CMS (Centers for Medicare and Medicaid Services) eAPD - Modernizing the APD experience

Eligibility Made Easy (Emmy) using Consent-Based Verification (CBV) is a prototype that allows benefit applicants to verify their income directly using payroll providers. It is currently being piloted for testing and validation purposes.

These are the official datasets used on the Medicare.gov Hospital Compare Website provided by the Centers for Medicare & Medicaid Services. These data allow you to compare the quality of care at over 4,000 Medicare-certified hospitals across the country.

The Poplin project seeks to develop a cohesive, free, open-source set of application programming interfaces (APIs) for states to use in developing a modern, modular Medicaid IT system.

Python toolkit for Medicaid claims data analysis — preprocessing, cleaning, risk adjustment (Elixhauser, CDPS-Rx), quality measures (PQI, BETOS, low-value care), and patient-level analytic file construction for MAX and TAF CMS data. Built on Dask for scalable processing of large-scale healthcare claims datasets.

Software Development Kit (SDK) to interact with the data.gov Medicaid API

HIPAA compliant SaaS platform for Claims Processing, CMS 057-F CMS Regulatory FHIR APIs, EDI integration platform for healthcare payers. Process X12 transactions (270/275/277/278/837), FHIR R4 APIs, and CMS-0057-F compliance. Deploy on Azure, AWS (EKS), GCP (GKE), Digital Ocean (DOKS), Kubernetes.

Editrix is a gem for parsing Healthcare Eligibility Response (271) ASC X12 EDI data into a painless and manageable hash structure.

Shiny App to visualize the relationship between state Medicaid policy & Google searches for opiate addiction treatment medication, Suboxone, in 2015

A regression analysis of the various types of health insurance offerings and its impact on the U.S. healthcare system. All regressions are routed to control for heteroskedasticity and empirical models in this study are adjusted for R2 with equally distributed residuals.

Criteria to determine the cost category for health care encounters using New York State Dept of Health methodology

.ipynb containing data cleaning, transformation, visualization, and analysis of Medicaid Unwinding data exploring possible health coverage gaps

Web scraper to check a list of provider NPIs to see if they're enrolled in New York Medicaid's Enrolled Practitioner (OPRA) list

Collaborative hub for sharing and shaping AI best practices in Medicaid through the Safe AI in Medicaid Alliance (SAMA).

A map showing where Medicare beneficiaries are also eligible for Medicaid.

Medicare Provider and Utilization Payment | CMS

Map of Medicaid spending by county & HCPCS code

Parse a XML file of ICD10 codes

Code and Data respository of 'Prescriptions and Reimbursement of Glucagon Products for Severe Hypoglycemia in Medicaid'

Drug Pricing Lookup