Assess whether to recoup, waive, or refer for prosecution from issuance

SITUATION After a recoupment that would make a household homeless, issuance file-control totals that will not balance is what Medicaid eligibility integrity analyst can touch in a child-care subsidy program with related-provider clusters. Public Benefits will live with To recoup, waive, versus Refer for prosecution on this Trafficking and Eligibility Fraud file.

DECISION Medicaid eligibility integrity analyst in a child-care subsidy program with related-provider clusters must choose To recoup, waive, / Refer for prosecution using issuance file-control totals that will not balance after a recoupment that would make a household homeless.

HYPOTHESES TO TEST 1. Authorize To recoup, waive, now; issuance file-control totals that will not balance already has the discriminator after a recoupment that would make a household homeless. 2. Keep Refer for prosecution in force until issuance file-control totals that will not balance is completed after a recoupment that would make a household homeless for Medicaid eligibility integrity analyst. 3. Treat issuance file-control totals that will not balance as To recoup, waive, because both readings appear after a recoupment that would make a household homeless. 4. Refuse a Public Benefits close: Medicaid eligibility integrity analyst does not have the decision to recoup, waive, or refer turns on in issuance file-control totals that will not balance.

ANALYSIS REQUIRED 1. Match household facts in issuance file-control totals that will not balance to the rule that pays the benefit. 2. Trace the notice and appeal path Medicaid eligibility integrity analyst must preserve. 3. Test eligibility, recoupment, and improper-payment facts in issuance file-control totals that will not balance after a recoupment that would make a household homeless. 4. For this Public Benefits Trafficking and Eligibility Fraud file, read issuance file-control totals that will not balance against a recoupment that would make a household homeless and write the one fact that would move to recoup, waive, or refer for Medicaid eligibility integrity analyst.

RECOMMENDATION Choose To recoup, waive, / Refer for prosecution on this Public Benefits / Trafficking and Eligibility Fraud packet (issuance file-control totals that will not balance after a recoupment that would make a household homeless). The follow-on Trafficking and Eligibility Fraud 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 recoup, waive, or refer, then the evidence in issuance file-control totals that will not balance, then the action for Medicaid eligibility integrity analyst - Hypothesis scorecard against issuance file-control totals that will not balance: supported / rejected / untestable - Owner and next date for Medicaid eligibility integrity analyst in a child-care subsidy program with related-provider clusters - What changes to recoup, waive, or refer if a recoupment that would make a household homeless is later withdrawn