Assess whether to brief the legislature with a number that will survive audit

SITUATION After a MAGI mismatch that could be a household-size coding error, TANF work-hours that cannot be corroborated is what Medicaid eligibility integrity analyst can touch in a benefits issuance vendor after a file-control break. Public Benefits will live with Pay or continue versus Recoup on this Recoupment and Policy file.

DECISION Medicaid eligibility integrity analyst in a benefits issuance vendor after a file-control break must choose Pay or continue / Recoup / Deny / Hold using TANF work-hours that cannot be corroborated after a MAGI mismatch that could be a household-size coding error.

HYPOTHESES TO TEST 1. Authorize Pay or continue now; TANF work-hours that cannot be corroborated already has the discriminator after a MAGI mismatch that could be a household-size coding error. 2. Keep Recoup in force until TANF work-hours that cannot be corroborated is completed after a MAGI mismatch that could be a household-size coding error for Medicaid eligibility integrity analyst. 3. Treat TANF work-hours that cannot be corroborated as Deny because both readings appear after a MAGI mismatch that could be a household-size coding error. 4. Refuse a Public Benefits close: Medicaid eligibility integrity analyst does not have the decision to brief the legislature turns on in TANF work-hours that cannot be corroborated.

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 TANF work-hours that cannot be corroborated 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 TANF work-hours that cannot be corroborated against a MAGI mismatch that could be a household-size coding error and write the one fact that would move to brief the legislature for Medicaid eligibility integrity analyst.

RECOMMENDATION Choose Pay or continue / Recoup / Deny / Hold on this Public Benefits / Recoupment and Policy packet (TANF work-hours that cannot be corroborated after a MAGI mismatch that could be a household-size coding error). 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.

COMMAND RETURNS - Bottom-line Public Benefits option on to brief the legislature, then the evidence in TANF work-hours that cannot be corroborated, then the action for Medicaid eligibility integrity analyst - Hypothesis scorecard against TANF work-hours that cannot be corroborated: supported / rejected / untestable - What changes to brief the legislature if a MAGI mismatch that could be a household-size coding error is later withdrawn - Named option among Pay or continue, Recoup, Deny and the fact that kills the others