Maximizing Efficiency Through Interstate Data Leveraging
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[lev-er-ij, lee-ver-]
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resultDictionary.com link for the word leverage: https://www.dictionary.com/browse/leverage
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Further enhance PARIS matches
•
Better investigations
•
Prioritize investigations
•
Assists in Identifying:
•
Residency
•
Over-issuances
•
Current eligibility
•
Group composition
•
Other affected programs
•
Program disqualifications
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Excel
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Access
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Teradata SQL Assistant
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Your office’s Data Geek
Can all be of great assistance when leveraging the
PARIS Interstate Return File
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Michigan fields are appended to other
State’s record for direct comparison
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Stored in a Data Warehouse (DW)
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Note: In the following slides PARIS Field Names
are referred to by name, not Position in the PARIS
Interstate file
PARIS State Input Record Format:
https://www.acf.hhs.gov/paris/state-input-record-format
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In Michigan,
ClientFirstName
field is the first name of the
recipient from Michigan
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The
ResultClientFirstName
field is the first name of the
recipient from the other state
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When
ClientFirstName
=
ResultClientFirstName
, it means
both the Michigan and the other state have the same first
name for that recipient
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Field names may vary depending on how
your Interstate Return File is formatted by
your State
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Identifies:
•
Individuals receiving dual
Medicaid in California and
Michigan
•
Why California?
•
They submit Medicaid only
•
No eligibility dates populated
•
Data is typically reliable
•
Data Source:
•
PARIS Interstate Return File
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ClientFirstName
(MI) =
ResultClientFirstName
(CA)
•
ClientDOB
(MI) =
ResultClientDOB
(CA)
•
Filedate
= current PARIS file date
•
(i.e., 201911)
•
ResultStatename
= CA
•
Identifies dual assistance with California
•
MAIndicator
= Y (MI) &
ResultMAIndicator
= Y (CA)
•
Individual receiving Medicaid in Michigan and California
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PARIS Matches exist based on DMDC
matching individual’s SSNs across multiple
states
•
Last Name:
•
Common to see Maiden name versus Married Name
across multiple states
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Dual Medicaid in Michigan and California
•
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:
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Recipient failed to respond and out of state address
was found
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Case closed
•
$619 monthly cost avoidance (SNAP & Medicaid)
•
$7,428 yearly cost avoidance (SNAP & Medicaid)
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Identifies:
•
Individuals receiving dual assistance
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Eligibility began in other state after
Michigan eligibility began
•
Implying the individual moved
•
At least 60 days of dual assistance has
already occurred
•
Past reporting timeframes for recipient
•
Ensures dual assistance situation is
continuing and needs to be addressed
•
Data Sources:
•
PARIS Interstate Return
File
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ClientFirstName
(MI) =
ResultClientFirstName
(Other
State)
ClientDOB
(MI) =
ResultClientDOB
(Other State)
Filedate
= current file date
◦
(i.e., 201911)
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:
MAIndicator
= Y (MI) &
ResultMAIndicator
= Y (Other State)
•
Individual receiving Medicaid in Michigan and Other State
ResultMAEligibilityStart
(Other State) greater than
MAEligibilityStart
(MI)
MAEligibilityEnd
(MI) &
ResultMAEligibilityEnd
(Other State)
•
Date must be future date or null to increase the chances that benefits will
continue (and should be investigated/stopped in one state)
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:
FSIndicator
= Y (MI) &
ResultFSIndicator
= Y (Other State)
•
Individual receiving Medicaid in Michigan and Other State
ResultFAEligibilityStart
(Other State) greater than
FAEligibilityStart
(MI)
FAEligibilityEnd
(MI) &
ResultFAEligibilityEnd
(Other State)
•
Date must be future date or null to increase the chances that benefits
will continue (and should be investigated/stopped in one state)
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Step 1:
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Ensure Michigan’s Program (SNAP or Medicaid) is not set to
expire
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Example:
MAEligibilityStart
(MI) = 12/31/9999
Step 2:
•
Ensure other state’s program eligibility began after
Michigan’s program eligibility
•
Example:
