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TMSIS Dataguide Medicaid.gov
Version 3.27.0

EL-6-018-18

Data Quality Measure
Last updated

No Updates

Key Information

Measure Name # of Other duals (DUAL-ELIGIBLE-CODE = 08)
File Type ELG
Measure ID EL-6-018-18
Measure Type Count
Content area ELG

Validation

Validation Type Longitudinal

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 N/A
Maximum N/A
TA Minimun
TA Maximum
Longitudinal Threshold 0.05
For TA
(for including in compliance training)
No
For TA
(Longitudinal)
No

Data Elements

DD Data Element MSIS-IDENTIFICATION-NUM • DUAL-ELIGIBLE-CODE
DD Data Element Number ELG082ELG085

Annotation Count the number of 'Other Duals'
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 of number of 'Other Duals'

Of the MSIS IDs which meet the criteria from STEP 2, count the number with

1. DUAL-ELIGIBLE-CODE = '08'