Assess whether to recoup, waive, or refer for prosecution (0615c7)

SITUATION Recoupment and Policy work in a Medicaid agency with a surge in MAGI mismatches now turns on to recoup, waive, or refer because an issuance file that is 1,104 issuances over control put TANF work-hours that cannot be corroborated in play. Issuance-system integrity manager should say what TANF work-hours that cannot be corroborated proves.

DECISION Issuance-system integrity manager in a Medicaid agency with a surge in MAGI mismatches must choose To recoup, waive, / Refer for prosecution using TANF work-hours that cannot be corroborated after an issuance file that is 1,104 issuances over control.

HYPOTHESES TO TEST 1. The population in TANF work-hours that cannot be corroborated is the one an issuance file that is 1,104 issuances over control named, so To recoup, waive, follows for this Recoupment and Policy file. 2. The population in TANF work-hours that cannot be corroborated is adjacent only to an issuance file that is 1,104 issuances over control; Refer for prosecution is the honest Public Benefits call. 3. A Medicaid agency with a surge in MAGI mismatches already contained an issuance file that is 1,104 issuances over control before TANF work-hours that cannot be corroborated arrived; no new Recoupment and Policy path. 4. Provenance on TANF work-hours that cannot be corroborated after an issuance file that is 1,104 issuances over control is broken; do not pick To recoup, waive, or Refer for prosecution yet.

ANALYSIS REQUIRED 1. Separate a case-level error from a program-design failure in a Medicaid agency with a surge in MAGI mismatches. 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 issuance-system integrity manager must preserve. 4. For this Public Benefits Recoupment and Policy file, read TANF work-hours that cannot be corroborated 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 issuance-system integrity manager.

RECOMMENDATION Choose To recoup, waive, / Refer for prosecution on this Public Benefits / Recoupment and Policy packet (TANF work-hours that cannot be corroborated after an issuance file that is 1,104 issuances over control). Lead with the Public Benefits option TANF work-hours that cannot be corroborated can support after an issuance file that is 1,104 issuances over control, then the two facts that force it, then the Monday action for issuance-system integrity manager in a Medicaid agency with a surge in MAGI mismatches.

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 issuance-system integrity manager - Hypothesis scorecard against TANF work-hours that cannot be corroborated: supported / rejected / untestable - Missing page in TANF work-hours that cannot be corroborated after an issuance file that is 1,104 issuances over control, if any - Regulatory or exam hook Recoupment and Policy would cite