Are you ready for CDL?
References to the guides are used throughout the CDL so you will need the guides to implement the CDL:
- X12 Post-Adjudicated Claims Data Reporting Implementation Guides (referenced in CDL medical claims file layout and dental claims file layout)
- X12 Eligibility and Enrollment Implementation Guides (referenced in CDL eligibility file layout)
- NCPDP Uniform Healthcare Payer Data Standard Implementation Guide (referenced in CDL pharmacy claims file layout)
If so, you may want to write your rule so that you can continue to use the most updated version without having to go to rulemaking every time.
This can make updating your data submission guide every time the CDL is updated, a bit easier.
What should an HDO do if its APCD legislation or administrative rules prohibit the collection of direct identifiers, or personally identified information, or require certain hashing or encryption?
Hashing identifiers should not be an issue in using the CDL as the CDL describes the format of the files to be created. Prior to submission of the files, the submitter can run the files through a hashing application.
Work with your vendor to understand hashing and encryption options.
All the cool kids are doing it!
- Several new states have committed to using the CDL. By transitioning to the CDL you may be able to participate more fully in sharing analytic code with other CDL-formatted APCD states.
- When you have the same format as other states that use the CDL, you can more easily share information about data quality issues
- You can incorporate the CDL by reference in your DSG and leave the updates and maintenance to NAHDO!
- If DOL follows through with its recommendations to use the CDL for collection of self-insured data, you will be positioned to take in that data too.
- Add historical context
- Add reference to the SAPDAC report
- Proprietary data standards are difficult for payers to keep up with… take it easy on your data submitters… Data Submission Guide updates are easier on submitters with the CDL. Currently submitters must make updates to multiple APCD submission layouts and these required changes usually occur at the same time (at the end of the year for the new year). Submitters will need to only make the change once to the updated CDL and that can be used across APCDs. Easier/quicker implementation revisions.
- By reference
- Appropriate citation (see above)
- If you refer to the CDL™ in your DSG, you may copy the content of the CDL in to your DSG. DO not remove or re-order the data elements of the CDL. You may add information (see #3) about the data elements (e.g. required/situational; thresholds)
Please bring any suggestions for additions to the CDL to the CDL Data Maintenance Committee. For questions about adding data elements, please contact: EMAIL. To request the addition of a data element, submit a Data Maintenance Request
- If states are not able to add the requested data element through the CDL DMR process, we recommend appending them to the end of the file or developing a companion guide to articulate the additional data elements and business rules.
- YES, some APCDs add columns to the CDL to describe the expectations about population of the field:
- Required or Situational
Percentage of records to be populated (thresholds)
You could also use a companion guide to describe this metadata
Your vendor may be able to help with this. Many of the vendors have experience with cross-walking the CDL to state DSGs.
In some cases, this will be difficult because the same code is being used but will have a different meaning. Your vendor may be able to help with this.
This will somewhat depend on how close your current DSG is to the CDL format.
The transition may also depend on how many national vs. local payers are in your market. Between the multiple states that have adopted the CDL, most National submitters may be able to transition quicker than local or smaller submitters.
Some states have made changes to their DSG to align with the CDL more closely. Adopting code sets that are used in the CDL is one example.
Work with your vendor to determine how best to make changes to the DSG.
Many existing Medicaid programs have their own submission guides that usually start with the State's commercial standard and then add additional Medicaid specific data elements of interest to the State.
What if there are additional data elements from the Medicaid program that are not included in the CDL
- Bring them to the CDL DM committee for consideration to be added using the DMR form.
- Create a supplemental data file for the additional Medicaid data elements.
- Work with your data vendor. Many vendors able to receive Medicaid data in a different format that what is required for the commercial submitters.
No, not today.