EL-1-036-43

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Measure Name	% of MSIS IDs with Native Hawaiian or Other Pacific Islander race (RACE = 012, 013, 014, 015, 016) where ETHNICITY-CODE is missing, unspecified, or invalid
File Type	ELG
Measure ID	EL-1-036-43
Measure Type	Non-Claims Percentage
Content area	ELG

Validation Type	Inferential

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

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

Minimum	N/A
Maximum	N/A
TA Minimun
TA Maximum
Longitudinal Threshold	N/A
For TA (for including in compliance training)	No
For TA (Longitudinal)	No

DD Data Element	MSIS-IDENTIFICATION-NUM • ETHNICITY-CODE • RACE
DD Data Element Number	ELG212 • ELG204 • ELG213

Annotation	N/A
Specification	N/A

Published Date	Data Guide Version	DQM	Action	Field	Before	After
11/20/2025	4.0.22	EL-1-036-43	UPDATE	Annotation	Calculate the percentage of eligibles with a Native Hawaiian or Other Pacific Islander race where ethnicity is missing, unspecified, or invalid	N/A
11/20/2025	4.0.22	EL-1-036-43	UPDATE	Specification	STEP 1: Enrolled on the last day of DQ report monthDefine 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 missing3. MSIS-IDENTIFICATION-NUM is not missingSTEP 2: Race information on the last day of DQ report monthUsing the MSIS IDs that meet the criteria from STEP 1, join to segment RACE-INFORMATION ELG00016 by keeping records that satisfy the following criteria:1a. RACE-DECLARATION-EFF-DATE <= last day of the DQ report month2a. RACE-DECLARATION-END-DATE >= last day of the DQ report month OR missingOR1b. RACE-DECLARATION-EFF-DATE is missing2b. RACE-DECLARATION-END-DATE is missingSTEP 3: Race is Native Hawaiian or Other Pacific IslanderOf the MSIS IDs that meet the criteria from STEP 2, further restrict the population by keeping MSIS IDs where:1. RACE = “012,” "013," "014," "015," or "016" on any record segmentSTEP 4: Ethnicity information on the last day of DQ report monthUsing the MSIS IDs that meet the criteria from STEP 3, join to segment ETHNICITY-INFORMATION-ELG00015 by keeping active records that satisfy the following criteria:1a. ETHNICITY-DECLARATION-EFF-DATE <= last day of the DQ report month2a. ETHNICITY-DECLARATION-END-DATE >= last day of the DQ report month OR missingOR1b. ETHNICITY-DECLARATION-EFF-DATE is missing2b. ETHNICITY-DECLARATION-END-DATE is missingSTEP 5 : MSIS IDs where ethnicity is missing, unspecified, or invalidOf the MSIS IDs that meet the criteria from STEP 4, further refine the population by keeping MSIS IDs where:1a. ETHNICITY-CODE is not “0,” “1,” “2,” “3,” “4,” or “5”OR1b. ETHNICITY-CODE is missingSTEP 6: Calculate percentage Divide the count of unique MSIS IDs from STEP 5 by the count of unique MSIS IDs from STEP 3	N/A
04/24/2025	4.0.7	EL-1-036-43	ADD	N/A		Created

EL-1-036-43

Key Information

Validation

Measure Priority

Claim Information

Thresholds

Data Elements