Key Information

Measure Name	Total # of duals
File Type	ELG
Measure ID	EL-S-002-2
Measure Type	Count
Content area	ELG

Validation

Validation Type	Longitudinal

Measure Priority

Measure Priority	Medium
Focus Area	N/A
Category	Beneficiary eligibility

Claim Information

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

Thresholds

Minimum	N/A
Maximum	N/A
TA Minimun
TA Maximum
Longitudinal Threshold	0.05
For TA (for including in compliance training)	TA- Longitudinal
For TA (Longitudinal)	Yes

Data Elements

DD Data Element	MSIS-IDENTIFICATION-NUM • DUAL-ELIGIBLE-CODE
DD Data Element Number	ELG082 • ELG085

Annotation

Count the number of unique MSIS ID's that have a valid dual code

Specification

STEP 1: Enrolled on the last day of DQ report month Define the eligible population from segment ENROLLMENT-TIME-SPAN-ELG00021 by keeping active records that satisfy the following criteria: 1. ENROLLMENT-EFF-DATE <= last day of the DQ report month 2. ENROLLMENT-END-DATE >= last day of the DQ report month OR missing 3. MSIS-IDENTIFICATION-NUM is not missing STEP 2: Eligibility determinants on the last day of DQ report month Using the MSIS IDs that meet the criteria from STEP 1, join to segment ELIGIBILITY-DETERMINANTS-ELG00005 by keeping records that satisfy the following criteria: 1. PRIMARY-ELIGIBILITY-GROUP-IND = 1 2a. ELIGIBILITY-DETERMINANT-EFF-DATE <= last day of the DQ report month 3a. ELIGIBILITY-DETERMINANT-END-DATE >= last day of the DQ report month OR missing OR 2b. ELIGIBILITY-DETERMINANT-EFF-DATE is missing 3b. ELIGIBILITY-DETERMINANT-END-DATE is missing STEP 3: Count duals Of the MSIS IDs that meet the criteria from STEP 2, count the number of unique MSIS IDs that satisfy the following criterion: 1. DUAL-ELIGIBLE-CODE = "01" or “02” or "03" or “04” or "05" or “06” or “08” or “09” or “10”