ELG.001.010

END-OF-TIME-PERIOD

Data Element

DE Number

ELG010

System DE Number

ELG.001.010

File Name

ELG - ELIGIBLE

File Segment Number

ELG00001

File Segment Name

FILE-HEADER-RECORD-ELIGIBILITY

Last updated

Overview Valid Values Related Rules Related DQ Measures Other Instances

Definition	This value must be the last day of the reporting month, regardless of the actual date span.
Size	9(8)
FLF Start Position	58
FLF Stop Position	65
Segment Key Field Identifier	Not Applicable
Coding Requirements	1. Value must be 8 characters in the form "CCYYMMDD" 2. Value of the CC component must be "20" 3. The date must be a valid calendar date (i.e. Feb 29th only on the leap year, never April 31st or Sept 31st) 4. Value must be equal to or earlier than associated Date File Created 5. Value must be equal to or after associated Start of Time Period 6. Mandatory

Valid Value Code Set	Valid Value Code	Valid Value Name	Valid Value Description	Effective Start Date	Effective End Date

RULE ID	RULE Definition
RULE-7422	If a segment is a variable demographics eligibility segment from an ELG file, and the chip code is for Medicaid, then the max(variable demographics eligibility effective date, 2015-01-01) is greater than or equal to eligibility determinants effective date and the variable demographics eligibility end date is less than or equal to eligibility determinants end date and the eligibility determinants end date is greater than or equal to '2015-01-01' and the primary eligibility group indicator is equal to '1' and the eligibility group is not equal to '61', '62', '63', '64', '65', '66', '67' or '68'
RULE-7810	If restricted benefits code is for Money Follows the Person (MFP) on an eligibility determinants segment from an ELG file, and the primary eligibility group indicator is equal to '1', then the effective date and end date on the eligibility determinants segment must fall within the effective and end dates of one or more continuous mfp information segments.
RULE-7709	If the MSIS ID is populated on a managed care participation ELG file segment and the managed care participation managed care plan enrollment end date is greater than or equal to the states tmsis cutover date then the effective and end dates on the managed care participation segment must fall with the effective and end dates of one or more continuous enrollment time span segments.
RULE-7677	If a segment is a variable demographic eligibility segment from an ELG file, and the medicare beneficiary identifier or the medicare hic num are populated, and the variable demographic element end date is greater than or equal to the TMSIS cutover date, and the primary eligibility group indicator is '1', then the dual eligible code are equal to one of the following values '01', '02', '03', '04', '05', '06', '08', '09', or '10' and the effective and end dates on the variable demographic eligibility segment fall within the effective and end dates of one or more continuous eligibility determinants segments.
RULE-7641	If a segment is an eligibility determinants segment from an ELG file, and the dual eligible code is '01', '02', '03', '04', '05', '06', '08', '09', or '10', and the eligibility determinants end date is greater than or equal to the TMSIS cutover date, and the primary eligibility group indicator is '1', then the MBI or the Medicare Hic number are populated and the effective and end dates on the eligibility determinants segment fall within the effective and end dates of one or more continuous variable demographic segments.
RULE-7540	If MSIS ID is populated on an enrollment time span segment from an ELG file, then the effective date and end date on the enrollment time span segment must fall within the effective and end dates of one or more continuous eligibility determinants segments and the MSIS ID is populated in the eligibility determinants segment.
RULE-7539	If MSIS ID is populated on an enrollment time span segment from an ELG file, then the effective date and end date on the enrollment time span segment must fall within the effective and end dates of one or more continuous variable demographics eligibility segments and the MSIS ID is populated in the variable demographics eligibility segment.
RULE-7538	If MSIS ID is populated on an enrollment time span segment from an ELG file, then the effective date and end date on the enrollment time span segment must fall within the effective and end dates of one or more continuous primary demographics eligibility segments and the MSIS ID is populated in the primary demographics eligibility segment.
RULE-7529	If restricted benefits code is for restricted benefits based on alien status on an eligibility determinants segment from an ELG file, and eligibility determinants has a primary eligibility group indicator equal to '1' then the effective date and end date on the eligibility determinants segment must fall within the effective and end dates of one or more continuous variable demographics eligibility segments and the immigration status must be for a non-citizen on the variable demographics eligibility segment.
RULE-7429	If MSIS ID is populated on an mfp information segment from an ELG file, then the effective date and end date on the mfp information segment must fall within the effective and end dates of one or more continuous eligibility determinants segments and the primary eligibility group indicator is equal to '1' and the restricted benefits code must be for Medicaid Money Follows the Person (MFP) rebalancing demonstration on the eligibility determinants segment.
RULE-7428	If restricted benefits code is for S-CHIP dental on an eligibility determinants segment from an ELG file, and the eligibility determinants has a primary eligibility group indicator equal to '1', then the effective date and end date on the eligibility determinants segment must fall within the effective and end dates of one or more continuous variable demographics eligibility segments and the CHIP code must be for S-CHIP for the month on the variable demographic eligibility segment.
