PRV.007.101

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TMSIS Dataguide

Medicaid.gov

Version 3.27.0

STATE-PLAN-ENROLLMENT

Data Element

DE Number

PRV101

System DE Number

PRV.007.101

File Name

File Segment Number

File Segment Name

PROV-MEDICAID-ENROLLMENT

Last updated

No Updates

Overview Valid Values Related Rules Related DQ Measures Other Instances

Definition	The state plan with which a provider has an affiliation and is able to provide services to the state's fee for service enrollees.
Size	X(1)
FLF Start Position	70
FLF Stop Position	70
Segment Key Field Identifier	Not Applicable
Coding Requirements	1. Value must be in State Plan Enrollment List (VVL) 2. Value must be 1 character 3. 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-2957	If the state plan enrollment is populated on a provider medicaid enrollment file, then the state plan enrollment reported must be found in the list of valid values.
RULE-6634	If a segment is a provider Medicaid enrollment segment from a PRV file, the state plan enrollment value reported must be compatible with the specified T-MSIS picture format: X(1).
RULE-7350	If the business key fields match on more than one provider medicaid enrollment segment in a PRV file, then the segment effective and end date values reported must not overlap.

Measure ID	Measure Name
MIS-11-046-46	% distinct SUBMITTING-STATE-PROV-IDs with only missing values in any active segment: STATE-PLAN-ENROLLMENT (PRV00007)
PRV-3-001-3	% of Submitting State Provider IDs with STATE-PLAN-ENROLLMENT = 1 (Medicaid)
PRV-3-002-4	% of Submitting State Provider IDs with STATE-PLAN-ENROLLMENT = 2 (CHIP)
PRV-3-003-5	% of Submitting State Provider IDs with STATE-PLAN-ENROLLMENT = 3 (both Medicaid and CHIP)
PRV-3-004-6	% of Submitting State Provider IDs with STATE-PLAN-ENROLLMENT = 4 (not state plan affiliated)

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

Published Date	Data Guide Version	Data Element	Action	Field	Before	After