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Measure Name | % difference between T-MSIS Other - specific CMS approval duals and MMA Other - specific CMS approval duals (Dual Code=09) |
---|---|
File Type | ELG |
Measure ID | EL-15-011-11 |
Measure Type | Non-claims percentage |
Content area | ELG |
Validation Type | Inferential |
---|
Measure Priority | Medium |
---|---|
Focus Area | N/A |
Category | Beneficiary eligibility |
Claim Type | N/A |
---|---|
Adjustment Type | N/A |
Crossover Type | N/A |
Minimum | -0.1 |
---|---|
Maximum | 0.1 |
TA Minimun | -0.1 |
TA Maximum | 0.1 |
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 T-MSIS Pharm Plus or specials duals count and the MMA Pharm Plus or specials duals count |
---|---|
Specification |
STEP 1: MMA Pharm Plus or special duals count Retrieve the Pharm Plus or special duals 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 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: Pharm Plus or special duals count Use the measure statistic from 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 |