Centers for Medicare and Medicaid Services (CMS) – Medicare Advantage

Description:

Centers for Medicare & Medicaid Services (CMS) provides Medicare Advantage (MA) enrollment data for the following plan types (when there are active contracts): 1976 Cost HCPP – 1933 Cost HMO/HMOPOS LI NET Sponsor Plan Local PPO Medicare-Medicaid Plan HMO/HMOPOS MSA National PACE PFFS Regional PPO The privacy laws of HIPAA have been interpreted to prohibit publishing enrollment data with values of 10 or less. Consequently, some enrollment data in this file have been set to blank because the enrollment was 10 or less. This dataset lists enrollees by their legal state and county of residence; this is the county used for payment purposes. For example, an individual who moved from Baltimore to Los Angeles and enrolled in XYZ Insurance company of California would be paid at the Baltimore rate until the change of address was recorded in the Social Security system. Consequently, the XYZ enrollment records will include both the California counties in its approved contract service area as well as the counties throughout the United States where XYZ has enrollees.