EL-6-029-29

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Measure Name	% of record segments with an invalid waiver ID format for 1915(b) and 1915(c) waivers (WAIVER-TYPE = 02 - 20, 32, or 33)
File Type	ELG
Measure ID	EL-6-029-29
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	0
Maximum	0.01
TA Minimun
TA Maximum
Longitudinal Threshold	N/A
For TA (for including in compliance training)	No
For TA (Longitudinal)	No

DD Data Element	WAIVER-ID • WAIVER-TYPE
DD Data Element Number	ELG172 • ELG173

Annotation	N/A
Specification	N/A

Published Date	Data Guide Version	DQM	Action	Field	Before	After
11/20/2025	4.0.22	EL-6-029-29	UPDATE	Annotation	Calculate the percentage of rows in the ELG00012 segment with a 1915(b) or 1915(c) waiver type that have a waiver ID in an invalid format	N/A
11/20/2025	4.0.22	EL-6-029-29	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: Waiver participation on the last day of DQ report monthUsing the MSIS IDs that meet the criteria from STEP 1, join to segment WAIVER-PARTICIPATION-ELG00012 by keeping records that satisfy the following criteria:1a. WAIVER-ENROLLMENT-EFF-DATE <= last day of the DQ report month2a. WAIVER-ENROLLMENT-END-DATE >= last day of the DQ report month OR missingOR1b. WAIVER-ENROLLMENT-EFF-DATE is missing2b. WAIVER-ENROLLMENT-END-DATE is missingSTEP 3: 1915(b) or 1915(c) waiver typeOf the record segments that meet the criteria from STEP 2, keep those that satisfy the following criteria:1. WAIVER-TYPE = ("02" - "20") or "32" or "35"STEP 4: Invalid waiver ID valuesOf the record segments that meet the criteria from STEP 3, define invalid waiver ID values by counting the number of segments that meet the following criteria:1. WAIVER-ID does not begin with [A-Z/a-z]OR2. WAIVER-ID position 3 is not ”.” OR3. WAIVER-ID does not contain [0-9] in positions 4 to endOR4. WAIVER-ID is missingSTEP 5: Calculate percentage Divide the count of record segments from STEP 4 by the count of record segments from STEP 3	N/A
04/24/2025	4.0.7	EL-6-029-29	ADD	N/A		Created

EL-6-029-29

Key Information

Validation

Measure Priority

Claim Information

Thresholds

Data Elements