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TMSIS Dataguide Medicaid.gov
Version 3.36.0

RULE-2676

Validation Rule
Last updated

01/31/2020

Tier 1.1
Tier Description Value Error
Error Category E1103
Error Category Message Value not in specified valid value set
Rule Type Valid Value
File Segment Number MCR00006
Data Element Name MANAGED-CARE-PLAN-POPULATION-ENROLLED.MANAGED-CARE-PLAN-POP
Validation Logic 'If the MANAGED-CARE-PLAN-POP field is populated, the value must be contained in the set of valid values with id: 'ELIGIBILITY-GROUP' and (if MANAGED-CARE-PLAN-POPULATION-ENROLLED.MANAGED-CARE-PLAN-POP-EFF-DATE is non-null then MANAGED-CARE-PLAN-POPULATION-ENROLLED.MANAGED-CARE-PLAN-POP-EFF-DATE >= Valid Values Effective-Date and MANAGED-CARE-PLAN-POPULATION-ENROLLED.MANAGED-CARE-PLAN-POP-EFF-DATE <= Valid Values End-Date)'
Rule Definition If the managed care plan population is populated on a managed care plan population enrolled file, then the managed care plan population reported must be found in the list of valid values.
Denominator Logic # of MANAGED-CARE-PLAN-POPULATION-ENROLLED segments with MANAGED-CARE-PLAN-POPULATION-ENROLLED.ELIGIBILITY-GROUP equal to a valid, non-null value