DEPARTMENT OF HEALTH & HUMAN SERVICES 
Centers for Medicare & Medicaid Services 
7500 Security Boulevard, Mail Stop S2-26-12 
Baltimore, Maryland   21244-1850 
 
CMCS Informational Bulletin 
 
DATE:    March 18, 2019 
 
FROM:    Chris Traylor, Deputy Administrator  and Director,  
Center for Medicaid & CHIP Services 
 
SUBJECT:   T-MSIS State Compliance 
 
CMS recognizes and appreciate states ongoing  commitment  to improving  their T-MSIS data. 
Access to high-quality,  timely  data is essential for ensuring robust monitoring  and oversight of 
the Medicaid and CHIP programs. Over the last 5 years, together CMS and states have produced 
the T-MSIS dataset and, for the last two years, have been working collaboratively  to improve the 
quality of the data. CMS will begin to share and use T-MSIS data publicly in 2019.  
 
On August 10, 2018, CMS issued a State Health Official (SHO) Letter 18-008, outlining  T-MSIS 
data reporting requirements for state Medicaid and CHIP programs.1 This informational  bulletin 
further discusses T-MSIS data quality requirements and timelines associated with CMSs review 
of compliance with these requirements. The letter also highlights  resources available to states in 
meeting them.  As conveyed in SHO Letter 18-008, states are expected to continue to improve 
the quality of their T-MSIS data and to ensure changes to state systems or operations will not 
degrade T-MSIS data submission  quality,  completeness, and/or timeliness.  
 
 T-MSIS Data Quality Compliance 
 
To meet the requirements described in the T-MSIS SHO letter, states must: 
 
1.  Maintain monthly  production submissions  of T-MSIS files; e.g., submit all May 2019 
data to CMS by June 30, 2019. 
2.  Resolve data issues associated with the 12 Top Priority Items (TPIs), as discussed in 
SHO Letter 18-008.2 CMS has identified  its next set of eleven priority  data quality items, 
which are being shared with states through routine technical assistance processes, with 
the expectation to resolve the new TPIs after resolving the first twelve.  
                                                             
1 The August 10, 2018 T-MSIS State Health Official letter can be found on Medicaid.gov 
https://www.medicaid.gov/Federal-Policy-Guidance/downloads/SHO18008.pdf. 
 
2 For more detail on the top 12 Priority Issues, see the T-MSIS coding blog, The Top 12 Priority Issues from T-MSIS 
Coding Blog, https://www.medicaid.gov/medicaid/data-and-systems/macbis/tmsis/tmsis-blog/?entry=45422.  3.  Resolve key missing  data elements critical for file linking  and data use. We will work 
individually  with each state in the identification,  prioritization  and resolution of key 
missing data elements relevant to that state.  
4.  Continue to resolve other data quality issues identified  in the T-MSIS operations 
dashboard, data quality database, and through ongoing  review and use of T-MSIS data as 
part of states regular T-MSIS data submissions. 
 
CMS has been, and will continue to be, a committed partner with all states in support of their 
good-faith efforts to meet and maintain compliance with the T-MSIS requirements.  However, 
states should be aware CMS may reduce enhanced Federal Financial  Participation (FFP) for 
operational costs of systems unable to produce timely,  accurate, and complete T-MSIS data.  Per 
42 C.F.R.  433.120, CMS may reduce FFP for expenditures for systems with non-compliant 
functionality. 
 
T-MSIS Data Quality SHO Timeline 
 
Date  Action 
April 2019  All State Medicaid Directors will receive an individual  email 
describing their states current compliance status with respect to the 
above requirements. 
May 31, 2019  Deadline for states to submit improved TMSIS data for inclusion  in the 
first T-MSIS public file release. 
September 2019  State Medicaid Directors of states with significant  data quality  issues 
will receive a letter identifying  specific issues to address. 
November 2019  State Medicaid Directors of states with remaining  data quality issues 
will be asked to submit a corrective action plan.  
 
CMS will  include information  regarding T-MSIS data quality in the 
Medicaid and CHIP Scorecard release. 
 
Resources available to assist states with T-MSIS Data Quality 
 
Individual State Technical Assistance - Over the last year, CMS has been working with each 
state to improve the quality  and completeness of its T-MSIS submissions  and will  continue to do 
so throughout  2019. CMS state liaisons are assigned for each state to assist in T-MSIS 
communication,  coordination,  planning,  and oversight.  
 
T-MSIS Data Quality Tools - CMS has provided states with tools and resources including  the 
T-MSIS operations dashboard and a data quality  database for identifying  and resolving  data 
quality issues. In support of state data quality efforts, CMS will  continue to improve state tools 
and resources for states, highlight  top priority data issues, and issue executive level summaries of 
state data and usability  features to improve states ability  to identify and resolve these issues. 
Working with states individually,  CMS has been sharing each states individual  progress in  resolving  the current 12 Top Priority Issues and will continue providing  each state with one-on-
one technical assistance. 
 
Enhanced Funding for Information Technology  States may request 90/10 enhanced system 
funding through the Advanced Planning  Document process to assist in funding necessary 
systems enhancements to comply with data quality  requirements. 
 
Any questions may be sent to Julie Boughn, Data and Systems Group Director, 
julie.boughn1@cms.hhs.gov,  or Barbara Richards, Director of the Division  of Business and Data 
Analysis, barbara.richards@cms.hhs.gov.