Assess whether a policy change would reduce error without harming access

Situation

After a MAGI mismatch that could be a household-size coding error, housing overlapping-address and income file is what disability continuing-eligibility reviewer can touch in a disability unit facing a backlog of CDRs. Public Benefits will live with Pay or continue versus Recoup on this Compliance and Integrity Operations file.

Decision

Disability continuing-eligibility reviewer in a disability unit facing a backlog of CDRs must choose Pay or continue / Recoup / Deny / Hold using housing overlapping-address and income file after a MAGI mismatch that could be a household-size coding error.

Hypotheses to test

• Housing overlapping-address and income file reads as Pay or continue once a MAGI mismatch that could be a household-size coding error is lined up to the same Public Benefits population.
• Housing overlapping-address and income file is closer to Recoup after a MAGI mismatch that could be a household-size coding error; Pay or continue would over-claim this Compliance and Integrity Operations extract.
• Deny is still live in housing overlapping-address and income file for disability continuing-eligibility reviewer in a disability unit facing a backlog of CDRs.
• Housing overlapping-address and income file is missing the fact disability continuing-eligibility reviewer needs after a MAGI mismatch that could be a household-size coding error; stop this Public Benefits close.

Analysis required

• Quantify overpayment if a policy change would is wrong.
• Separate a case-level error from a program-design failure in a disability unit facing a backlog of CDRs.
• Match household facts in housing overlapping-address and income file to the rule that pays the benefit.
• For this Public Benefits Compliance and Integrity Operations file, read housing overlapping-address and income file against a MAGI mismatch that could be a household-size coding error and write the one fact that would move a policy change would for disability continuing-eligibility reviewer.

Recommendation

Choose Pay or continue / Recoup / Deny / Hold on this Public Benefits / Compliance and Integrity Operations packet (housing overlapping-address and income file after a MAGI mismatch that could be a household-size coding error). Lead with the Public Benefits option housing overlapping-address and income file can support after a MAGI mismatch that could be a household-size coding error, then the two facts that force it, then the Monday action for disability continuing-eligibility reviewer in a disability unit facing a backlog of CDRs.