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TMSIS Dataguide Medicaid.gov

Version:

3.40.0

RULE-7428

Validation Rule
Last updated

Tier 2.1
Tier Description Relational error
Error Category E2101
Error Category Message Missing parent record (single file)
Rule Type Two Record Type (1 to 1)
File Segment Number ELG00005
Data Element Name ELIGIBILITY-DETERMINANTS.SUBMITTING-STATE • ELIGIBILITY-DETERMINANTS.MSIS-IDENTIFICATION-NUM • VARIABLE-DEMOGRAPHICS-ELIGIBILITY.CHIP-CODE • ELIGIBILITY-DETERMINANTS.ELIGIBILITY-DETERMINANT-EFF-DATE • ELIGIBILITY-DETERMINANTS.ELIGIBILITY-DETERMINANT-END-DATE • VARIABLE-DEMOGRAPHICS-ELIGIBILITY.VARIABLE-DEMOGRAPHIC-ELEMENT-EFF-DATE • VARIABLE-DEMOGRAPHICS-ELIGIBILITY.VARIABLE-DEMOGRAPHIC-ELEMENT-END-DATE • FILE-HEADER-RECORD-ELIGIBILITY.END-OF-TIME-PERIOD • ELIGIBILITY-DETERMINANTS.RESTRICTED-BENEFITS-CODE • ELIGIBILITY-DETERMINANTS.PRIMARY-ELIGIBILITY-GROUP-IND
Validation Logic if ELIGIBILITY-DETERMINANTS.RESTRICTED-BENEFITS-CODE equals 'C' and ELIGIBILITY-DETERMINANTS.PRIMARY-ELIGIBILITY-GROUP-IND equals '1' and ELIGIBILITY-DETERMINANTS.ELIGIBILITY-DETERMINANT-END-DATE is greater than or equal to 'cutover date', then for every record of type ELIGIBILITY-DETERMINANTS, there must be a valid record of type VARIABLE-DEMOGRAPHICS-ELIGIBILITY that matches on the join keys and (MAX(ELIGIBILITY-DETERMINANTS.ELIGIBILITY-DETERMINANT-EFF-DATE, null) >= VARIABLE-DEMOGRAPHICS-ELIGIBILITY.VARIABLE-DEMOGRAPHIC-ELEMENT-EFF-DATE and ELIGIBILITY-DETERMINANTS.ELIGIBILITY-DETERMINANT-END-DATE <= VARIABLE-DEMOGRAPHICS-ELIGIBILITY.VARIABLE-DEMOGRAPHIC-ELEMENT-END-DATE), and VARIABLE-DEMOGRAPHICS-ELIGIBILITY.CHIP-CODE equals '3'
Rule Definition If restricted benefits code is for S-CHIP dental on an eligibility determinants segment from an ELG file, and the eligibility determinants has a primary eligibility group indicator equal to '1' and the eligibility determinants end date is greater than or equal to the T-MSIS cutover date, then the effective date and end date on the eligibility determinants segment must fall within the effective and end dates of one or more continuous variable demographics eligibility segments and the CHIP code must be for S-CHIP for the month on the variable demographic eligibility segment.
Denominator Logic # of ELIGIBILITY-DETERMINANTS segments with ELIGIBILITY-DETERMINANTS.RESTRICTED-BENEFITS-CODE is equal to 'C' and with ELIGIBILITY-DETERMINANTS.PRIMARY-ELIGIBILITY-GROUP-IND is equal to '1' and with ELIGIBILITY-DETERMINANTS.ELIGIBILITY-DETERMINANT-END-DATE is greater than or equal to 'cutover date'