Assess whether to brief the legislature with a number that will survive audit

SITUATION After a provider billing full-time care during school hours, disability CDR medical-evidence pack is what child-care provider integrity lead can touch in a disability unit facing a backlog of CDRs. Public Benefits will live with Pay or continue versus Recoup on this Recoupment and Policy file.

DECISION Child-care provider integrity lead in a disability unit facing a backlog of CDRs must choose Pay or continue / Recoup / Deny / Hold using disability CDR medical-evidence pack after a provider billing full-time care during school hours.

HYPOTHESES TO TEST 1. Disability CDR medical-evidence pack reads as Pay or continue once a provider billing full-time care during school hours is lined up to the same Public Benefits population. 2. Disability CDR medical-evidence pack is closer to Recoup after a provider billing full-time care during school hours; Pay or continue would over-claim this Recoupment and Policy extract. 3. Deny is still live in disability CDR medical-evidence pack for child-care provider integrity lead in a disability unit facing a backlog of CDRs. 4. Disability CDR medical-evidence pack is missing the fact child-care provider integrity lead needs after a provider billing full-time care during school hours; stop this Public Benefits close.

ANALYSIS REQUIRED 1. Quantify overpayment if to brief the legislature is wrong. 2. Separate a case-level error from a program-design failure in a disability unit facing a backlog of CDRs. 3. Match household facts in disability CDR medical-evidence pack to the rule that pays the benefit. 4. For this Public Benefits Recoupment and Policy file, read disability CDR medical-evidence pack against a provider billing full-time care during school hours and write the one fact that would move to brief the legislature for child-care provider integrity lead.

RECOMMENDATION Choose Pay or continue / Recoup / Deny / Hold on this Public Benefits / Recoupment and Policy packet (disability CDR medical-evidence pack after a provider billing full-time care during school hours). Lead with the Public Benefits option disability CDR medical-evidence pack can support after a provider billing full-time care during school hours, then the two facts that force it, then the Monday action for child-care provider integrity lead in a disability unit facing a backlog of CDRs.

COMMAND RETURNS - Bottom-line Public Benefits option on to brief the legislature, then the evidence in disability CDR medical-evidence pack, then the action for child-care provider integrity lead - Hypothesis scorecard against disability CDR medical-evidence pack: supported / rejected / untestable - Recoupment and Policy finding in disability CDR medical-evidence pack that a second reviewer can re-perform - Missing page in disability CDR medical-evidence pack after a provider billing full-time care during school hours, if any