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TMSIS Dataguide Medicaid.gov

Version:

3.40.0

EL-6-053-53

Data Quality Measure
Last updated

Key Information

Measure Name % of MSIS IDs in a state that has a SPA or waiver for CHIPRA 214 coverage and have IMMIGRATION-STATUS = 2 (CHIPRA 214)
File Type ELG
Measure ID EL-6-053-53
Measure Type Non-Claims Percentage
Content area ELG
Grace Period Expiration 04/30/2027

Validation

Validation Type Inferential

Measure Priority

Measure Priority High
Focus Area Wftcl - alien eligibility
Category Beneficiary demographics

Claim Information

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

Thresholds

Minimum 0.001
Maximum 0.75
TA Minimun 0.001
TA Maximum 0.75
Longitudinal Threshold N/A
For TA
(for including in compliance training) 		TA- Inferential
For TA
(Longitudinal) 		No

Data Elements

DD Data Element MSIS-IDENTIFICATION-NUM • SUBMITTING-STATE • IMMIGRATION-STATUS
DD Data Element Number ELG033 • ELG080 • ELG042

Annotation Calculate the percentage of eligible MSIS IDs with an immigration status indicating CHIPRA 214 eligibility in states with a CHIPRA 214 SPA or waiver.
Specification STEP 1: Measure applies to submitting state



Using the CHIPRA Lookup Table ((Table L.12 CHIPRA State Lookup), determine whether the submitting state has a SPA or waiver for CHIPRA 214 coverage.



1a. If the submitting state has a SPA or waiver for CHIPRA 214 coverage, proceed to STEP 2.



ELSE



1b. If the submitting state does not have a SPA or waiver for CHIPRA 214 coverage, the final measure statistic will be displayed as "Div by 0"



STEP 2: 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 3: Variable demographics on the last day of DQ report month

Restrict to unique MSIS IDs that meet the criteria from STEP 2 and 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 and is not missing

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



STEP 4: Lawfully residing immigration status



Of the MSIS IDs that meet the criteria from STEP 3, count the number of unique MSIS IDs where:

1. IMMIGRATION-STATUS = "2"



STEP 5: Calculate percentage



Divide the count of unique MSIS IDs from STEP 4 by the count of unique MSIS IDs from STEP 3.