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TMSIS Dataguide Medicaid.gov
Version 3.28.0

EL-6-029-29

Data Quality Measure
Last updated

Key Information

Measure Name % of record segments with an invalid waiver ID format for 1915(b) and 1915(c) waivers (WAIVER-TYPE = 02 - 20, 32, or 33)
File Type ELG
Measure ID EL-6-029-29
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 WAIVER-TYPE • WAIVER-ID
DD Data Element Number ELG173 • ELG172

Annotation Calculate the percentage of rows in the ELG00012 segment with a 1915(b) or 1915(c) waiver type that have a waiver ID in an invalid format
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: Waiver participation on the last day of DQ report month

Using the MSIS IDs that meet the criteria from STEP 1, join to segment WAIVER-PARTICIPATION-ELG00012 by keeping records that satisfy the following criteria:

1a. WAIVER-ENROLLMENT-EFF-DATE <= last day of the DQ report month

2a. WAIVER-ENROLLMENT-END-DATE >= last day of the DQ report month OR missing

OR

1b. WAIVER-ENROLLMENT-EFF-DATE is missing

2b. WAIVER-ENROLLMENT-END-DATE is missing



STEP 3: 1915(b) or 1915(c) waiver type

Of the record segments that meet the criteria from STEP 2, keep those that satisfy the following criteria:

1. WAIVER-TYPE = ("02" - "20") or "32" or "35"



STEP 4: Invalid waiver ID values

Of the record segments that meet the criteria from STEP 3, define invalid waiver ID values by counting the number of segments that meet the following criteria:

1. WAIVER-ID does not begin with [A-Z/a-z]

OR

2. WAIVER-ID position 3 is not ”.”

OR

3. WAIVER-ID does not contain [0-9] in positions 4 to end

OR

4. WAIVER-ID is missing



STEP 5: Calculate percentage

Divide the count of record segments from STEP 4 by the count of record segments from STEP 3