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TMSIS Dataguide Medicaid.gov

Version:

3.40.0

RULE-7529

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.IMMIGRATION-STATUS • 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 '2' 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.IMMIGRATION-STATUS is equal to one of the following: '1', '2', '3'
Rule Definition If restricted benefits code is for restricted benefits based on noncitizen status on an eligibility determinants segment from an ELG file, and 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 immigration status must be for a noncitizen on the variable demographics eligibility segment.
Denominator Logic # of ELIGIBILITY-DETERMINANTS segments with ELIGIBILITY-DETERMINANTS.RESTRICTED-BENEFITS-CODE equals '2', and with ELIGIBILITY-DETERMINANTS.PRIMARY-ELIGIBILITY-GROUP-IND is equal to '1' and with ENROLLMENT-TIME-SPAN-SEGMENT.ENROLLMENT-END-DATE is greater than or equal to 'cutover date'