MCR.002.028

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TMSIS Dataguide

Medicaid.gov

Version 3.27.0

PERCENT-BUSINESS

Data Element

DE Number

MCR028

System DE Number

MCR.002.028

File Name

MCR - MANAGED CARE PLAN INFORMATION

File Segment Number

File Segment Name

MANAGED-CARE-MAIN

Last updated

No Updates

Overview Valid Values Related Rules Related DQ Measures Other Instances

Definition	The percentage of the managed care entity's total revenue that is derived from contracts with Medicare (Part C and D) in the state and State Medicaid agency contract(s) prior calendar year. Include Medicaid and Medicare in calculation of percentage of business in public programs for IRS health insurer tax exemption as required in ACA.
Size	9(3)
FLF Start Position	113
FLF Stop Position	115
Segment Key Field Identifier	Not Applicable
Coding Requirements	1. Value must be between 0 and 100 inclusively 2. 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-2572	If the managed care main has a value populated for percent-business, then the percent-business is greater than or equal to zero and less than or equal to 100.
RULE-2573	If a segment is a managed care main segment, then the percent business value reported must be compatible with the specified T-MSIS picture format: 9(3).

Measure ID	Measure Name

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

Published Date	Data Guide Version	Data Element	Action	Field	Before	After