Assess whether a policy change would reduce error without harming access

Situation

A policy change would sits with Medicaid eligibility integrity analyst because a hearing officer reversing 40% of trafficking cases hit a Medicaid agency with a surge in MAGI mismatches. Evidence is issuance file-control totals that will not balance; 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 issuance file-control totals that will not balance after a hearing officer reversing 40% of trafficking cases.

Hypotheses to test

• Authorize Pay or continue now; issuance file-control totals that will not balance already has the discriminator after a hearing officer reversing 40% of trafficking cases.
• Keep Recoup in force until issuance file-control totals that will not balance is completed after a hearing officer reversing 40% of trafficking cases for Medicaid eligibility integrity analyst.
• Treat issuance file-control totals that will not balance as Deny because both readings appear after a hearing officer reversing 40% of trafficking cases.
• Refuse a Public Benefits close: Medicaid eligibility integrity analyst does not have the page a policy change would turns on in issuance file-control totals that will not balance.

Analysis required

• Quantify overpayment if a policy change would 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 issuance file-control totals that will not balance to the rule that pays the benefit.
• For this Public Benefits Compliance and Integrity Operations file, read issuance file-control totals that will not balance against a hearing officer reversing 40% of trafficking cases and write the one fact that would move a policy change would for Medicaid eligibility integrity analyst.

Recommendation

Choose Pay or continue / Recoup / Deny / Hold on this Public Benefits / Compliance and Integrity Operations packet (issuance file-control totals that will not balance after a hearing officer reversing 40% of trafficking cases). Lead with the Public Benefits option issuance file-control totals that will not balance can support after a hearing officer reversing 40% of trafficking cases, then the two facts that force it, then the Monday action for Medicaid eligibility integrity analyst in a Medicaid agency with a surge in MAGI mismatches.