Assess whether UI claims are a ring or copy-cat filings (d497b9)

Situation

A thousand UI claims from one IP block put identity-proofing exception queue in front of Medicaid eligibility integrity analyst in a Medicaid agency with a surge in MAGI mismatches. This Public Benefits / Compliance and Integrity Operations close is UI claims are a from identity-proofing exception queue, and the live options are UI claims are a ring, Copy-cat filings.

Decision

Medicaid eligibility integrity analyst in a Medicaid agency with a surge in MAGI mismatches must choose UI claims are a ring / Copy-cat filings using identity-proofing exception queue after a thousand UI claims from one IP block.

Hypotheses to test

• Identity-proofing exception queue reads as UI claims are a ring 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 Copy-cat filings after a thousand UI claims from one IP block; UI claims are a ring would over-claim this Compliance and Integrity Operations extract.
• A dual reading is still live in identity-proofing exception queue for Medicaid eligibility integrity analyst in a Medicaid agency with a surge in MAGI mismatches.
• 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

• Test eligibility, recoupment, and improper-payment facts in identity-proofing exception queue after a thousand UI claims from one IP block.
• Quantify overpayment if UI claims are a is wrong.
• Separate a case-level error from a program-design failure in a Medicaid agency with a surge in MAGI mismatches.
• For this Public Benefits Compliance and Integrity Operations file, read identity-proofing exception queue against a thousand UI claims from one IP block and write the one fact that would move UI claims are a for Medicaid eligibility integrity analyst.

Recommendation

Choose UI claims are a ring / Copy-cat filings on this Public Benefits / Compliance and Integrity Operations packet (identity-proofing exception queue after a thousand UI claims from one IP block). 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.