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TMSIS Dataguide Medicaid.gov

Version:

3.38.0

MCR-28-001-1

Data Quality Measure
Last updated

Key Information

Measure Name % of plan IDs with capitation payment ratios <0.9 or >1.1 (non-PCCM)
File Type Multiple Files
Measure ID MCR-28-001-1
Measure Type Non-Claims Percentage
Content area MCR

Validation

Validation Type Longitudinal and 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 N/A
Maximum N/A
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 STATE-PLAN-ID-NUM • ADJUSTMENT-IND • PAYMENT-OR-RECOUPMENT-AMOUNT • MSIS-IDENTIFICATION-NUM • PAYEE-ID • PAYEE-ID • PAYMENT-AMOUNT • PAYMENT-OR-RECOUPMENT-AMOUNT • MANAGED-CARE-PLAN-TYPE • MANAGED-CARE-PLAN-ID • ADJUSTMENT-IND • ADJUSTMENT-IND • PAYEE-ID
DD Data Element Number MCR019 • FTX070 • FTX157 • ELG191 • FTX078 • FTX033 • FTX072 • FTX025 • MCR024 • ELG192 • FTX023 • FTX155 • FTX163

Annotation N/A
Specification N/A