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TMSIS Dataguide Medicaid.gov

Version:

3.39.0

RULE-3099

Validation Rule
Last updated

No Updates

Tier 1.1
Tier Description Value Error
Error Category E1103
Error Category Message Value not in specified valid value set
Rule Type Valid Value
File Segment Number TPL00003
Data Element Name TPL-MEDICAID-ELIGIBLE-PERSON-HEALTH-INSURANCE-COVERAGE-INFO.POLICY-OWNER-CODE
Validation Logic 'If the POLICY-OWNER-CODE field is populated, the value must be contained in the set of valid values with id: 'POLICY-OWNER-CODE' and (if TPL-MEDICAID-ELIGIBLE-PERSON-HEALTH-INSURANCE-COVERAGE-INFO.INSURANCE-COVERAGE-EFF-DATE is non-null then TPL-MEDICAID-ELIGIBLE-PERSON-HEALTH-INSURANCE-COVERAGE-INFO.INSURANCE-COVERAGE-EFF-DATE >= Valid Values Effective-Date and TPL-MEDICAID-ELIGIBLE-PERSON-HEALTH-INSURANCE-COVERAGE-INFO.INSURANCE-COVERAGE-EFF-DATE <= Valid Values End-Date)'
Rule Definition If the policy owner code is populated on a TPL medicaid eligible person health insurance coverage information file, then the policy owner code reported must be found in the list of valid values.
Denominator Logic # of TPL-MEDICAID-ELIGIBLE-PERSON-HEALTH-INSURANCE-COVERAGE-INFO segments with TPL-MEDICAID-ELIGIBLE-PERSON-HEALTH-INSURANCE-COVERAGE-INFO.POLICY-OWNER-CODE equal to a valid, non-null value