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SAS Name
EL_PHP_TYPE_1_<1-12>

CODE INDICATING THE TYPE OF THE FIRST OF UP TO FOUR MANAGED CARE PLAN TYPES IN WHICH THE ELIGIBLE WAS ENROLLED FOR THE RESPECTIVE MONTH.

NOTE: IN MAX 2008, A CLARIFICATION NOTE WAS ADDED ABOUT THE VALUE ASSIGNED WHEN SOMEONE HAS CLAIMS BUT NO ELIGIBILITY INFORMATION.

Comments

USER NOTE: WHEN SOMEONE HAS CLAIMS BUT NO ELIGIBILITY INFORMATION, THIS DATA ELEMENT IS 9-FILLED.

CodeCode value
00
INDIVIDUAL WAS NOT ELIGIBLE FOR MEDICAID THIS MONTH.
01
ELIGIBLE IS ENROLLED IN A MEDICAL OR COMPREHENSIVE MANAGED CARE PLAN THIS MONTH (E.G. HMO)
02
ELIGIBLE IS ENROLLED IN A DENTAL MANAGED CARE PLAN THIS MONTH.
03
ELIGIBLE IS ENROLLED IN A BEHAVIORAL MANAGED CARE PLAN THIS MONTH.
04
ELIGIBLE IS ENROLLED IN A PRENATAL/DELIVERY MANAGED CARE PLAN THIS MONTH.
05
ELIGIBLE IS ENROLLED IN A LONG-TERM CARE MANAGED CARE PLAN THIS MONTH.
06
ELIGIBLE IS ENROLLED IN A PROGRAM FOR ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PLAN THIS MONTH.
07
ELIGIBLE IS ENROLLED IN A PRIMARY CARE CASE MANAGEMENT (PCCM) PLAN THIS MONTH.
08
ELIGIBLE IS ENROLLED IN AN OTHER MANAGED CARE PLAN THIS MONTH.
88
NOT APPLICABLE, INDIVIDUAL IS ELIGIBLE FOR MEDICAID, BUT NOT ENROLLED IN A MANAGED CARE PLAN THIS MONTH.
99
ELIGIBLE'S MANAGED CARE PLAN STATUS IS UNKNOWN THIS MONTH.