PAY2_N (where _N indicates nonuniform) preserves much of the original expected secondary payer detail from the various data sources. However, some categories of PAY2_N are not available from some sources because not all sources have the same level of detail available. The data element PAY2_N was discontinued in 1998.

The HCUP data element PAY2_X retains the expected secondary payer as provided by the data source.

In the 1988-1997 HCUP databases, the secondary pay source (PAY2_N) was set to inconsistent (.C) if the primary pay source and the secondary pay source are the same and the source is one of the following:

• Medicare (ED951),
• Medicaid (ED951),
• CHAMPUS (ED952),
• Worker's Compensation (ED952), and
• Title V (ED952).

No edit checks were performed on the payer data elements beginning in the 1998 databases.

The HCUP category "Medicare" (PAY2_N = 1) includes the source code "Medicare HMO."

The HCUP category "Medicaid" (PAY2_N = 2) includes the source codes "Medicaid State Only (MSO)" and "Medicaid HMO."

In addition to the usual categories coded under the HCUP category "Other" (PAY2_N = 12), a pay source of "Donor" is included.

Maryland did not separately classify "CHAMPUS/CHAMPVA" (PAY2_N = 10). The source documentation available for Maryland did not indicate which payer type(s) were used for "CHAMPUS/CHAMPVA."

For all years:

• Massachusetts does not separately classify Title V (PAY2_N = 8) or CHAMPUS/CHAMPVA (PAY2_N = 10). The source documentation available for Massachusetts did not indicate which payer type(s) were used for Title V or CHAMPUS/CHAMPVA.
• The source payer codes for "Other or principal source covered payment in full" were included in the HCUP category "Other" (PAY2_N = 12).

Beginning in 1993, quarter 4, Massachusetts reports separate managed care categories:

Beginning in 1996, "PPO and Other Managed Care not listed elsewhere" was recoded into the uniform category "Commercial, PPO" (PAY2_N = 4). From 1993 to 1995, "PPO and Other Managed Care not listed elsewhere" was recoded into the uniform category "Other" (PAY2_N = 12).

Beginning in the 4th quarter of 1997, the source code "Point of Service" was included in the HCUP uniform category "Alternative Delivery Systems" (PAY2_N = 5).

Unusual pay sources were recoded as follows:

The source pay category "Indigent" was incorrectly mapped to "Other" (PAY2_N = 11) during HCUP processing of 1988 1992 data.

New York does not separately classify Title V (PAY2_N = 8). The source documentation available for New York does not indicate which payer type(s) were used for Title V.

The source categories "No Fault," "Self Insured," and "Self Administered Plan" are included in the HCUP category "Commercial, PPO" (PAY2_N = 4).

Prior to 1996, the source category "Corrections (State, County or City)" is included in the HCUP category "Other Government" (PAY2_N = 11). Beginning in 1996, New York separately reported pay categories for "Corrections - Federal", "Corrections - State", and "Corrections - Local." All of these source values were recoded to the HCUP uniform category "Other Government" (PAY2_N = 11).

Beginning in 1993:

• The source separately classifies "Medicare HMO." This is assigned to the HCUP category "Medicare" (PAY2_N = 1).
• The source separately classifies "Medicaid HMO." This is assigned to the HCUP category "Medicaid" (PAY2_N = 2).

Prior to 1995, Oregon did not separately classify the HCUP categories:

• "Alternative Delivery System" (PAY2_N = 5),
• "No Charge" (PAY2_N = 7),
• "TITLE V" (PAY2_N = 8), or
• "CHAMPUS, CHAMPVA" (PAY2_N = 10).

The source documentation supplied by Oregon did not indicate which source categories are used for these payers. Starting in 1995, these payers are reported as separate categories.

In 1995, two source categories for payer were added:

• the source category "Self insured" is included in the HCUP category "Commercial insurance" (PAY2_N = 4), and
• The source category "Managed Assistance" is included in the HCUP category "Other Government" (PAY2_N = 11).

Utah does not separately classify:

• No Charge (PAY2_N = 7),
• Title V (PAY2_N = 8), or
• CHAMPUS, CHAMPVA (PAY2_N = 10).

The source documentation indicates that No Charge is included in Other (PAY2_N = 12). No documentation was available about which payer type(s) were used for Title V or CHAMPUS.

Washington does not separately classify CHAMPUS and CHAMPVA payers (PAY2_N = 10). According to the documentation available from the state, CHAMPUS and CHAMPVA are categorized as "other sponsored patients," which are included in the HCUP category "Other" (PAY2_N = 12).

Washington does not separately classify Blue Cross payers (PAY2_N= 3). The source category "Health Care Service Contractors" includes a mix of Blue Cross, County Medical Bureaus, Washington Physicians Service, and other commercial payers. This source value was recoded into the non-uniform category "Other" (PAY2_N = 12).

Wisconsin does not separately classify:

• No Charge (PAY2_N = 7), or
• Title V (PAY2_N = 8).

No documentation was available about which payer type(s) were used for Title V and No charge.