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TMSIS Dataguide Medicaid.gov
Version 3.27.0

EL-1-023-23

Data Quality Measure
Last updated

No Updates

Key Information

Measure Name % of MSIS IDs in which the primary home address county code, zip code, or state is not in-state
File Type ELG
Measure ID EL-1-023-23
Measure Type Non-Claims Percentage
Content area ELG

Validation

Validation Type Inferential

Measure Priority

Measure Priority High
Focus Area N/A
Category Beneficiary demographics

Claim Information

Claim Type N/A
Adjustment Type N/A
Crossover Type N/A

Thresholds

Minimum 0
Maximum 0.01
TA Minimun 0
TA Maximum 0.01
Longitudinal Threshold N/A
For TA
(for including in compliance training) 		TA- Inferential
For TA
(Longitudinal) 		No

Data Elements

DD Data Element MSIS-IDENTIFICATION-NUM • ADDR-TYPE • ELIGIBLE-STATE • SUBMITTING-STATE • ELIGIBLE-COUNTY-CODE • ELIGIBLE-ZIP-CODE
DD Data Element Number ELG064 • ELG065 • ELG070 • ELG062 • ELG072 • ELG071

Annotation Calculate the percentage of eligibles where the primary address county code, zip code, or state is not in-state
Specification STEP 1: Enrolled on the last day of DQ report month

Define the eligible population from segment ENROLLMENT-TIME-SPAN-ELG00021 by keeping active records that satisfy the following criteria:

1. ENROLLMENT-EFF-DATE <= last day of the DQ report month

2. ENROLLMENT-END-DATE >= last day of the DQ report month OR missing

3. MSIS-IDENTIFICATION-NUM is not missing



STEP 2: Eligible contact on the last day of the DQ report month

Using the MSIS IDs that meet the criteria from STEP 1, join to segment ELIGIBLE-CONTACT-INFORMATION-ELG00004 by keeping records that satisfy the following criteria:

1a. ELIGIBLE-ADDR-EFF-DATE<= last day of the DQ report month

2a. ELIGIBLE-ADDR-END-DATE >= last day of the DQ report month OR missing

OR

1b. ELIGIBLE-ADDR-EFF-DATE is missing

2b. ELIGIBLE-ADDR-END-DATE is missing



STEP 3: Primary home address

Of the records that meet the criteria from STEP 2, restrict to segments where:

1. ELIGIBLE-ADDR-TYPE = "01"



STEP 4: Eligible county code, zip code, or state is not in-state

Of the segments that meet the criteria from STEP 3, further refine the population by keeping segments where:

1 ELIGIBLE-STATE does not equal SUBMITTING-STATE

OR

2.ELIGIBLE-COUNTY-CODE is not in-state

OR

3. ELIGIBLE-ZIP-CODE is not in-state



STEP 5: Calculate percentage

Divide the count of unique MSIS IDs from STEP 4 by the count of unique MSIS IDs from STEP 3