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TMSIS Dataguide Medicaid.gov
Version 3.27.0

MCR-54-010-10

Data Quality Measure
Last updated

No Updates

Key Information

Measure Name # of plans where MC plan type does not match EL plan type
File Type ELG
Measure ID MCR-54-010-10
Measure Type Count
Content area MCR

Validation

Validation Type Inferential

Measure Priority

Measure Priority High
Focus Area Managed care
Category Program participation

Claim Information

Claim Type N/A
Adjustment Type N/A
Crossover Type N/A

Thresholds

Minimum 0
Maximum 0
TA Minimun 0
TA Maximum 0
Longitudinal Threshold N/A
For TA
(for including in compliance training) 		TA- Inferential
For TA
(Longitudinal) 		No

Data Elements

DD Data Element PLAN-ID-NUMBER • PLAN-ID-NUMBER • PLAN-ID-NUMBER • PLAN-ID-NUMBER • MANAGED-CARE-PLAN-TYPE • STATE-PLAN-ID-NUM • MANAGED-CARE-PLAN-TYPE • MANAGED-CARE-PLAN-ID • TYPE-OF-SERVICE • ADJUSTMENT-IND • ADJUSTMENT-IND • ADJUSTMENT-IND • ADJUSTMENT-IND • TYPE-OF-CLAIM • TYPE-OF-CLAIM • TYPE-OF-CLAIM
DD Data Element Number CIP130 • CLT080 • COT066 • CRX056 • MCR024 • MCR019 • ELG193 • ELG192 • COT186 • CIP026 • CLT025 • COT025 • CRX025 • CIP100 • CLT052 • COT037

Annotation Count plan ids in the EL-8-002-2 table where the plan type on the eligibility file does not match the plan type on the managed care file, excluding cases where either plan type is missing
Specification STEP 1: Non-missing plan types

Of the Plan_Ids identified in EL-8-002-2, limit to Plan_Ids where:

1. Plan_Type_El is not missing

2. Plan_Type_Mc is not missing



STEP 2: Plan types do not match

Of the Plan_Ids that meet the criteria in STEP 1, count the non-missing Plan_Ids that also satisfy the following criteria:

1. Plan_Type_El does not equal Plan_Type_Mc