Assess whether to recoup, waive, or refer for prosecution (3f8859)

SITUATION Recoupment and Policy work in a benefits issuance vendor after a file-control break now turns on to recoup, waive, or refer because two Section 8 files with the same landlord and overlapping tenants put issuance file-control totals that will not balance in play. Medicaid eligibility integrity analyst should say what issuance file-control totals that will not balance proves.

DECISION Medicaid eligibility integrity analyst in a benefits issuance vendor after a file-control break must choose To recoup, waive, / Refer for prosecution using issuance file-control totals that will not balance after two Section 8 files with the same landlord and overlapping tenants.

HYPOTHESES TO TEST 1. Medicaid eligibility integrity analyst can defend To recoup, waive, from issuance file-control totals that will not balance after two Section 8 files with the same landlord and overlapping tenants in a Public Benefits challenge. 2. Medicaid eligibility integrity analyst cannot defend To recoup, waive, from issuance file-control totals that will not balance; Refer for prosecution is what the extract actually supports after two Section 8 files with the same landlord and overlapping tenants. 3. Two Section 8 files with the same landlord and overlapping tenants never reached the population in issuance file-control totals that will not balance — reopen intake, do not close to recoup, waive, or refer. 4. Two facts in issuance file-control totals that will not balance after two Section 8 files with the same landlord and overlapping tenants conflict for Medicaid eligibility integrity analyst; hold this Recoupment and Policy file.

ANALYSIS REQUIRED 1. Separate a case-level error from a program-design failure in a benefits issuance vendor after a file-control break. 2. Match household facts in issuance file-control totals that will not balance to the rule that pays the benefit. 3. Trace the notice and appeal path Medicaid eligibility integrity analyst must preserve. 4. For this Public Benefits Recoupment and Policy file, read issuance file-control totals that will not balance against two Section 8 files with the same landlord and overlapping tenants and write the one fact that would move to recoup, waive, or refer for Medicaid eligibility integrity analyst.

RECOMMENDATION Choose To recoup, waive, / Refer for prosecution on this Public Benefits / Recoupment and Policy packet (issuance file-control totals that will not balance after two Section 8 files with the same landlord and overlapping tenants). The follow-on Recoupment and Policy action is what Medicaid eligibility integrity analyst does next: implement the option, assign an owner, and log the missing fact.