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TMSIS Dataguide Medicaid.gov
Version 3.28.0

RULE-7810

Validation Rule
Last updated

Tier 2.1
Tier Description Relational error
Error Category E2101
Error Category Message Missing parent record (single file)
Rule Type Two Record Type (1 to 1)
File Segment Number ELG00005
Data Element Name ELIGIBILITY-DETERMINANTS.SUBMITTING-STATE • ELIGIBILITY-DETERMINANTS.ELIGIBILITY-DETERMINANT-EFF-DATE • ELIGIBILITY-DETERMINANTS.ELIGIBILITY-DETERMINANT-END-DATE • MFP-INFORMATION.MFP-ENROLLMENT-EFF-DATE • MFP-INFORMATION.MFP-ENROLLMENT-END-DATE • FILE-HEADER-RECORD-ELIGIBILITY.END-OF-TIME-PERIOD • ELIGIBILITY-DETERMINANTS.PRIMARY-ELIGIBILITY-GROUP-IND • ELIGIBILITY-DETERMINANTS.RESTRICTED-BENEFITS-CODE • ELIGIBILITY-DETERMINANTS.MSIS-IDENTIFICATION-NUM
Validation Logic if ELIGIBILITY-DETERMINANTS.RESTRICTED-BENEFITS-CODE equals 'D' and ELIGIBILITY-DETERMINANTS.PRIMARY-ELIGIBILITY-GROUP-IND equals '1', then for every record of type ELIGIBILITY-DETERMINANTS, there must be a valid record of type MFP-INFORMATION that matches on the join keys and (ELIGIBILITY-DETERMINANTS.ELIGIBILITY-DETERMINANT-EFF-DATE >= MFP-INFORMATION.MFP-ENROLLMENT-EFF-DATE and ELIGIBILITY-DETERMINANTS.ELIGIBILITY-DETERMINANT-END-DATE <= MFP-INFORMATION.MFP-ENROLLMENT-END-DATE)
Rule Definition If restricted benefits code is for Money Follows the Person (MFP) on an eligibility determinants segment from an ELG file, and the primary eligibility group indicator is equal to '1', then the effective date and end date on the eligibility determinants segment must fall within the effective and end dates of one or more continuous mfp information segments.
Denominator Logic # of ELIGIBILITY-DETERMINANTS segments with ELIGIBILITY-DETERMINANTS.RESTRICTED-BENEFITS-CODE is equal to 'D' and with ELIGIBILITY-DETERMINANTS.PRIMARY-ELIGIBILITY-GROUP-IND is equal to '1'