RULE-2069
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If a segment is a variable demographics eligibility segment from an ELG file, then the variable demographic element effective date value reported must be a valid date of the form CCYYMMDD.
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RULE-2075
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If variable demographic element effective date and variable demographic element end date are populated on a variable demographics eligibility segment from an ELG file, then the variable demographic element effective date value reported must be before or equal to the variable demographic element end date value reported.
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RULE-7191
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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.
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RULE-7192
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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.
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RULE-7409
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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'
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RULE-7410
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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'
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RULE-7422
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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'
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RULE-7428
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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.
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RULE-7529
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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.
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RULE-7539
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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.
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RULE-7641
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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.
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RULE-7677
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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.
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