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

SITUATION The working file is TANF work-hours that cannot be corroborated after a thousand UI claims from one IP block. Medicaid eligibility integrity analyst in a child-care subsidy program with related-provider clusters has to name To recoup, waive, or Refer for prosecution for this Public Benefits 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 TANF work-hours that cannot be corroborated after a thousand UI claims from one IP block.

HYPOTHESES TO TEST 1. Medicaid eligibility integrity analyst can defend To recoup, waive, from TANF work-hours that cannot be corroborated after a thousand UI claims from one IP block in a Public Benefits challenge. 2. Medicaid eligibility integrity analyst cannot defend To recoup, waive, from TANF work-hours that cannot be corroborated; Refer for prosecution is what the extract actually supports after a thousand UI claims from one IP block. 3. A thousand UI claims from one IP block never reached the population in TANF work-hours that cannot be corroborated — reopen intake, do not close to recoup, waive, or refer. 4. Two facts in TANF work-hours that cannot be corroborated after a thousand UI claims from one IP block conflict for Medicaid eligibility integrity analyst; hold this Trafficking and Eligibility Fraud file.

ANALYSIS REQUIRED 1. Separate a case-level error from a program-design failure in a child-care subsidy program with related-provider clusters. 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 Trafficking and Eligibility Fraud file, read TANF work-hours that cannot be corroborated against a thousand UI claims from one IP block 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 (TANF work-hours that cannot be corroborated after a thousand UI claims from one IP block). 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 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 - Missing page in TANF work-hours that cannot be corroborated after a thousand UI claims from one IP block, if any - Regulatory or exam hook Trafficking and Eligibility Fraud would cite