An official website of the United States government

Official websites use .gov
A .gov website belongs to an official government organization in the United States.

Secure .gov websites use HTTPS
A lock () or https:// means you've safely connected to the .gov website. Share sensitive information only on official, secure websites.

TMSIS Dataguide Medicaid.gov

Version:

3.40.0

EL-6-049-49

Data Quality Measure
Last updated

Key Information

Measure Name % of MSIS IDs Age > 1 with IMMIGRATION-STATUS = 3 where SSN is missing
File Type ELG
Measure ID EL-6-049-49
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 TBD
Maximum TBD
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 MSIS-IDENTIFICATION-NUM • ELIGIBILITY-GROUP • IMMIGRATION-STATUS • SSN • CONCEPTION-TO-BIRTH-IND • MSIS-IDENTIFICATION-NUM
DD Data Element Number ELG019 • ELG087 • ELG042 • ELG036 • ELG094 • ELG082

Annotation Calculate the percentage of eligibles over the age of 1 with an immigration status indicating eligibility only for payment for emergency services without an SSN
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: Primary demographics on the last day of DQ report month

Using the MSIS IDs that meet the criteria from STEP 1, join to segment PRIMARY-DEMOGRAPHICS-ELIGIBILITY (ELG00002) by keeping records that satisfy the following criteria:

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

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

OR

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

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



STEP 3: Calculate Age and Keep Age > 1

Of the MSIS IDs that meet the criteria from STEP 2, calculate Age:

1a. If DATE-OF-DEATH is non-missing and occurs before the last day of the DQ report month, Age is equal to the years between DATE-OF-DEATH and DATE-OF-BIRTH.

1b. Otherwise, Age is equal to the years between the last day of the DQ report month and DATE-OF-BIRTH.

Note: perform calculations to count full years (e.g., 5/1/2015 – 8/1/1950 = 64)

2. Only keep records where Age > 1.



STEP 4: Eligibility determinants on the last day of DQ report month

Using the MSIS IDs that meet the criteria from STEP 3, join to segment ELIGIBILITY-DETERMINANTS (ELG00005) by keeping records that satisfy the following criteria:

1. PRIMARY-ELIGIBILITY-GROUP-IND = 1

2a. ELIGIBILITY-DETERMINANT-EFF-DATE <= last day of the DQ report month

3a. ELIGIBILITY-DETERMINANT-END-DATE >= last day of the DQ report month OR missing

OR

2b. ELIGIBILITY-DETERMINANT-EFF-DATE is missing

3b. ELIGIBILITY-DETERMINANT-END-DATE is missing



STEP 5: MSIS IDs without eligibility group 64

Of the MSIS IDs that meet the criteria from STEP 4, count the number of unique MSIS IDs where:

1. ELIGIBILITY-GROUP is not "64"



STEP 6: MSIS IDs without conception to birth

Of the MSIS IDs that meet the criteria from STEP 5, count the number of unique MSIS IDs where:

1.CONCEPTION-TO-BIRTH-IND is not "1"



STEP 7: Variable demographics on the last day of DQ report month

Using the MSIS IDs that meet the criteria from STEP 6, join to segment VARIABLE-DEMOGRAPHICS-ELIGIBILITY (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 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: Primary demographics on the last day of DQ report month

Using the MSIS IDs that meet the criteria from STEP 1, join to segment PRIMARY-DEMOGRAPHICS-ELIGIBILITY (ELG00002) by keeping records that satisfy the following criteria:

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

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

OR

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

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



STEP 3: Calculate Age and Keep Age > 1

Of the MSIS IDs that meet the criteria from STEP 2, calculate Age:

1a. If DATE-OF-DEATH is non-missing and occurs before the last day of the DQ report month, Age is equal to the years between DATE-OF-DEATH and DATE-OF-BIRTH.

1b. Otherwise, Age is equal to the years between the last day of the DQ report month and DATE-OF-BIRTH.

Note: perform calculations to count full years (e.g., 5/1/2015 – 8/1/1950 = 64)

2. Only keep records where Age > 1.F4



STEP 4: Eligibility determinants on the last day of DQ report month

Using the MSIS IDs that meet the criteria from STEP 3, join to segment ELIGIBILITY-DETERMINANTS (ELG00005) by keeping records that satisfy the following criteria:

1. PRIMARY-ELIGIBILITY-GROUP-IND = 1

2a. ELIGIBILITY-DETERMINANT-EFF-DATE <= last day of the DQ report month

3a. ELIGIBILITY-DETERMINANT-END-DATE >= last day of the DQ report month OR missing

OR

2b. ELIGIBILITY-DETERMINANT-EFF-DATE is missing

3b. ELIGIBILITY-DETERMINANT-END-DATE is missing



STEP 5: MSIS IDs without eligibility group 64

Of the MSIS IDs that meet the criteria from STEP 4, count the number of unique MSIS IDs where:

1. ELIGIBILITY-GROUP is not "64"



STEP 6: MSIS IDs without conception to birth

Of the MSIS IDs that meet the criteria from STEP 5, count the number of unique MSIS IDs where:

1.CONCEPTION-TO-BIRTH-IN+G4D is not "1"



STEP 7: Variable demographics on the last day of DQ report month

Using the MSIS IDs that meet the criteria from STEP 6, join to segment VARIABLE-DEMOGRAPHICS-ELIGIBILITY (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 8: U.S. citizen immigration status

Of the MSIS IDs that meet the criteria from STEP 7, further refine the population by keeping MSIS IDs where:

1. IMMIGRATION-STATUS = "3"



STEP 9: Missing SSN

Of the MSIS IDs that meet the criteria from STEP 8, further refine the population by keeping records where:

1. SSN is null



STEP 10: Calculate percentage

Divide the count of unique MSIS IDs from STEP 9 by the count of unique MSIS IDs from STEP 8