseas migration is the movement of people from overseas to Australia's sub-state areas and vice-versa. It cannot be directly measured and is estimated by breaking down overseas migrant arrivals and departures at the state level to sub-state areas, using information from the most recent Census. The state-level overseas migration data is sourced from Department of Home Affairs processing systems, visa information, and incoming passenger cards, and is published in National, state and territory population. Internal migration is the movement of people across a specified boundary within Australia involving a change in place of usual residence. It cannot be directly measured and is instead estimated using administrative data. The movement of people between and within Australia's states and territories cannot be directly measured and is estimated using administrative data. Internal migration is estimated based on a combination of Census data (usual address one year ago), Medicare change of address data (provided by Services Australia), and Department of Defence records (for military personnel only). The Medicare source data is assigned to a state or territory and GCCSA for a person's departure and arrival locations, based on the postcodes of their residential addresses as registered with Medicare. Postcodes are assigned wholly to a state/territory and GCCSA based on best fit. Where a postcode is split across areas, it is assigned to the area that contains the majority of that postcode's population. For more information please visit the Regional population methodology. AURIN has spatially enabled the original data.

Healthcare fraud is considered a challenge for many societies. Health care funding that could be spent on medicine, care for the elderly, or emergency room visits is instead lost to fraudulent activities by materialistic practitioners or patients. With rising healthcare costs, healthcare fraud is a major contributor to these increasing healthcare costs.

Try out various unsupervised techniques to find the anomalies in the data.

Detailed Data File:

The following variables are included in the detailed Physician and Other Supplier data file (see Appendix A for a condensed version of variables included)).

npi – National Provider Identifier (NPI) for the performing provider on the claim. The provider NPI is the numeric identifier registered in NPPES.

nppes_provider_last_org_name – When the provider is registered in NPPES as an individual (entity type code=’I’), this is the provider’s last name. When the provider is registered as an organization (entity type code = ‘O’), this is the organization's name.

nppes_provider_first_name – When the provider is registered in NPPES as an individual (entity type code=’I’), this is the provider’s first name. When the provider is registered as an organization (entity type code = ‘O’), this will be blank.

nppes_provider_mi – When the provider is registered in NPPES as an individual (entity type code=’I’), this is the provider’s middle initial. When the provider is registered as an organization (entity type code= ‘O’), this will be blank.

nppes_credentials – When the provider is registered in NPPES as an individual (entity type code=’I’), these are the provider’s credentials. When the provider is registered as an organization (entity type code = ‘O’), this will be blank.

nppes_provider_gender – When the provider is registered in NPPES as an individual (entity type code=’I’), this is the provider’s gender. When the provider is registered as an organization (entity type code = ‘O’), this will be blank.

nppes_entity_code – Type of entity reported in NPPES. An entity code of ‘I’ identifies providers registered as individuals and an entity type code of ‘O’ identifies providers registered as organizations.

nppes_provider_street1 – The first line of the provider’s street address, as reported in NPPES.

nppes_provider_street – The second line of the provider’s street address, as reported in NPPES.

nppes_provider_city – The city where the provider is located, as reported in NPPES.

nppes_provider_zip – The provider’s zip code, as reported in NPPES.

nppes_provider_state – The state where the provider is located, as reported in NPPES. The fifty U.S. states and the District of Columbia are reported by the state postal abbreviation. The following values are used for all other areas:

'XX' = 'Unknown' 'AA' = 'Armed Forces Central/South America' 'AE' = 'Armed Forces Europe' 'AP' = 'Armed Forces Pacific' 'AS' = 'American Samoa' 'GU' = 'Guam' 'MP' = 'North Mariana Islands' 'PR' = 'Puerto Rico' 'VI' = 'Virgin Islands' 'ZZ' = 'Foreign Country'

nppes_provider_country – The country where the provider is located, as reported in NPPES. The country code will be ‘US’ for any state or U.S. possession. For foreign countries (i.e., state values of ‘ZZ’), the provider country values include the following: AE=United Arab Emirates IT=Italy AG=Antigua JO= Jordan AR=Argentina JP=Japan AU=Australia KR=Korea BO=Bolivia KW=Kuwait BR=Brazil KY=Cayman Islands CA=Canada LB=Lebanon CH=Switzerland MX=Mexico CN=China NL=Netherlands CO=Colombia NO=Norway DE= Germany NZ=New Zealand ES= Spain PA=Panama FR=France PK=Pakistan GB=Great Britain RW=Rwanda GR=Greece SA=Saudi Arabia HU= Hungary SY=Syria IL= Israel TH=Thailand IN=India TR=Turkey IS= Iceland VE=Venezuela

provider_type – Derived from the provider specialty code reported on the claim.

medicare_participation_indicator – Identifies whether the provider participates in Medicare and/or accepts the assigned assignment of Medicare allowed amounts.

place_of_service – Identifies whether the place of service submitted on the claims is a facility (value of ‘F’) or non-facility (value of ‘O’). Non-facility is generally an office setting; however other entities are included in non-facility.

hcpcs_code – HCPCS code used to identify the specific medical service furnished by the provider.

hcpcs_description – Description of the HCPCS code for the specific medical service furnished by the provider.

hcpcs_drug_indicator –Identifies whether the HCPCS code for the specific service furnished by the provider is an HCPCS listed on the Medicare Part B Drug Average Sales Price (ASP) File.

line_srvc_cnt – Number of services provided; note that the metrics used to count the number provided can vary from service to service.

bene_unique_cnt – Number of distinct Medicare beneficiaries rec...

This dataset presents the estimates of the internal and overseas migration statistics of Australia by age by Statistical Area Level 3 (SA3) following the 2016 Australian Statistical Geography Standard (ASGS). The dataset spans from the 2016-17 financial year up to the 2019-20 financial year. Overseas migration is the movement of people from overseas to Australia's sub-state areas and vice-versa. It cannot be directly measured and is estimated by breaking down overseas migrant arrivals and departures at the state level to sub-state areas, using information from the most recent Census. The state-level overseas migration data is sourced from Department of Home Affairs processing systems, visa information, and incoming passenger cards, and is published in National, state and territory population. Internal migration is the movement of people across a specified boundary within Australia involving a change in place of usual residence. It cannot be directly measured and is instead estimated using administrative data. The movement of people between and within Australia's states and territories cannot be directly measured and is estimated using administrative data. Internal migration is estimated based on a combination of Census data (usual address one year ago), Medicare change of address data (provided by Services Australia), and Department of Defence records (for military personnel only). The Medicare source data is assigned to a state or territory and GCCSA for a person's departure and arrival locations, based on the postcodes of their residential addresses as registered with Medicare. Postcodes are assigned wholly to a state/territory and GCCSA based on best fit. Where a postcode is split across areas, it is assigned to the area that contains the majority of that postcode's population. For more information please visit the Regional population methodology. AURIN has spatially enabled the original data.

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.