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TMSIS Dataguide Medicaid.gov

Version:

RULE-8446

Validation Rule
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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 FTX00004
Data Element Name GROUP-INSURANCE-PREMIUM-PAYMENT.CATEGORY-FOR-FEDERAL-REIMBURSEMENT
Validation Logic 'If the CATEGORY-FOR-FEDERAL-REIMBURSEMENT field is populated, the value must be contained in the set of valid values with id: 'CATEGORY-FOR-FEDERAL-REIMBURSEMENT' and (if GROUP-INSURANCE-PREMIUM-PAYMENT.PREMIUM-PERIOD-END-DATE is non-null then GROUP-INSURANCE-PREMIUM-PAYMENT.PREMIUM-PERIOD-END-DATE >= Valid Values Effective-Date and GROUP-INSURANCE-PREMIUM-PAYMENT.PREMIUM-PERIOD-END-DATE <= Valid Values End-Date)'
Rule Definition If the category for federal reimbursement is populated on the Group Insurance Premium Payment Transaction from a FTX file, then the category for federal reimbursement reported must be found in the list of valid values.
Denominator Logic # of FTX Group Insurance Premium Payment Transactions with GROUP-INSURANCE-PREMIUM-PAYMENT.CATEGORY-FOR-FEDERAL-REIMBURSEMENT equal to a valid, non-null value