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TMSIS Dataguide Medicaid.gov
Version 3.27.0

EL-3-002_4-32

Data Quality Measure
Last updated

No Updates

Key Information

Measure Name % of MSIS IDs with CHIP-CODE = 3 (S-CHIP) that have ENROLLMENT-TYPE = 1 (Medicaid or M-CHIP)
File Type ELG
Measure ID EL-3-002_4-32
Measure Type Non-Claims 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 0.01
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 • CHIP-CODE • ENROLLMENT-TYPE
DD Data Element Number ELG033 • ELG054 • ELG252

Annotation Calculate the percentage of S-CHIP eligibles defined by CHIP-CODE that are designated as Medicaid according to ENROLLMENT-TYPE
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: Variable demographics on the last day of DQ report month

Using the MSIS IDs that meet the criteria from STEP 1, join to segment VARIABLE-DEMOGRAPHIC-ELG00003 by keeping records that satisfy the following criteria:

1a. VARIABLE-DEMOGRAPHIC-ELEMENT-EFF-DATE <= last day of the DQ report month

2a. VARIABLE-DEMOGRAPHIC-ELEMENT-END-DATE >= last day of the DQ report month OR missing

OR

1b. VARIABLE-DEMOGRAPHIC-ELEMENT-EFF-DATE is missing

2b. VARIABLE-DEMOGRAPHIC-ELEMENT-END-DATE is missing



STEP 3: S-CHIP

Of the MSIS IDs that meet the criteria from STEP 2, further refine the population by keeping records that satisfy the following criteria:

1. CHIP-CODE = "3"



STEP 4: Medicaid enrollment type

Of the records that meet the criteria rom STEP 3, further refine the population by keeping records that satisfy the following criteria:

1. ENROLLMENT-TYPE = "1"



STEP 5: Percentage

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