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Measure Name | Total # of duals |
---|---|
File Type | ELG |
Measure ID | EL-S-002-2 |
Measure Type | Count |
Content area | ELG |
Validation Type | Longitudinal |
---|
Measure Priority | Medium |
---|---|
Focus Area | N/A |
Category | Beneficiary eligibility |
Claim Type | N/A |
---|---|
Adjustment Type | N/A |
Crossover Type | N/A |
Minimum | N/A |
---|---|
Maximum | N/A |
TA Minimun | |
TA Maximum | |
Longitudinal Threshold | 0.05 |
For TA
(for including in compliance training) |
TA- Longitudinal |
For TA
(Longitudinal) |
Yes |
DD Data Element | MSIS-IDENTIFICATION-NUM • DUAL-ELIGIBLE-CODE |
---|---|
DD Data Element Number | ELG082 • ELG085 |
Annotation | Count the number of unique MSIS ID's that have a valid dual code |
---|---|
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 duals Of the MSIS IDs that meet the criteria from STEP 2, count the number of unique MSIS IDs that satisfy the following criterion: 1. DUAL-ELIGIBLE-CODE = "01" or “02” or "03" or “04” or "05" or “06” or “08” or “09” or “10” |