Assess whether a provider's attendance is fabricated after a provider billing

Situation

Compliance and Integrity Operations work in a TANF office with thin work-participation documentation now turns on a provider's attendance is because a provider billing full-time care during school hours put identity-proofing exception queue in play. UI identity-fraud caseworker should say what identity-proofing exception queue proves.

Decision

UI identity-fraud caseworker in a TANF office with thin work-participation documentation must choose Pay or continue / Recoup / Deny / Hold using identity-proofing exception queue after a provider billing full-time care during school hours.

Hypotheses to test

• A provider billing full-time care during school hours is noise around an already-controlled Compliance and Integrity Operations process in a TANF office with thin work-participation documentation, given identity-proofing exception queue.
• A provider billing full-time care during school hours is the event in identity-proofing exception queue that forces Pay or continue for UI identity-fraud caseworker under Public Benefits.
• Identity-proofing exception queue shows a one-file miss after a provider billing full-time care during school hours, not a Compliance and Integrity Operations program failure.
• Identity-proofing exception queue cannot decide a provider's attendance is yet after a provider billing full-time care during school hours; hold is the only Public Benefits close a TANF office with thin work-participation documentation can defend.

Analysis required

• Quantify overpayment if a provider's attendance is is wrong.
• Separate a case-level error from a program-design failure in a TANF office with thin work-participation documentation.
• Match household facts in identity-proofing exception queue to the rule that pays the benefit.
• For this Public Benefits Compliance and Integrity Operations file, read identity-proofing exception queue against a provider billing full-time care during school hours and write the one fact that would move a provider's attendance is for UI identity-fraud caseworker.

Recommendation

Choose Pay or continue / Recoup / Deny / Hold on this Public Benefits / Compliance and Integrity Operations packet (identity-proofing exception queue after a provider billing full-time care during school hours). If identity-proofing exception queue cannot force a Public Benefits label under Compliance and Integrity Operations, stop. If identity-proofing exception queue after a provider billing full-time care during school hours cannot support Pay or continue versus Recoup on this Public Benefits Compliance and Integrity Operations close, UI identity-fraud caseworker must do not pay, recoup, or deny beyond the eligibility record.