ELG.003.054

CHIP-CODE

Data Element

DE Number

ELG054

System DE Number

ELG.003.054

File Name

ELG - ELIGIBLE

File Segment Number

ELG00003

File Segment Name

VARIABLE-DEMOGRAPHICS-ELIGIBILITY

Last updated

Overview Valid Values Related Rules Related DQ Measures Other Instances

Definition	A code used to distinguish among Medicaid, Medicaid Expansion CHIP, and Separate CHIP populations.
Size	X(1)
FLF Start Position	150
FLF Stop Position	150
Segment Key Field Identifier	Not Applicable
Coding Requirements	1. Value must be in CHIP Code List (VVL) 2. If value is in [ 2, 3 ], then associated Eligibility Group (ELG.005.087) value must be in [ "07", "31", "61", 62", "63", "64", "65", "66", "67", or "68" ] 3. If value is "1", then associated Eligibility Group (ELG.005.087) value must not be in [ "61", 62", "63", "64", "65", "66", "67", or "68" ] 4. Value must be 1 character 5. 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-2067	If CHIP code is populated on a variable demographics eligibility segment from an ELG file, then the CHIP code value reported must be in the list of valid values for CHIP code.
RULE-2068	If conception-to-birth indicator is for conception-to-birth coverage on an eligibility determinants segment from an ELG file, then the CHIP code reported on the corresponding variable demographics eligibility segment must be for S-CHIP.
RULE-6667	If a segment is a variable demographics eligibility segment from an ELG file, the CHIP code value reported must be compatible with the specified T-MSIS picture format: X(1).
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-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-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-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-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-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.

Measure ID	Measure Name
EL-5-003-2	# of MSIS IDs in S-CHIP (CHIP-CODE = 3)
EL-6-004-4	S-CHIP Churn: % of eligibles enrolled in a month that were also enrolled 12 months prior (continuous enrollment over 12 months)
EL-6-003-3	Medicaid Churn: % of eligibles enrolled in a month that were also enrolled 12 months prior (continuous enrollment over 12 months)
EL-6-002-2	S-CHIP Churn: % of eligibles enrolled in a month that were also enrolled six months prior (continuous enrollment over 6 months)
EL-6-001-1	Medicaid Churn: % of eligibles enrolled in a month that were also enrolled six months prior (continuous enrollment over 6 months)
EL-3-012-17	% of M-CHIP and S-CHIP eligibles with a non-CHIP eligibility group
RULE-7192	% of record segments with ENROLLMENT-TYPE=2 that do not have a CHIP-CODE=3
RULE-7191	% of record segments with ENROLLMENT-TYPE=1 that do not have a CHIP-CODE=1 or 2
MIS-1-007-7	% distinct MSIS IDs with only missing values in any active segment: CHIP-CODE (ELG00003)
EL-S-003-3	Total # of MSIS IDs in CHIP (CHIP-CODE = 2 + CHIP-CODE = 3)
EL-6-030-30	% of MSIS IDs with S-CHIP dental coverage (RESTRICTED-BENEFITS-CODE = C) that are not S-CHIP (CHIP-CODE not 3)
EL-10-005-6	% of MSIS IDs in CHIP enrolled in comprehensive managed care (MANAGED-CARE-PLAN-TYPE = 01)
EL-5-002-1	# of MSIS IDs in M-CHIP (CHIP-CODE = 2)
EL-5-001-3	Index of dissimilarity - CHIP by age group for M-CHIP and S-CHIP (CHIP-CODE = 2, 3)
EL-4-001-1	Enrollment Type values where CHIP-CODE = 2 (M-CHIP)
EL-3-021-26	% of MSIS IDs in S-CHIP reported without an S-CHIP Eligibility Group
EL-3-020-25	% of MSIS IDs in M-CHIP reported without an M-CHIP Eligibility Group
EL-3-013-18	% of Medicaid MSIS IDs with a CHIP Eligibility Group
EL-3-002_4-32	% of MSIS IDs with CHIP-CODE = 3 (S-CHIP) that have ENROLLMENT-TYPE = 1 (Medicaid or M-CHIP)
EL-3-002_3-16	% of MSIS IDs with CHIP-CODE = 2 (M-CHIP) that have ENROLLMENT-TYPE = 2 (Separate Title XXI CHIP)
EL-3-002_2-31	% of MSIS IDs with CHIP-CODE = 1 (Medicaid) that have ENROLLMENT-TYPE = 2 (Separate Title XXI CHIP)
EL-15-002-2	% difference between T-MSIS CHIP count (EL-S-003-3) and PI CHIP count (M-CHIP + S-CHIP)

DE Number	System DE Number	DE Name	File Segment Number	File Segment Name