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Measure Name | % of MFP participants that do not have restricted benefits code designating MFP participation (RESTRICTED-BENEFITS-CODE not D) |
---|---|
File Type | ELG |
Measure ID | EL-6-031-31 |
Measure Type | Non-Claims Percentage |
Content area | ELG |
Validation Type | Inferential |
---|
Measure Priority | High |
---|---|
Focus Area | N/A |
Category | Program participation |
Claim Type | N/A |
---|---|
Adjustment Type | N/A |
Crossover Type | N/A |
Minimum | 0 |
---|---|
Maximum | 0.01 |
TA Minimun | 0 |
TA Maximum | 0.01 |
Longitudinal Threshold | N/A |
For TA
(for including in compliance training) |
TA- Inferential |
For TA
(Longitudinal) |
No |
DD Data Element | MSIS-IDENTIFICATION-NUM • RESTRICTED-BENEFITS-CODE |
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DD Data Element Number | ELG149 • ELG097 |
Annotation | Calculate the percentage of Money Follows the Person participants without a restricted benefits code designating Money Follows the Person participation |
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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: MFP enrollment on the last day of DQ report month Using the MSIS IDs that meet the criteria from STEP 1, join to segment MFP-INFORMATION-ELG00010 by keeping records that satisfy the following criteria: 1. MFP-ENROLLMENT-EFF-DATE <= last day of the DQ report month 2. MFP-ENROLLMENT-END-DATE >= last day of the DQ report month OR missing STEP 3: Eligibility determinants on the last day of DQ report month Using the MSIS IDs that meet the criteria from STEP 2, 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 4: Money Follows the Person Participation Of the MSIS IDs that meet the criteria from STEP 3, further refine the population using by keeping MSIS IDs where: 1. RESTRICTED-BENEFITS-CODE does not equal “D” OR 2. RESTRICTED-BENEFITS-CODE is missing STEP 5: Calculate percentage Divide the count from STEP 4 by the count from STEP 2 |