Assess whether a household is receiving duplicate subsidies (10a823)

Situation

Recoupment and Policy work in a Medicaid agency with a surge in MAGI mismatches now turns on a household is receiving because an issuance file that is 1,104 issuances over control put EBT out-of-state redemption cluster in play. Issuance-system integrity manager should say what EBT out-of-state redemption cluster proves.

Decision

Issuance-system integrity manager in a Medicaid agency with a surge in MAGI mismatches must choose Pay or continue / Recoup / Deny / Hold using EBT out-of-state redemption cluster after an issuance file that is 1,104 issuances over control.

Hypotheses to test

• Issuance-system integrity manager can defend Pay or continue from EBT out-of-state redemption cluster after an issuance file that is 1,104 issuances over control in a Public Benefits challenge.
• Issuance-system integrity manager cannot defend Pay or continue from EBT out-of-state redemption cluster; Recoup is what the extract actually supports after an issuance file that is 1,104 issuances over control.
• An issuance file that is 1,104 issuances over control never reached the population in EBT out-of-state redemption cluster — reopen intake, do not close a household is receiving.
• Two facts in EBT out-of-state redemption cluster after an issuance file that is 1,104 issuances over control conflict for issuance-system integrity manager; hold this Recoupment and Policy file.

Analysis required

• Match household facts in EBT out-of-state redemption cluster to the rule that pays the benefit.
• Trace the notice and appeal path issuance-system integrity manager must preserve.
• Test eligibility, recoupment, and improper-payment facts in EBT out-of-state redemption cluster after an issuance file that is 1,104 issuances over control.
• For this Public Benefits Recoupment and Policy file, read EBT out-of-state redemption cluster against an issuance file that is 1,104 issuances over control and write the one fact that would move a household is receiving for issuance-system integrity manager.

Recommendation

Choose Pay or continue / Recoup / Deny / Hold on this Public Benefits / Recoupment and Policy packet (EBT out-of-state redemption cluster after an issuance file that is 1,104 issuances over control). The follow-on Recoupment and Policy action is what issuance-system integrity manager does next: implement the option, assign an owner, and log the missing fact.