RULE-7427	If a segment is a waiver participation segment from an ELG file, and the waiver participation segment has a family planning demonstration waiver type and the effective and end dates on the waiver participation segment fall within the effective and end dates of one or more continuous eligibility determinants segments, and the eligibility determinants has a primary eligibility group indicator equal to '1', then the restricted benefits code is equal to '6'.
RULE-1991	If a segment is a file header record eligibility segment from an ELG file, then the end of time period value reported must be a valid date of the form CCYYMMDD.
RULE-7410	If a segment is a variable demographics eligibility segment from an ELG file, and the chip code is for S-CHIP, then the max(variable demographics eligibility effective date, 2015-01-01) is greater than or equal to eligibility determinants effective date and the variable demographics eligibility end date is less than or equal to eligibility determinants end date and the eligibility determinants end date is greater than or equal to '2015-01-01' and the primary eligibility group indicator is equal to '1' and the eligibility group is equal to '61', '62', '63', '64', '65', '66', '67' or '68'
RULE-7409	If a segment is a variable demographics eligibility segment from an ELG file, and the chip code is M-CHIP, then the max(variable demographics eligibility effective date, 2015-01-01) is greater than or equal to eligibility determinants effective date and the variable demographics eligibility end date is less than or equal to eligibility determinants end date and the eligibility determinants end date is greater than or equal to '2015-01-01' and the primary eligibility group indicator is equal to '1' and the eligibility group is equal to '07', '31', or '61'
RULE-7192	If enrollment type is for S-CHIP on an enrollment time span segment from an ELG file, then the effective date and end date on the enrollment time span segment must fall within the effective and end dates of one or more continuous variable demographics eligibility segments and the CHIP code must be for S-CHIP on the variable demographic eligibility segment.
RULE-7191	If enrollment type is for Medicaid or Medicaid expansion CHIP on an enrollment time span segment from an ELG file, then the effective date and end date on the enrollment time span segment must fall within the effective and end dates of one or more continuous variable demographics eligibility segments and the CHIP code must be for Medicaid or Medicaid expansion CHIP on the variable demographic eligibility segment.
RULE-3106	If the date of death is populated on a primary demographics eligibility segment and the primary demographics eligibility primary demographic element end date is greater than the states tmsis cutover date and the insurance coverage end date is populated on the TPL medicaid eligible person health insurance coverage information segment then the TPL medicaid eligible person health insurance coverage info insurance coverage end date is less than or equal to the primary demographics eligibilty date of death and the effective and end dates on the primary demographics eligibility segment must fall with the effective and end dates of one or more continuous TPL medicaid eligible person health insurance coverage information segments.
RULE-2384	If the managed care participation plan type is populated on a managed care participation segment and the managed care main plan type is populated on the managed care main file segment and the managed care participation managed care plan enrollment end date is greater than the states tmsis cutover date then managed care participation managed care plan type equals the managed care main managed care plan type and the effective and end dates on the managed care participation segment must fall within the effective and end dates of one or more continuous managed care main segments.
RULE-2382	If the managed care plan ID is populated on a managed care participation ELG file segment and the managed care participation managed care plan enrollment end date is greater than the states tmsis cutover date then the effective and end dates on the managed care participation segment must fall within the effective and end dates of one or more continuous managed care main segments.
RULE-2357	If the LTSS provider number is populated on a LTSS participation ELG file segment and the LTSS participation LTSS eligibility end date is greater than the states tmsis cutover date then the effective and end dates on the LTSS participation segment must fall with the effective and end dates of one or more continuous provider identifiers segments.
RULE-2258	If the lock-in provider number is populated on a lock-in information ELG file segment and the lock-in information lockin end date is greater than the states tmsis cutover date then the effective and end dates on the lock-in information segment must fall with the effective and end dates of one or more continuous provider identifiers segments.
RULE-2212	If the health home spa name is populated on a health home SPA providers ELG file segment and the health home SPA providers health home spa provider end date is greater than the states tmsis cutover date then the effective and end dates on the health home SPA providers segment must fall with the effective and end dates of one or more continuous provider identifiers segments.
RULE-2016	If conception-to-birth indicator is not for conception-to-birth coverage and the eligibility group is not for conception-to-birth coverage on an eligibility determinants segment from an ELG file, then the date of birth reported on the corresponding primary demographics segment must be before or equal to the end of time period value reported.

Measure ID	Measure Name

DE Number	System DE Number	DE Name	File Segment Number	File Segment Name
CIP010	CIP.001.010	END-OF-TIME-PERIOD	CIP00001	FILE-HEADER-RECORD-IP
CLT010	CLT.001.010	END-OF-TIME-PERIOD	CLT00001	FILE-HEADER-RECORD-LT
COT010	COT.001.010	END-OF-TIME-PERIOD	COT00001	FILE-HEADER-RECORD-OT
CRX010	CRX.001.010	END-OF-TIME-PERIOD	CRX00001	FILE-HEADER-RECORD-RX
MCR010	MCR.001.010	END-OF-TIME-PERIOD	MCR00001	FILE-HEADER-RECORD-MANAGED-CARE
PRV010	PRV.001.010	END-OF-TIME-PERIOD	PRV00001	FILE-HEADER-RECORD-PROVIDER
TPL010	TPL.001.010	END-OF-TIME-PERIOD	TPL00001	FILE-HEADER-RECORD-TPL