Assess whether to recoup, waive, or refer for prosecution after an issuance

SITUATION Trafficking and Eligibility Fraud work in a benefits issuance vendor after a file-control break now turns on to recoup, waive, or refer because an issuance file that is 1,104 issuances over control put identity-proofing exception queue in play. Disability continuing-eligibility reviewer should say what identity-proofing exception queue proves.

DECISION Disability continuing-eligibility reviewer in a benefits issuance vendor after a file-control break must choose To recoup, waive, / Refer for prosecution using identity-proofing exception queue after an issuance file that is 1,104 issuances over control.

HYPOTHESES TO TEST 1. Disability continuing-eligibility reviewer can defend To recoup, waive, from identity-proofing exception queue after an issuance file that is 1,104 issuances over control in a Public Benefits challenge. 2. Disability continuing-eligibility reviewer cannot defend To recoup, waive, from identity-proofing exception queue; Refer for prosecution is what the extract actually supports after an issuance file that is 1,104 issuances over control. 3. An issuance file that is 1,104 issuances over control never reached the population in identity-proofing exception queue — reopen intake, do not close to recoup, waive, or refer. 4. Two facts in identity-proofing exception queue after an issuance file that is 1,104 issuances over control conflict for disability continuing-eligibility reviewer; hold this Trafficking and Eligibility Fraud file.

ANALYSIS REQUIRED 1. Test eligibility, recoupment, and improper-payment facts in identity-proofing exception queue after an issuance file that is 1,104 issuances over control. 2. Quantify overpayment if to recoup, waive, or refer is wrong. 3. Separate a case-level error from a program-design failure in a benefits issuance vendor after a file-control break. 4. For this Public Benefits Trafficking and Eligibility Fraud file, read identity-proofing exception queue against an issuance file that is 1,104 issuances over control and write the one fact that would move to recoup, waive, or refer for disability continuing-eligibility reviewer.

RECOMMENDATION Choose To recoup, waive, / Refer for prosecution on this Public Benefits / Trafficking and Eligibility Fraud packet (identity-proofing exception queue after an issuance file that is 1,104 issuances over control). The follow-on Trafficking and Eligibility Fraud action is what disability continuing-eligibility reviewer does next: implement the option, assign an owner, and log the missing fact.

COMMAND RETURNS - Bottom-line Public Benefits option on to recoup, waive, or refer, then the evidence in identity-proofing exception queue, then the action for disability continuing-eligibility reviewer - Hypothesis scorecard against identity-proofing exception queue: supported / rejected / untestable - Regulatory or exam hook Trafficking and Eligibility Fraud would cite - Trafficking and Eligibility Fraud finding in identity-proofing exception queue that a second reviewer can re-perform