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Measure Name | % difference between total T-MSIS duals count and total MMA duals count |
---|---|
File Type | ELG |
Measure ID | EL-15-003-3 |
Measure Type | Non-claims percentage |
Content area | ELG |
Validation Type | Inferential |
---|
Measure Priority | High |
---|---|
Focus Area | N/A |
Category | Beneficiary eligibility |
Claim Type | N/A |
---|---|
Adjustment Type | N/A |
Crossover Type | N/A |
Minimum | -0.05 |
---|---|
Maximum | 0.05 |
TA Minimun | -0.05 |
TA Maximum | 0.05 |
Longitudinal Threshold | N/A |
For TA
(for including in compliance training) |
TA- Inferential |
For TA
(Longitudinal) |
No |
DD Data Element | MSIS-IDENTIFICATION-NUM • DUAL-ELIGIBLE-CODE |
---|---|
DD Data Element Number | ELG082 • ELG085 |
Annotation | Calculate the percent difference between the total T-MSIS duals count and the total MMA duals count |
---|---|
Specification |
STEP 1: MMA total duals count Retrieve the total dual count from the MMA data. This is an external source. More information is available at: https://www.cms.gov/Medicare-Medicaid-Coordination/Medicare-and-Medicaid-Coordination/Medicare-Medicaid-Coordination-Office/DataStatisticalResources/StateMMAFile Note: The MMA total duals count is not always available for the T-MSIS DQ analysis month at the time of the measure calculation. In such cases, the DQ team will wait until the MMA data are ready to do the calculation, so that the MMA count and T-MSIS count are for the same month. STEP 2: Total dual-eligible beneficiary count Sum the measure statistics from the individual dual code measures: total count of dual-elibible beneficiaries = EL-6-012-12 + EL-6-013-13 + EL-6-014-14 + EL-6-015-15 + EL-6-016-16 + EL-6-017-17 + EL-6-018-18 + EL-6-019-19 STEP 3: Difference Subtract the count from STEP 1 from the count of dual eligible beneficiaries from STEP 2 STEP 4: Percentage Divide the difference from STEP 3 by the count in STEP 1 |