ELG.002.027

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TMSIS Dataguide

Medicaid.gov

Version:

PRIMARY-DEMOGRAPHIC-ELEMENT-END-DATE

Data Element

DE Number

ELG027

System DE Number

ELG.002.027

File Name

File Segment Number

File Segment Name

PRIMARY-DEMOGRAPHICS-ELIGIBILITY

Last updated

Overview Valid Values Related Rules Related DQ Measures Other Instances

Definition	The last calendar day on which all of the other data elements in the same segment were effective.
Size	9(8)
FLF Start Position	128
FLF Stop Position	135
Segment Key Field Identifier	Not Applicable
Coding Requirements	1. The date must be a valid calendar date in the form "CCYYMMDD" 2. Value must be on or after the associated Segment Effective Date value 3. Mandatory 4. Value of the CC component must be in [18,19,20,99]

Valid Value Code Set	Valid Value Code	Valid Value Name	Valid Value Description	Effective Start Date	Effective End Date

RULE ID	RULE Definition
RULE-2027	If primary demographic element effective date and primary demographic element end date are populated on a primary demographics eligibility segment from an ELG file, then the primary demographic element effective date value reported must be before or equal to the primary demographic element end date value reported.
RULE-2030	If a segment is a primary demographics eligibility segment from an ELG file, then the primary demographic element end date value reported must be a valid date of the form CCYYMMDD.
RULE-3106	If the date of death is populated on a primary demographics eligibility segment and the primary demographics eligibility primary demographic element end date is greater than the states tmsis cutover date and the insurance coverage end date is populated on the TPL medicaid eligible person health insurance coverage information segment then the TPL medicaid eligible person health insurance coverage info insurance coverage end date is less than or equal to the primary demographics eligibilty date of death and the effective and end dates on the primary demographics eligibility segment must fall with the effective and end dates of one or more continuous TPL medicaid eligible person health insurance coverage information segments.
RULE-7538	If MSIS ID is populated on an enrollment time span segment from an ELG file, then the effective date and end date on the enrollment time span segment must fall within the effective and end dates of one or more continuous primary demographics eligibility segments and the MSIS ID is populated in the primary demographics eligibility segment.
RULE-8767	If a financial transaction is a non-void, and the PAYEE ID is populated on Individual Capitation Payment segment from the FTX file and the PAYEE ID Type is Beneficiary, then the PAYEE ID value reported must be equal to a MSIS Identification Number on a primary demographics eligibility segment from a ELG file where the primary demographic element effective and end dates of the primary demographics eligibility segment overlap with the capitation period start date on the financial transaction.
RULE-8768	If a financial transaction is a non-void, and the PAYEE ID is populated on Individual Health Insurance Premium Payment segment from the FTX file and the PAYEE ID Type is Beneficiary, then the PAYEE ID value reported must be equal to a MSIS Identification Number on a primary demographics eligibility segment from a ELG file where the primary demographic element effective and end dates of the primary demographics eligibility segment overlap with the premium period start date on the financial transaction.
RULE-8769	If a financial transaction is a non-void, and the PAYEE ID is populated on Group Insurance Premium Payment segment from the FTX file and the PAYEE ID Type is Beneficiary, then the PAYEE ID value reported must be equal to a MSIS Identification Number on a primary demographics eligibility segment from a ELG file where the primary demographic element effective and end dates of the primary demographics eligibility segment overlap with the premium period start date on the financial transaction.
RULE-8770	If a financial transaction is a non-void, and the PAYEE ID is populated on Cost Sharing Offset segment from the FTX file and the PAYEE ID Type is Beneficiary, then the PAYEE ID value reported must be equal to a MSIS Identification Number on a primary demographics eligibility segment from a ELG file where the primary demographic element effective and end dates of the primary demographics eligibility segment overlap with the coverage period start date on the financial transaction.
RULE-8771	If a financial transaction is a non-void, and the PAYEE ID is populated on Value Based Payment segment from the FTX file and the PAYEE ID Type is Beneficiary, then the PAYEE ID value reported must be equal to a MSIS Identification Number on a primary demographics eligibility segment from a ELG file where the primary demographic element effective and end dates of the primary demographics eligibility segment overlap with the performance period start date on the financial transaction.
RULE-8772	If a financial transaction is a non-void, and the PAYEE ID is populated on State Directed Payment Separate Payment Term segment from the FTX file and the PAYEE ID Type is Beneficiary, then the PAYEE ID value reported must be equal to a MSIS Identification Number on a primary demographics eligibility segment from a ELG file where the primary demographic element effective and end dates of the primary demographics eligibility segment overlap with the payment period start date on the financial transaction.
RULE-8773	If a financial transaction is a non-void, and the PAYEE ID is populated on Cost Settlement Payment segment from the FTX file and the PAYEE ID Type is Beneficiary, then the PAYEE ID value reported must be equal to a MSIS Identification Number on a primary demographics eligibility segment from a ELG file where the primary demographic element effective and end dates of the primary demographics eligibility segment overlap with the cost settlement period start date on the financial transaction.
RULE-8774	If a financial transaction is a non-void, and the PAYEE ID is populated on FQHC Wrap Payment segment from the FTX file and the PAYEE ID Type is Beneficiary, then the PAYEE ID value reported must be equal to a MSIS Identification Number on a primary demographics eligibility segment from a ELG file where the primary demographic element effective and end dates of the primary demographics eligibility segment overlap with the wrap period start date on the financial transaction.
RULE-8775	If a financial transaction is a non-void, and the PAYEE ID is populated on Miscellaneous Payment segment from the FTX file and the PAYEE ID Type is Beneficiary, then the PAYEE ID value reported must be equal to a MSIS Identification Number on a primary demographics eligibility segment from a ELG file where the primary demographic element effective and end dates of the primary demographics eligibility segment overlap with the payment period start date on the financial transaction.

