Assess whether a provider's attendance is fabricated (e038c8)

Situation

The Compliance and Integrity Operations desk packet is housing overlapping-address and income file after a provider billing full-time care during school hours. Issuance-system integrity manager in a child-care subsidy program with related-provider clusters must name Pay or continue or Recoup for this Public Benefits file. Issuance-system integrity manager in a child-care subsidy program with related-provider clusters has to name Pay or continue or Recoup for this Public Benefits Compliance and Integrity Operations file.

Decision

Issuance-system integrity manager in a child-care subsidy program with related-provider clusters must choose Pay or continue / Recoup / Deny / Hold using housing overlapping-address and income file after a provider billing full-time care during school hours.

Hypotheses to test

• The population in housing overlapping-address and income file is the one a provider billing full-time care during school hours named, so Pay or continue follows for this Compliance and Integrity Operations file.
• The population in housing overlapping-address and income file is adjacent only to a provider billing full-time care during school hours; Recoup is the honest Public Benefits call.
• A child-care subsidy program with related-provider clusters already contained a provider billing full-time care during school hours before housing overlapping-address and income file arrived; no new Compliance and Integrity Operations path.
• Provenance on housing overlapping-address and income file after a provider billing full-time care during school hours is broken; do not pick Pay or continue or Recoup yet.

Analysis required

• Match household facts in housing overlapping-address and income file to the rule that pays the benefit.
• Trace the notice and appeal path issuance-system integrity manager must preserve.
• Test eligibility, recoupment, and improper-payment facts in housing overlapping-address and income file after a provider billing full-time care during school hours.
• For this Public Benefits Compliance and Integrity Operations file, read housing overlapping-address and income file against a provider billing full-time care during school hours and write the one fact that would move a provider's attendance is for issuance-system integrity manager.

Recommendation