Whether identity proofing exceptions are being abused from identity-proofing

Situation

A thousand UI claims from one IP block put identity-proofing exception queue in front of Medicaid eligibility integrity analyst in a child-care subsidy program with related-provider clusters. This Public Benefits / Trafficking and Eligibility Fraud close is identity proofing exceptions are from identity-proofing exception queue, and the live options are Pay or continue, Recoup, Deny.

Decision

Medicaid eligibility integrity analyst in a child-care subsidy program with related-provider clusters must choose Pay or continue / Recoup / Deny / Hold using identity-proofing exception queue after a thousand UI claims from one IP block.

Hypotheses to test

• Identity-proofing exception queue reads as Pay or continue once a thousand UI claims from one IP block is lined up to the same Public Benefits population.
• Identity-proofing exception queue is closer to Recoup after a thousand UI claims from one IP block; Pay or continue would over-claim this Trafficking and Eligibility Fraud extract.
• Deny is still live in identity-proofing exception queue for Medicaid eligibility integrity analyst in a child-care subsidy program with related-provider clusters.
• Identity-proofing exception queue is missing the fact Medicaid eligibility integrity analyst needs after a thousand UI claims from one IP block; stop this Public Benefits close.

Analysis required

• Quantify overpayment if identity proofing exceptions are is wrong.
• Separate a case-level error from a program-design failure in a child-care subsidy program with related-provider clusters.
• Match household facts in identity-proofing exception queue to the rule that pays the benefit.
• For this Public Benefits Trafficking and Eligibility Fraud file, read identity-proofing exception queue against a thousand UI claims from one IP block and write the one fact that would move identity proofing exceptions are for Medicaid eligibility integrity analyst.

Recommendation

Choose Pay or continue / Recoup / Deny / Hold on this Public Benefits / Trafficking and Eligibility Fraud packet (identity-proofing exception queue after a thousand UI claims from one IP block). Lead with the Public Benefits option identity-proofing exception queue can support after a thousand UI claims from one IP block, then the two facts that force it, then the Monday action for Medicaid eligibility integrity analyst in a child-care subsidy program with related-provider clusters.