ResultMAEligibilityStart
(other state) is 2/1/2020 and
MAEligibilityStart
(MI) is 09/01/2019
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Step 3:
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Ensure that the other state’s program eligibility end field is either
blank, or set to expire at a future date
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Example:
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filedate = 201911
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ResultMAEligibilityEnd (other state) date must be greater than 12/31/2019
Step 4:
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Subtract today’s date (the date you’re running the match) from the
other state’s eligibility start date
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Example:
•
Today’s Date – ResultFAEligibilityStart (other state)
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Dual Medicaid in Michigan and Oregon
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More than 60 Days Dual Assistance
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:
•
Recipient and family moved and did not inform case
worker
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Case closed
•
$1,281 monthly cost avoidance (Medicaid)
•
$15,372 yearly cost avoidance (Medicaid)
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Identifies:
•
PARIS Match individual
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Dual assistance received
•
Michigan SNAP spending in
PARIS state
Data Sources:
•
Interstate Return File
•
SNAP Transaction Data
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ClientFirstName
(MI) =
ResultClientFirstName
(Other State)
ClientDOB
(MI) =
ResultClientDOB
(Other State)
Filedate
= current filedate
•
(i.e., 201911)
ResultStatename
•
Identifies dual assistance state
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&
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s
:
FSIndicator
= Y (MI) &
ResultFSIndicator
= Y (Other State)
•
If matching for SNAP Dual Assistance
MAIndicator
= Y (MI) &
ResultMAIndicator
= Y (Other State)
•
If matching for Medicaid Dual Assistance
S
N
A
P
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F
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:
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Collect and review EBT transaction data for timeframe of PARIS
Quarter to Date of Query
•
Example: filedate 201908, timeframe 8/1/2019 – 10/18/2019
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Dual Medicaid in Michigan and Colorado
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Timeframe of 8-01-2018 through 10-18-18, the individual has
completed 77 SNAP transactions in Colorado
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:
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Recipient and family moved and did not inform case worker
•
Case closed
•
$1,207 monthly cost avoidance (SNAP & Medicaid)
•
$14,484 yearly cost avoidance (SNAP & Medicaid)
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Identifies:
•
PARIS Match individual
•
Dual assistance received
•
Logins to Michigan Online
Portal from matched PARIS
state
Data Sources:
•
Interstate Return File
•
Online Portal Data
•
Michigan: MIBridges
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ClientFirstName
(MI) =
ResultClientFirstName
(Other
State)
ClientDOB
(MI) =
ResultClientDOB
(Other State)
Filedate
= current filedate
•
(i.e., 201911)
Statename
•
Identifies dual assistance state
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s
:
FSIndicator
= Y (MI) &
ResultFSIndicator
= Y (Other State)
•
If matching for SNAP Dual Assistance
MAIndicator
= Y (MI) &
ResultMAIndicator
= Y (Other State)
•
If matching for Medicaid Dual Assistance
M
I
B
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s
F
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:
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Online Portal’s login information for timeframe of PARIS
Quarter to Date of Query
•
Example: filedate = 201911, timeframe 11/1/2019 – 1/22/2020
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•
Dual Medicaid in Michigan and Arizona
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Individual has completed at least 1 login to the MIBridges website
from Arizona per IP address location
R
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s
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:
•
Recipient moved and failed to inform
•
Case closed
•
$427 monthly cost avoidance (Medicaid)
•
$5,124 yearly cost avoidance (Medicaid)
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FY2017 (10/1/2016-9/30/2017):
•
$
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FY2018 (10/1/2017-9/30/2018):
•
$
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J
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IP Locator Specialist
Michigan Department of Health & Human Services
Office of Inspector General, Investigative Analytics Unit
BrinksJ1@Michigan.gov
Explore how leveraging interstate output files can enhance investigations, improve program management, and optimize data analysis in government agencies. Michigan's specialized field formats and the benefits of efficient data leveraging tools are highlighted in this informative content.
