ELG.012.174

WAIVER-ENROLLMENT-EFF-DATE

Data Element

DE Number

ELG174

System DE Number

ELG.012.174

File Name

ELG - ELIGIBLE

File Segment Number

ELG00012

File Segment Name

WAIVER-PARTICIPATION

Last updated

09/12/2024

Overview Valid Values Related Rules Related DQ Measures Other Instances

Definition	The first calendar day on which all of the other data elements in the same segment were effective.
Size	9(8)
FLF Start Position	64
FLF Stop Position	71
Segment Key Field Identifier	(a)
Coding Requirements	1. Value must be 8 characters in the form "CCYYMMDD" 2. The date must be a valid calendar date (i.e. Feb 29th only on the leap year, never April 31st or Sept 31st) 3. Value must be before or the same as the associated Segment End Date value 4. Mandatory 5. Value of the CC component must be in [18,19,20]

Valid Value Code Set	Valid Value Code	Valid Value Name	Valid Value Description	Effective Start Date	Effective End Date
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RULE ID	RULE Definition
RULE-2335	If a segment is a waiver participation segment from an ELG file, then the waiver enrollment effective date value reported must be a valid date of the form CCYYMMDD.
RULE-2337	If waiver enrollment effective date and waiver enrollment end date are populated on a waiver participation segment from an ELG file, then the waiver enrollment effective date value reported must be before or equal to the waiver enrollment end date value reported.
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-7770	If a claim is a non-denied claim from an IP file, and the waiver type is populated, and the claim admission date is between the waiver enrollment effective and end dates, then the claim waiver type is equal to the waiver participation waiver type.
RULE-7771	If a claim is a non-denied claim from an LT file, and the waiver type is populated, and the claim beginning date of service is between the waiver enrollment effective and end dates, then the claim waiver type is equal to the waiver participation waiver type.
RULE-7772	If a claim is a non-denied claim from an OT file, and the waiver type is populated, and the claim beginning date of service is between the waiver enrollment effective and end dates, then the claim waiver type is equal to the waiver participation waiver type.
RULE-7773	If a claim is a non-denied claim from an RX file, and the waiver type is populated, and the claim prescription fill date is between the waiver enrollment effective and end dates, then the claim waiver type is equal to the waiver participation waiver type.

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Measure ID	Measure Name
EL-14-011-11	Ratio of errors for overlapping segment eff/end dates [RULE-2338] to all active WAIVER-PARTICIPATION (ELG00012) segments across all reporting and coverage periods
MIS-1-062-62	% distinct MSIS IDs with only missing values in any active segment: WAIVER-ENROLLMENT-EFF-DATE (ELG00012)
RULE-2338	Ratio of errors for overlapping segment eff/end dates [RULE-2338] to all active WAIVER-PARTICIPATION (ELG00012) segments

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DE Number	System DE Number	DE Name	File Segment Number	File Segment Name
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Published Date	Data Guide Version	Data Element	Action	Field	Before	After
09/12/2024	3.29.0	ELG.012.174	UPDATE	Coding requirement	1. Value must be 8 characters in the form "CCYYMMDD"2. The date must be a valid calendar date (i.e. Feb 29th only on the leap year, never April 31st or Sept 31st)3. Value must be before or the same as the associated Segment End Date value4. Mandatory5. Value of the CC component must be in ['18', '19', '20']	1. Value must be 8 characters in the form "CCYYMMDD"2. The date must be a valid calendar date (i.e. Feb 29th only on the leap year, never April 31st or Sept 31st)3. Value must be before or the same as the associated Segment End Date value4. Mandatory5. Value of the CC component must be in [18,19,20]
09/21/2023	3.13.0	ELG.012.174	UPDATE	Segment key field identifier	Not Applicable	(a)