March 15 and 16, 2006
Alabama, Arizona, California, Idaho, Illinois, Iowa, Kentucky, Massachusetts, Michigan, Minnesota, Missouri, Montana, Nebraska, New Hampshire, New York, North Carolina, Nebraska, New Hampshire, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, South Dakota, Tennessee, Utah, Washington, West Virginia, Wisconsin, and Wyoming.
Two conference calls were held to discuss the DEERS/FCR Quarterly Match: March 15th at 2:00 pm ET and March 16th at 11:00 am ET.
Purpose of the Call
The purpose of the calls was to share with the states what we have learned since the initial match, provide a clarification on the use of matching data for performance measurement purposes, review what has changed in the record specifications, notify states of the availability of a new print program, and discuss future matches. In addition, the calls were to gather feedback from the states about their experiences with the match. The first DEERS/FCR Proactive Match responses were sent to states on December 6, 2005.
Objectives of the DEERS/FCR Match (aka DMDC/FCR Match)
The objectives of the DEERS/FCR match are to:
- Provide states with matches on:
- Children currently enrolled in DEERS
- Children eligible for enrollment in DEERS
- Children terminated from previous coverage in DEERS; and
- Eliminate the need for the National Medical Support Notice (NMSN) to be sent to the Defense Manpower Data Center (DMDC).
DEERS Matched Results Can Be Counted on the OCSE-157
When states verify through this match that a child is enrolled in TRICARE, states can count the child on line 21a ("medical support ordered and provided") of the OCSE-157 provided that there is a provision for health care in the child support order. The person providing the medical coverage does not need to be the person ordered to provide the medical coverage.
If there is not a provision for health care in the order, states will need to obtain an order for health care before they can count the children on line 21a.
Overview of the DEERS/FCR Match
The match process was reviewed, including how cases are selected from the FCR, how DMDC performs the match, and what checks are made at the FCR before responses are sent to states. In particular, we stressed what we have learned about how DMDC performs the match.
First, we have learned that DMDC is checking whether the adult case participants are in the military. This differs from what we had thought. We previously documented that DMDC was checking whether each of the adult case participants had medical coverage.
To match on adults DMDC uses a "point in time" extract from the DEERS database that is updated monthly. This extract contains military personnel who are active duty, retirees, or "special" civilians who are classified as such because of overseas assignments or other special circumstances. If the adult case participant is in the military, the dependent children are eligible for health care coverage with that person as the sponsor.
Second, DMDC uses a different extract from the DEERS database to check on children. This extract is updated more regularly to reflect the current medical coverage status of children. Dates of coverage are attached to the child’s record, which indicate whether a child is currently enrolled or has been terminated from coverage in DEERS. The person who is, or was, sponsoring the child is identified.
Because the two extracts used for the match are updated on different schedules, it is possible that the sponsor on the child’s record points to an adult whom DMDC did not identify as being in the military. This type of disconnect should occur only as an exception, and the next quarter’s DEERS match will resolve such disconnects.
Changes in the Record Specifications
Corrections have been made to the record specifications for the FCR DMDC/PROACTIVE MATCH RESPONSE RECORD. The revised record specifications will be posted to the OCSE website and distributed to states through an FCR EFlash.
DMDC Print Program
States may request software to print the results of the DEERS match, if the state is not ready to automate the process at present. This software allows the states to print the matched results in three reports: children currently enrolled, children eligible for enrollment, and children terminated from previous coverage.
States that have processed all of the responses from the prior quarter’s DEERS match may request a fourth print program from OCSE that highlights only the data that has changed. It is critical that states have processed all of the responses from the prior DEERS match before requesting "Report 4" software. If not, the state will lose track of responses not yet updated into the state system. It is also critical that the state maintains the responses from the prior match. The software for "Report 4" requires both the current match responses and the prior match responses to make data comparisons and identify changes.
Possible Changes to the DEERS Match
States were asked for their input on three possible changes that are being discussed for future matches after the upcoming match in April. There is no guarantee that all or any of these changes will be implemented since DMDC costs and confidentiality concerns may preclude implementation, as well as whether the states decide the changes are not desirable from their perspective. None of these changes will be implemented before the April 2006 match.
First, a generic "Other" sponsor was identified when the NCP, CP or PF was not the child’s sponsor in DEERS. This generic "Other" was used due to DMDC confidentiality rules. During discussions with DMDC, it was determined that a "Relationship" value exists on the child’s record. DMDC has been asked if they could supply the value, if not the name of the "Other" sponsor. DMDC is investigating whether their confidentiality rules would be violated by release of a "Relationship" value as well as associated costs. If DMDC can provide this information, a code could be added to the sponsor field so the record layout would not change.
Second, DMDC is examining whether they could identify adult case participants who are covered in DEERS similar to how children are matched. Currently, the match only identifies whether an adult case participant is in the military. The match does not identify other adults who may be covered by someone else. For example, the CP may be the wife of a military member. Under certain conditions, the step-parent may provide Tricare coverage for the child. DMDC is examining the costs associated with making these matches.
Note: one point to consider is that the current match process allows for the identification of children who are eligible for coverage because the military member has been identified and dependent coverage is regarded as an entitlement. Including adults covered by others would mean that children may or may not be eligible for coverage. Additional information and follow-up with the parents would be required.
Third, a change could be implemented by the FCR to resolve the ambiguity in what spaces mean in the fields for an adult case participant. Currently, spaces on an adult record can mean two different things: either the adult participant was deleted by the state after the match was made by DMDC, or the adult case participant was never registered on the FCR by the state. An indicator could be added to distinguish whether the person was deleted from the case or was never a registered participant on the FCR. This would entail a change to the record specifications.
What States Should Focus On
States were encouraged to focus on the matches that indicate whether children are already enrolled in DEERS and children eligible for enrollment. States were also advised that state systems should be updated with termination dates for children no longer enrolled in DEERS.
Given that medical support can be counted when it is "ordered and provided" on the OCSE-157 (without regard to whether medical support is provided by the person so ordered), the identity of the sponsor is not as important. States should not contact DMDC about "other" sponsors since they are bound by confidentiality restrictions to not release this data. PIQ 06-02 states that "IV-D agencies should not send the NMSN to DMDC for dependents of active duty and retired military personnel."