EL-15-003-3

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Measure Name	% difference between total T-MSIS duals count and total MMA duals count
File Type	ELG
Measure ID	EL-15-003-3
Measure Type	Non-claims percentage
Content area	ELG

Validation Type	Inferential

Measure Priority	High
Focus Area	N/A
Category	Beneficiary eligibility

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

Minimum	-0.05
Maximum	0.05
TA Minimun	-0.05
TA Maximum	0.05
Longitudinal Threshold	N/A
For TA (for including in compliance training)	TA- Inferential
For TA (Longitudinal)	No

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

Annotation	N/A
Specification	N/A

Published Date	Data Guide Version	DQM	Action	Field	Before	After
11/20/2025	4.0.22	EL-15-003-3	UPDATE	Annotation	Calculate the percent difference between the total T-MSIS duals count and the total MMA duals count	N/A
11/20/2025	4.0.22	EL-15-003-3	UPDATE	Specification	STEP 1: MMA total duals countRetrieve the total dual count from the MMA data. This is an external source. More information is available at: https://www.cms.gov/Medicare-Medicaid-Coordination/Medicare-and-Medicaid-Coordination/Medicare-Medicaid-Coordination-Office/DataStatisticalResources/StateMMAFileNote: The MMA total duals count is not always available for the T-MSIS DQ analysis month at the time of the measure calculation. In such cases, the DQ team will wait until the MMA data are ready to do the calculation, so that the MMA count and T-MSIS count are for the same month.STEP 2: Total dual-eligible beneficiary countSum the measure statistics from the individual dual code measures: total count of dual-eligible beneficiaries = EL-6-012-12 + EL-6-013-13 + EL-6-014-14 + EL-6-015-15 + EL-6-016-16 + EL-6-017-17 + EL-6-018-18 + EL-6-019-19STEP 3: Difference Subtract the count from STEP 1 from the count of dual eligible beneficiaries from STEP 2STEP 4: PercentageDivide the difference from STEP 3 by the count in STEP 1	N/A
10/07/2025	4.0.19	EL-15-003-3	UPDATE	Grace period expiration date	None	2025-02-28
04/24/2025	4.0.7	EL-15-003-3	ADD	N/A		Created

EL-15-003-3

Key Information

Validation

Measure Priority

Claim Information

Thresholds

Data Elements