Measure ID	Measure Name
EL-6-001-1	Medicaid Churn: % of eligibles enrolled in a month that were also enrolled six months prior (continuous enrollment over 6 months)
EL-6-002-2	S-CHIP Churn: % of eligibles enrolled in a month that were also enrolled six months prior (continuous enrollment over 6 months)
EL-6-003-3	Medicaid Churn: % of eligibles enrolled in a month that were also enrolled 12 months prior (continuous enrollment over 12 months)
EL-6-004-4	S-CHIP Churn: % of eligibles enrolled in a month that were also enrolled 12 months prior (continuous enrollment over 12 months)
EL-14-001-1	Ratio of errors for overlapping segment eff/end dates [RULE-2028] to all active PRIMARY-DEMOGRAPHICS-ELIGIBILITY (ELG00002) segments across all reporting and coverage periods
MIS-1-005-5	% distinct MSIS IDs with only missing values in any active segment: PRIMARY-DEMOGRAPHIC-ELEMENT-END-DATE (ELG00002)
RULE-2028	Ratio of errors for overlapping segment eff/end dates [RULE-2028] to all active PRIMARY-DEMOGRAPHICS-ELIGIBILITY (ELG00002) segments

DE Number	System DE Number	DE Name	File Segment Number	File Segment Name

Published Date	Data Guide Version	Data Element	Action	Field	Before	After
12/19/2024	4.0.1	ELG.002.027	UPDATE	Coding requirement	1. The date must be a valid calendar date in the form "CCYYMMDD"2. Value must be greater than or equal to associated Segment Effective Date value3. Mandatory4. Value of the CC component must be in [18,19,20,99]	1. The date must be a valid calendar date in the form "CCYYMMDD"2. Value must be on or after the associated Segment Effective Date value3. Mandatory4. Value of the CC component must be in [18,19,20,99]
09/16/2024	4.0.0	ELG.002.027	UPDATE	File segment	None	45
09/16/2024	4.0.0	ELG.002.027	ADD	N/A		Created