Assess whether identity proofing exceptions are being abused (93adfd)

SITUATION In a Medicaid agency with a surge in MAGI mismatches, EBT out-of-state redemption cluster is the evidence after an issuance file that is 1,104 issuances over control. Issuance-system integrity manager has to pick Pay or continue or Recoup for this Public Benefits Recoupment and Policy close using EBT out-of-state redemption cluster.

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 1. EBT out-of-state redemption cluster reads as Pay or continue once an issuance file that is 1,104 issuances over control is lined up to the same Public Benefits population. 2. EBT out-of-state redemption cluster is closer to Recoup after an issuance file that is 1,104 issuances over control; Pay or continue would over-claim this Recoupment and Policy extract. 3. Deny is still live in EBT out-of-state redemption cluster for issuance-system integrity manager in a Medicaid agency with a surge in MAGI mismatches. 4. EBT out-of-state redemption cluster is missing the fact issuance-system integrity manager needs after an issuance file that is 1,104 issuances over control; stop this Public Benefits close.

ANALYSIS REQUIRED 1. Quantify overpayment if identity proofing exceptions are is wrong. 2. Separate a case-level error from a program-design failure in a Medicaid agency with a surge in MAGI mismatches. 3. Match household facts in EBT out-of-state redemption cluster to the rule that pays the benefit. 4. 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 identity proofing exceptions are 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). If EBT out-of-state redemption cluster cannot force a Public Benefits label under Recoupment and Policy, stop. Do not invent missing evidence a Medicaid agency with a surge in MAGI mismatches does not have.

COMMAND RETURNS - Bottom-line Public Benefits option on identity proofing exceptions are, then the evidence in EBT out-of-state redemption cluster, then the action for issuance-system integrity manager - Hypothesis scorecard against EBT out-of-state redemption cluster: supported / rejected / untestable - Recoupment and Policy finding in EBT out-of-state redemption cluster that a second reviewer can re-perform - Missing page in EBT out-of-state redemption cluster after an issuance file that is 1,104 issuances over control, if any