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TMSIS Dataguide Medicaid.gov
Version 3.29.0

RULE-7411

Validation Rule
Last updated

Tier 2.1
Tier Description Relational error
Error Category E2102
Error Category Message Values inconsistently specified (multi record, single file)
Rule Type One Record Type (Single Record)
File Segment Number ELG00005
Data Element Name ELIGIBILITY-DETERMINANTS.ELIGIBILITY-GROUP
Validation Logic 'if ELIGIBILITY-DETERMINANTS has a non-null value for MSIS-IDENTIFICATION-NUM and ELIGIBILITY-DETERMINANTS.RESTRICTED-BENEFITS-CODE equals '6' and ELIGIBILITY-DETERMINANTS.PRIMARY-ELIGIBILITY-GROUP-IND equals '1' and ELIGIBILITY-DETERMINANTS has a non-null and not invalidly formatted value for ELIGIBILITY-DETERMINANT-EFF-DATE and ELIGIBILITY-DETERMINANTS.ELIGIBILITY-DETERMINANT-END-DATE is greater than or equal to '2015-01-01', then ELIGIBILITY-DETERMINANTS.ELIGIBILITY-GROUP is equal to one of the following: '35', '70''
Rule Definition If a segment is a eligibility determinants segment from an ELG file, and the MSIS ID is populated and the restricted benefits code is equal to '6', and the primary eligibility group indicator is equal to '1' and eligibility determinant end date is greater than or equal to '01/01/2015', then the eligibility group is equal to one of the following values: '35','70'.
Denominator Logic # of ELIGIBILITY-DETERMINANTS segments with ELIGIBILITY-DETERMINANTS has a non-null value for MSIS-IDENTIFICATION-NUM and with ELIGIBILITY-DETERMINANTS.RESTRICTED-BENEFITS-CODE is equal to '6' and with ELIGIBILITY-DETERMINANTS.PRIMARY-ELIGIBILITY-GROUP-IND is equal to '1' and with ELIGIBILITY-DETERMINANTS.ELIGIBILITY-DETERMINANT-EFF-DATE has non-null and not invalidly formatted value and with ELIGIBILITY-DETERMINANTS.ELIGIBILITY-DETERMINANT-END-DATE is greater than or equal to '01/01/2015'