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TMSIS Dataguide Medicaid.gov

Version:

3.40.0

RULE-9232

Validation Rule
Last updated

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 MCR00010
Data Element Name MANAGED-CARE-ID.SUBMITTING-STATE • MANAGED-CARE-ID.MANAGED-CARE-PLAN-OTHER-ID
Validation Logic 'if the MANAGED-CARE-PLAN-OTHER-ID field is populated and MANAGED-CARE-ID.MANAGED-CARE-PLAN-OTHER-ID-TYPE equals '03', then the value must be contained in the set of valid values with id: 'MANAGED-CARE-PLAN-OTHER-ID-03' and StateAbbreviation(MANAGED-CARE-ID.SUBMITTING-STATE) equals to the substring of (MANAGED-CARE-ID.MANAGED-CARE-PLAN-OTHER-ID, 1, 2) and (if MANAGED-CARE-ID.MANAGED-CARE-ID-EFF-DATE is non-null then MANAGED-CARE-ID.MANAGED-CARE-ID-EFF-DATE >= Valid Values Effective-Date and MANAGED-CARE-ID.MANAGED-CARE-ID-EFF-DATE <= Valid Values End-Date)'
Rule Definition If the managed care plan other ID is populated and managed care plan other ID type is '03' on the Managed Care ID segment from a MCR file, then the managed care plan other ID reported must be found in the list of valid values.
Denominator Logic # of MCR Managed Care ID segments with MANAGED-CARE-ID.MANAGED-CARE-PLAN-OTHER-ID equal to a valid, non-null value and with MANAGED-CARE-ID.MANAGED-CARE-PLAN-OTHER-ID-TYPE is equal to '03'