1115A-DEMONSTRATION-INFORMATION

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TMSIS Dataguide

Medicaid.gov

Version 3.36.0

1115A-DEMONSTRATION-INFORMATION

File Segment

File Segment Number

ELG00018

File Name

Last updated

Data Elements Reference

DE Number	System DE Number	Data Element	Definition	Valid Values
ELG229	ELG.018.229	RECORD-ID	The Record ID represents the type of segment being reported. The Record ID communicates how the contents of a given row of data should be interpreted depending on which segment type the Record ID represents. Each type of segment collects different data elements so each segment type has a distinct layout. The first 3 characters identify the relevant file (e.g., ELG, PRV, CIP, etc.). The last 5 digits are the segment identifier padded with leading zeros (e.g., 00001, 00002, 00003, etc.).	ELG229 Values
ELG230	ELG.018.230	SUBMITTING-STATE	A code that uniquely identifies the U.S. State or Territory from which T-MSIS system data resources were received.	ELG230 Values
ELG231	ELG.018.231	RECORD-NUMBER	A sequential number assigned by the submitter to identify each record segment row in the submission file. The Record Number, in conjunction with the Record Identifier, uniquely identifies a single record within the submission file.	N/A
ELG232	ELG.018.232	MSIS-IDENTIFICATION-NUM	A state-assigned unique identification number used to identify a Medicaid/CHIP enrolled individual (except on service tracking payments). Value may be an SSN, temporary SSN or State-assigned eligible individual identifier. MSIS Identification Numbers are a unique "key" value used to maintain referential integrity of data distributed over multiples files, segments and reporting periods. See T-MSIS Guidance Document, "CMS Guidance: Reporting Shared MSIS Identification Numbers" for information on reporting the MSIS Identification Numbers ID for pregnant women, unborn children, mothers, and their deemed newborns younger than 1 year of age who share the same MSIS Identification Number. https://www.medicaid.gov/medicaid/data-and-systems/macbis/tmsis/tmsis-blog/entry/47572	N/A
ELG233	ELG.018.233	1115A-DEMONSTRATION-IND	Indicates that the individual participates in an 1115A demonstration. 1115A is a Center for Medicare and Medicaid Innovation (CMMI) demonstration.	ELG233 Values
ELG234	ELG.018.234	1115A-EFF-DATE	The first calendar day on which all of the other data elements in the same segment were effective.	N/A
ELG235	ELG.018.235	1115A-END-DATE	The last calendar day on which all of the other data elements in the same segment were effective.	N/A
ELG236	ELG.018.236	STATE-NOTATION	A free text field for the submitting state to enter whatever information it chooses.	N/A

Definition: A record to capture an eligible person's 1115A participation.
File Segment Length: 1000

Published Date	Data Guide Version	File Segment	Action	Field	Before	After
02/18/2025	3.34.0	1115A-DEMONSTRATION-INFORMATION	UPDATE	Record segment definition	A record to capture an eligible person's 1115A participation."	A record to capture an eligible person's 1115A participation.