EL-6-033-33

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TMSIS Dataguide

Medicaid.gov

Version 3.27.0

EL-6-033-33

Data Quality Measure

Last updated

Key Information

Measure Name	% of MSIS IDs with an alien restricted benefits code status (RESTRICTED-BENEFITS-CODE = 2) but a non-qualified alien immigration status (IMMIGRATION-STATUS not 1, 2, or 3)
File Type	ELG
Measure ID	EL-6-033-33
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 • RESTRICTED-BENEFITS-CODE • IMMIGRATION-STATUS
DD Data Element Number	ELG082 • ELG097 • ELG042

Annotation	N/A
Specification	N/A

Published Date	Data Guide Version	DQM	Action	Field	Before	After
03/27/2024	3.22.0	EL-6-033-33	UPDATE	Priority	High	N/A
03/27/2024	3.22.0	EL-6-033-33	UPDATE	Category	Beneficiary demographics	N/A
03/27/2024	3.22.0	EL-6-033-33	UPDATE	For ta comprehensive	TA- Inferential	No
03/27/2024	3.22.0	EL-6-033-33	UPDATE	For ta inferential	Yes	No
03/27/2024	3.22.0	EL-6-033-33	UPDATE	Ta min	0
03/27/2024	3.22.0	EL-6-033-33	UPDATE	Ta max	0.01
03/27/2024	3.22.0	EL-6-033-33	UPDATE	Annotation	Calculate the percentage of eligibles with a restricted benefits code status designating alien status whose immigration is not a qualified alien status	N/A
03/27/2024	3.22.0	EL-6-033-33	UPDATE	Specification	STEP 1: Enrolled on the last day of DQ report monthDefine 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 missing3. MSIS-IDENTIFICATION-NUM is not missingSTEP 2: Eligibility determinants on the last day of DQ report monthUsing 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 = 12a. ELIGIBILITY-DETERMINANT-EFF-DATE <= last day of the DQ report month3a. ELIGIBILITY-DETERMINANT-END-DATE >= last day of the DQ report month OR missingOR2b. ELIGIBILITY-DETERMINANT-EFF-DATE is missing3b. ELIGIBILITY-DETERMINANT-END-DATE is missingSTEP 3: Alien restricted benefits codeOf the MSIS IDs that meet the criteria from STEP 2, further refine the population by keeping MSIS IDs where:1. RESTRICTED-BENEFITS-CODE equals “2” STEP 4: Variable demographics on the last day of DQ report monthUsing the MSIS IDs that meet the criteria from STEP 3, 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 month2a. VARIABLE-DEMOGRAPHIC-ELEMENT-END-DATE >= last day of the DQ report month OR missingOR1b. VARIABLE-DEMOGRAPHIC-ELEMENT-EFF-DATE is missing2b. VARIABLE-DEMOGRAPHIC-ELEMENT-END-DATE is missingSTEP 5: Immigration status is not a qualified alien statusOf the MSIS IDs that meet the criteria from STEP 4, further refine the population by keeping MSIS IDs where:1. IMMIGRATION-STATUS does not equal "1" or "2" or "3"STEP 6: Calculate percentageDivide the count from STEP 5 by the count from STEP 3	N/A