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Presentation Transcript
Leveraging the Interstate Output File JESSICA BRINKS IP LOCATOR SPECIALIST MICHIGAN DEPARTMENT OF HEALTH & HUMAN SERVICES OFFICE OF INSPECTOR GENERAL, INVESTIGATIVE ANALYTICS UNIT 1
Leveraging Defined leverage [lev-er-ij, lee-ver-] verb (used with object), lev er aged, lev er ag ing. to use (a quality or advantage) to obtain a desired effect or result Dictionary.com link for the word leverage: https://www.dictionary.com/browse/leverage 2
Results of Leveraging the Interstate File Further enhance PARIS matches Better investigations Prioritize investigations Assists in Identifying: Residency Over-issuances Current eligibility Group composition Other affected programs Program disqualifications 3
Assistants in Leveraging the File Excel Access Teradata SQL Assistant Your office s Data Geek Can all be of great assistance when leveraging the PARIS Interstate Return File 4
How Michigan stores/formats the Return File Michigan fields are appended to other State s record for direct comparison Stored in a Data Warehouse (DW) 5
Interstate File Field Names Note: In the following slides PARIS Field Names are referred to by name, not Position in the PARIS Interstate file PARIS State Input Record Format: https://www.acf.hhs.gov/paris/state-input-record-format 6
Michigan Specific Field Names In Michigan, ClientFirstName field is the first name of the recipient from Michigan The ResultClientFirstName field is the first name of the recipient from the other state When ClientFirstName = ResultClientFirstName, it means both the Michigan and the other state have the same first name for that recipient 7
Please Note, In Your State You will notsee records with a Result in front of the field name Field names may vary depending on how your Interstate Return File is formatted by your State 8
California Medicaid Match Data Source: PARIS Interstate Return File Identifies: Individuals receiving dual Medicaid in California and Michigan Why California? They submit Medicaid only No eligibility dates populated Data is typically reliable 9
California Medicaid Match: PARIS Fields ClientFirstName (MI) = ResultClientFirstName (CA) ClientDOB (MI) = ResultClientDOB (CA) Filedate = current PARIS file date (i.e., 201911) ResultStatename = CA Identifies dual assistance with California MAIndicator = Y (MI) & ResultMAIndicator = Y (CA) Individual receiving Medicaid in Michigan and California 10
What about SSN & Last Name? PARIS Matches exist based on DMDC matching individual s SSNs across multiple states Last Name: Common to see Maiden name versus Married Name across multiple states 11
California Medicaid Match: Case Example Dual Medicaid in Michigan and California Result: Recipient failed to respond and out of state address was found Case closed $619 monthly cost avoidance (SNAP & Medicaid) $7,428 yearly cost avoidance (SNAP & Medicaid) 12
PARIS 60 Day Match Data Sources: PARIS Interstate Return File Identifies: Individuals receiving dual assistance Eligibility began in other state after Michigan eligibility began Implying the individual moved At least 60 days of dual assistance has already occurred Past reporting timeframes for recipient Ensures dual assistance situation is continuing and needs to be addressed 13
60 Day Match: PARIS Fields ClientFirstName (MI) = ResultClientFirstName (Other State) ClientDOB (MI) = ResultClientDOB (Other State) Filedate = current file date (i.e., 201911) 14
60 Day Match: PARIS Fields If looking for Medicaid Matches: MAIndicator = Y (MI) & ResultMAIndicator = Y (Other State) Individual receiving Medicaid in Michigan and Other State ResultMAEligibilityStart (Other State) greater than MAEligibilityStart (MI) MAEligibilityEnd (MI) & ResultMAEligibilityEnd (Other State) Date must be future date or null to increase the chances that benefits will continue (and should be investigated/stopped in one state) 15
