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TMSIS Dataguide Medicaid.gov

Version:

4.0.20

MCR-28-001-1

Data Quality Measure
Last updated

No Updates

Key Information

Measure Name % of plan IDs with capitation payment ratios <0.9 or >1.1 (non-PCCM)
File Type Multiple Files
Measure ID MCR-28-001-1
Measure Type Non-Claims Percentage
Content area MCR

Validation

Validation Type Longitudinal and Inferential

Measure Priority

Measure Priority N/A
Focus Area N/A
Category N/A

Claim Information

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

Thresholds

Minimum TBD
Maximum TBD
TA Minimun
TA Maximum
Longitudinal Threshold TBD
For TA
(for including in compliance training) 		No
For TA
(Longitudinal) 		No

Data Elements

DD Data Element STATE-PLAN-ID-NUM • MANAGED-CARE-PLAN-TYPE • MSIS-IDENTIFICATION-NUM • MANAGED-CARE-PLAN-ID • PLAN-ID-NUMBER • MEDICAID-PAID-AMT • TYPE-OF-CLAIM • ADJUSTMENT-IND
DD Data Element Number MCR019 • MCR024 • ELG191 • ELG192 • COT066 • COT178 • COT037 • COT025

Annotation N/A
Specification N/A