Official websites use .gov
A
.gov website belongs to an official government
organization in the United States.
Secure .gov websites use HTTPS
A
lock () or https:// means you've safely connected to
the .gov website. Share sensitive information only on official,
secure websites.
Measure Name | % of MSIS IDs with an IMMIGRATION-STATUS = 3 (Eligible only for payment for emergency services) but RESTRICTED-BENEFITS-CODE does not equal 2 or 4 |
---|---|
File Type | ELG |
Measure ID | EL-6-037-37 |
Measure Type | Non-Claims Percentage |
Content area | ELG |
Validation Type | Inferential |
---|
Measure Priority | Medium |
---|---|
Focus Area | N/A |
Category | Beneficiary demographics |
Claim Type | N/A |
---|---|
Adjustment Type | N/A |
Crossover Type | N/A |
Minimum | 0 |
---|---|
Maximum | 0.1 |
TA Minimun | 0 |
TA Maximum | 0.1 |
Longitudinal Threshold | N/A |
For TA
(for including in compliance training) |
TA- Inferential |
For TA
(Longitudinal) |
No |
DD Data Element | RESTRICTED-BENEFITS-CODE • IMMIGRATION-STATUS • MSIS-IDENTIFICATION-NUM |
---|---|
DD Data Element Number | ELG097 • ELG042 • ELG212 |
Annotation | Calculate the percentage of eligibles with an immigration staus indicating eligibility only for payment for emergency services, that do not have a restricted benefits code indicating either alien status or eligibility only for pregnancy-related services |
---|---|
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: U.S. citizen immigration status Of the MSIS IDs that meet the criteria from STEP 2, further refine the population by keeping MSIS IDs where: 1. IMMIGRATION-STATUS = "3" STEP 4: Eligibility determinants on the last day of DQ report month Using the MSIS IDs that meet the criteria from STEP 3, 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 5: Restricted Benefits Code designation Of the MSIS IDs that meet the criteria from STEP 4, restrict to those where: 1. RESTRICTED-BENEFITS-CODE is not “2” or "4" STEP 6: Calculate percentage Divide the count of unique MSIS IDs from STEP 5 by the count of unique MSIS IDs from STEP 3 |