60 Day Match: PARIS Fields If looking for SNAP Matches: FSIndicator = Y (MI) & ResultFSIndicator = Y (Other State) Individual receiving Medicaid in Michigan and Other State ResultFAEligibilityStart (Other State) greater than FAEligibilityStart (MI) FAEligibilityEnd (MI) & ResultFAEligibilityEnd (Other State) Date must be future date or null to increase the chances that benefits will continue (and should be investigated/stopped in one state) 16
How to Calculate the Days of Dual Assistance Step 1: Ensure Michigan s Program (SNAP or Medicaid) is not set to expire Example: MAEligibilityStart (MI) = 12/31/9999 Step 2: Ensure other state s program eligibility began after Michigan s program eligibility Example: ResultMAEligibilityStart (other state) is 2/1/2020 and MAEligibilityStart (MI) is 09/01/2019 17
How to Calculate the Days of Dual Assistance Step 3: Ensure that the other state s program eligibility end field is either blank, or set to expire at a future date Example: filedate = 201911 ResultMAEligibilityEnd (other state) date must be greater than 12/31/2019 Step 4: Subtract today s date (the date you re running the match) from the other state s eligibility start date Example: Today s Date ResultFAEligibilityStart (other state) 18
PARIS 60 Day Match: Case Example Dual Medicaid in Michigan and Oregon More than 60 Days Dual Assistance Result: Recipient and family moved and did not inform case worker Case closed $1,281 monthly cost avoidance (Medicaid) $15,372 yearly cost avoidance (Medicaid) 19
PARIS & SNAP Spending Identifies: Data Sources: PARIS Match individual Dual assistance received Michigan SNAP spending in PARIS state Interstate Return File SNAP Transaction Data 20
PARIS & SNAP: PARIS Fields ClientFirstName (MI) = ResultClientFirstName (Other State) ClientDOB (MI) = ResultClientDOB (Other State) Filedate = current filedate (i.e., 201911) ResultStatename Identifies dual assistance state 21
PARIS & SNAP: Additional Data Fields Additional PARIS Fields: FSIndicator = Y (MI) & ResultFSIndicator = Y (Other State) If matching for SNAP Dual Assistance MAIndicator = Y (MI) & ResultMAIndicator = Y (Other State) If matching for Medicaid Dual Assistance SNAP Transaction Fields: Collect and review EBT transaction data for timeframe of PARIS Quarter to Date of Query Example: filedate 201908, timeframe 8/1/2019 10/18/2019 22
PARIS & SNAP: Case Example 201808 PARIS Medicaid Match with SNAP Spending Dual Medicaid in Michigan and Colorado Timeframe of 8-01-2018 through 10-18-18, the individual has completed 77 SNAP transactions in Colorado Result: Recipient and family moved and did not inform case worker Case closed $1,207 monthly cost avoidance (SNAP & Medicaid) $14,484 yearly cost avoidance (SNAP & Medicaid) 23
PARIS & IP Tracking Data Sources: Identifies: Interstate Return File Online Portal Data Michigan: MIBridges PARIS Match individual Dual assistance received Logins to Michigan Online Portal from matched PARIS state 24
PARIS & IP Tracking: PARIS Fields ClientFirstName (MI) = ResultClientFirstName (Other State) ClientDOB (MI) = ResultClientDOB (Other State) Filedate = current filedate (i.e., 201911) Statename Identifies dual assistance state 25
PARIS & IP Tracking: Additional Data Fields Additional PARIS Fields: FSIndicator = Y (MI) & ResultFSIndicator = Y (Other State) If matching for SNAP Dual Assistance MAIndicator = Y (MI) & ResultMAIndicator = Y (Other State) If matching for Medicaid Dual Assistance MIBridges Fields: Online Portal s login information for timeframe of PARIS Quarter to Date of Query Example: filedate = 201911, timeframe 11/1/2019 1/22/2020 26
PARIS & IP Tracking: Case Example Dual Medicaid in Michigan and Arizona Individual has completed at least 1 login to the MIBridges website from Arizona per IP address location Result: Recipient moved and failed to inform Case closed $427 monthly cost avoidance (Medicaid) $5,124 yearly cost avoidance (Medicaid) 27
Michigan PARIS Interstate Savings FY2017 (10/1/2016-9/30/2017): $26 Million in annualized Cost Avoidance FY2018 (10/1/2017-9/30/2018): $40.5 Million in annualized Cost Avoidance 28
Jessica Brinks IP Locator Specialist Michigan Department of Health & Human Services Office of Inspector General, Investigative Analytics Unit BrinksJ1@Michigan.gov 29
