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TMSIS Dataguide Medicaid.gov

Version:

3.40.0

RULE-8761

Data Quality Measure
Last updated

Key Information

Measure Name % of non-void sub-capitation payment records in the FTX file with a populated PAYER-ID (FTX028) that do not match a STATE-PLAN-ID-NUM reported in the Managed Care Plan segment in the MCR file.
File Type Multiple Files
Measure ID RULE-8761
Measure Type Non-Claims Percentage
Content area ALL MCR MULTI

Validation

Validation Type Inferential

Measure Priority

Measure Priority High
Focus Area Managed care
Category Program participation

Claim Information

Claim Type N/A
Adjustment Type All Adjustment Types
Crossover Type N/A

Thresholds

Minimum 0
Maximum 0.02
TA Minimun 0
TA Maximum 0.02
Longitudinal Threshold N/A
For TA
(for including in compliance training) 		TA- Inferential
For TA
(Longitudinal) 		No

Data Elements

DD Data Element MANAGED-CARE-CONTRACT-EFF-DATE • MANAGED-CARE-CONTRACT-END-DATE • CAPITATION-PERIOD-START-DATE • PAYER-ID • PAYER-ID-TYPE
DD Data Element Number MCR020 • MCR021 • FTX043 • FTX028 • FTX029

Annotation N/A
Specification RULE-8761