Assess whether a household is receiving duplicate subsidies (07870d)

Situation

A household is receiving sits with Medicaid eligibility integrity analyst because a TANF case with unsigned work-activity forms hit a Medicaid agency with a surge in MAGI mismatches. Evidence is recoupment aging versus collectability; write the Public Benefits Compliance and Integrity Operations option that extract can carry.

Decision

Medicaid eligibility integrity analyst in a Medicaid agency with a surge in MAGI mismatches must choose Pay or continue / Recoup / Deny / Hold using recoupment aging versus collectability after a TANF case with unsigned work-activity forms.

Hypotheses to test

• Recoupment aging versus collectability reads as Pay or continue once a TANF case with unsigned work-activity forms is lined up to the same Public Benefits population.
• Recoupment aging versus collectability is closer to Recoup after a TANF case with unsigned work-activity forms; Pay or continue would over-claim this Compliance and Integrity Operations extract.
• Deny is still live in recoupment aging versus collectability for Medicaid eligibility integrity analyst in a Medicaid agency with a surge in MAGI mismatches.
• Recoupment aging versus collectability is missing the fact Medicaid eligibility integrity analyst needs after a TANF case with unsigned work-activity forms; stop this Public Benefits close.

Analysis required

• Quantify overpayment if a household is receiving is wrong.
• Separate a case-level error from a program-design failure in a Medicaid agency with a surge in MAGI mismatches.
• Match household facts in recoupment aging versus collectability to the rule that pays the benefit.
• For this Public Benefits Compliance and Integrity Operations file, read recoupment aging versus collectability against a TANF case with unsigned work-activity forms and write the one fact that would move a household is receiving for Medicaid eligibility integrity analyst.

Recommendation

Choose Pay or continue / Recoup / Deny / Hold on this Public Benefits / Compliance and Integrity Operations packet (recoupment aging versus collectability after a TANF case with unsigned work-activity forms). The follow-on Compliance and Integrity Operations action is what Medicaid eligibility integrity analyst does next: implement the option, assign an owner, and log the missing fact.