EL-6-038-38

Data Quality Measure

Last updated

Key Information

Measure Name	% of MSIS IDs with an IMMIGRATION-STATUS = 3 (Eligible only for payment for emergency services)
File Type	ELG
Measure ID	EL-6-038-38
Measure Type	Non-Claims Percentage
Content area	ELG
Grace Period Expiration	10/31/2026

Validation

Validation Type	Inferential

Measure Priority

Measure Priority	High
Focus Area	N/A
Category	Beneficiary eligibility

Claim Information

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

Thresholds

Minimum	0.0001
Maximum	1
TA Minimun	0.0001
TA Maximum	1
Longitudinal Threshold	N/A
For TA (for including in compliance training)	TA- Inferential
For TA (Longitudinal)	No

Data Elements

DD Data Element	IMMIGRATION-STATUS • MSIS-IDENTIFICATION-NUM
DD Data Element Number	ELG042 • ELG033

Annotation	Calculate the percentage of eligibles with an immigration status indicating eligibility only for payment for emergency services
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: Variable demographics on the last day of DQ report month Using the MSIS IDs that meet the criteria from STEP 1, join to segment VARIABLE-DEMOGRAPHIC-ELG00003 by keeping records that satisfy the following criteria: 1a. VARIABLE-DEMOGRAPHIC-ELEMENT-EFF-DATE <= last day of the DQ report month 2a. VARIABLE-DEMOGRAPHIC-ELEMENT-END-DATE >= last day of the DQ report month OR missing OR 1b. VARIABLE-DEMOGRAPHIC-ELEMENT-EFF-DATE is missing 2b. VARIABLE-DEMOGRAPHIC-ELEMENT-END-DATE is missing STEP 3: U.S. citizen immigration status Of the MSIS IDs that meet the criteria from STEP 2, further refine the population by keeping MSIS IDs where: 1. IMMIGRATION-STATUS = "3" STEP 4: Calculate percentage Divide the count of unique MSIS IDs from STEP 3 by the count of unique MSIS IDs from STEP 2

Annotation

Calculate the percentage of eligibles with an immigration status indicating eligibility only for payment for emergency services

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: Variable demographics on the last day of DQ report month

Using the MSIS IDs that meet the criteria from STEP 1, join to segment VARIABLE-DEMOGRAPHIC-ELG00003 by keeping records that satisfy the following criteria:

1a. VARIABLE-DEMOGRAPHIC-ELEMENT-EFF-DATE <= last day of the DQ report month

2a. VARIABLE-DEMOGRAPHIC-ELEMENT-END-DATE >= last day of the DQ report month OR missing

OR

1b. VARIABLE-DEMOGRAPHIC-ELEMENT-EFF-DATE is missing

2b. VARIABLE-DEMOGRAPHIC-ELEMENT-END-DATE is missing

STEP 3: U.S. citizen immigration status

Of the MSIS IDs that meet the criteria from STEP 2, further refine the population by keeping MSIS IDs where:

1. IMMIGRATION-STATUS = "3"

STEP 4: Calculate percentage

Divide the count of unique MSIS IDs from STEP 3 by the count of unique MSIS IDs from STEP 2

Published Date	Data Guide Version	DQM	Action	Field	Before	After
04/24/2026	4.0.32	EL-6-038-38	UPDATE	Priority	N/A	High
04/24/2026	4.0.32	EL-6-038-38	UPDATE	Category	N/A	Beneficiary eligibility
04/24/2026	4.0.32	EL-6-038-38	UPDATE	For ta comprehensive	No	TA- Inferential
04/24/2026	4.0.32	EL-6-038-38	UPDATE	For ta inferential	No	Yes
04/24/2026	4.0.32	EL-6-038-38	UPDATE	Ta min		0.0001
04/24/2026	4.0.32	EL-6-038-38	UPDATE	Ta max		1
04/24/2026	4.0.32	EL-6-038-38	UPDATE	Threshold minimum	TBD	0.0001
04/24/2026	4.0.32	EL-6-038-38	UPDATE	Threshold maximum	TBD	1
04/24/2026	4.0.32	EL-6-038-38	UPDATE	Annotation	N/A	Calculate the percentage of eligibles with an immigration status indicating eligibility only for payment for emergency services
04/24/2026	4.0.32	EL-6-038-38	UPDATE	Specification	N/A	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: Variable demographics on the last day of DQ report monthUsing the MSIS IDs that meet the criteria from STEP 1, join to segment VARIABLE-DEMOGRAPHIC-ELG00003 by keeping records that satisfy the following criteria:1a. VARIABLE-DEMOGRAPHIC-ELEMENT-EFF-DATE <= last day of the DQ report month2a. VARIABLE-DEMOGRAPHIC-ELEMENT-END-DATE >= last day of the DQ report month OR missingOR1b. VARIABLE-DEMOGRAPHIC-ELEMENT-EFF-DATE is missing2b. VARIABLE-DEMOGRAPHIC-ELEMENT-END-DATE is missingSTEP 3: U.S. citizen immigration statusOf the MSIS IDs that meet the criteria from STEP 2, further refine the population by keeping MSIS IDs where:1. IMMIGRATION-STATUS = "3" STEP 4: Calculate percentageDivide the count of unique MSIS IDs from STEP 3 by the count of unique MSIS IDs from STEP 2
04/24/2026	4.0.32	EL-6-038-38	UPDATE	Grace period expiration date	None	2026-10-31
04/24/2025	4.0.7	EL-6-038-38	ADD	N/A		Created