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TMSIS Dataguide Medicaid.gov
Version 3.27.0

EL-3-001_2-14

Data Quality Measure
Last updated

Key Information

Measure Name % of MSIS IDs with more than one primary segment (PRIMARY-ELIGIBILITY-GROUP-IND = 1)
File Type ELG
Measure ID EL-3-001_2-14
Measure Type Duplicate percentage
Content area ELG

Validation

Validation Type Inferential

Measure Priority

Measure Priority N/A
Focus Area N/A
Category N/A

Claim Information

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

Thresholds

Minimum 0
Maximum 0.001
TA Minimun
TA Maximum
Longitudinal Threshold N/A
For TA
(for including in compliance training)
No
For TA
(Longitudinal)
No

Data Elements

DD Data Element MSIS-IDENTIFICATION-NUM
DD Data Element Number ELG082

Annotation Calculate the percentage of unique MSIS IDs that are associated with more than one primary eligibility group record of all unique MSIS IDs
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: Eligibility determinants on the last day of DQ report month

Using the MSIS IDs that meet the criteria from STEP 1, join to segment ELIGIBILITY-DETERMINANTS-ELG00005 by keeping records that satisfy the following criteria:

1. PRIMARY-ELIGIBILITY-GROUP-IND = 1

2a. ELIGIBILITY-DETERMINANT-EFF-DATE <= last day of the DQ report month

3a. ELIGIBILITY-DETERMINANT-END-DATE >= last day of the DQ report month OR missing

OR

2b. ELIGIBILITY-DETERMINANT-EFF-DATE is missing

3b. ELIGIBILITY-DETERMINANT-END-DATE is missing



STEP 3: Count duplicate MSIS IDs

Of the MSIS IDs that meet the criteria from STEP 2, count the number of unique MSIS IDs that appear more than once



STEP 4: Percentage

Divide the count of unique MSIS IDs from STEP 3 by the count in STEP 1