EL-6-029-29

Data Quality Measure

Last updated

Key Information

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

Validation Type	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	0
Maximum	0.01
TA Minimun
TA Maximum
Longitudinal Threshold	N/A
For TA (for including in compliance training)	No
For TA (Longitudinal)	No

Data Elements

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

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
Specification	STEP 1: Enrolled on the last day of DQ report month Define 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 missing 3. MSIS-IDENTIFICATION-NUM is not missing STEP 2: Waiver participation on the last day of DQ report month Using 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 month 2a. WAIVER-ENROLLMENT-END-DATE >= last day of the DQ report month OR missing OR 1b. WAIVER-ENROLLMENT-EFF-DATE is missing 2b. WAIVER-ENROLLMENT-END-DATE is missing STEP 3: 1915(b) or 1915(c) waiver type Of 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 values Of 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] OR 2. WAIVER-ID position 3 is not ”.” OR 3. WAIVER-ID does not contain [0-9] in positions 4 to end OR 4. WAIVER-ID is missing STEP 5: Calculate percentage Divide the count of record segments from STEP 4 by the count of record segments from STEP 3

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

Specification

STEP 1: Enrolled on the last day of DQ report month

Define 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 missing

3. MSIS-IDENTIFICATION-NUM is not missing

STEP 2: Waiver participation on the last day of DQ report month

Using 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 month

2a. WAIVER-ENROLLMENT-END-DATE >= last day of the DQ report month OR missing

OR

1b. WAIVER-ENROLLMENT-EFF-DATE is missing

2b. WAIVER-ENROLLMENT-END-DATE is missing

STEP 3: 1915(b) or 1915(c) waiver type

Of 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 values

Of 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]

OR

2. WAIVER-ID position 3 is not ”.”

OR

3. WAIVER-ID does not contain [0-9] in positions 4 to end

OR

4. WAIVER-ID is missing

STEP 5: Calculate percentage

Divide the count of record segments from STEP 4 by the count of record segments from STEP 3