CMS 2010 Medicaid Improper Payment Report 10-2011 GAO Highlights States, Partnership Fund as Examples of Efficiency Mechanisms 09-30-11 TANF GAO AuditResponse 08-2-11 Letter objecting to proposed steps required of states wishing to make "major changes" in SNAP administrative systems 07-5-2011 Letter Concannon QC Negative Error Process 9-23-10
QC in TANF
Some states adopted quality control reviews in the state's TANF program as means to measure performance and remain accountable for the block grant funds.
The sampling processes, use of the data, and QC methods, including requiring home visits, vary in the states performing TANF quality control.
Which states are doing TANF quality control? Results of NAPIPM Survey of States Performing QC in TANF updated June 2006.
If your state plans to adopt QC in TANF and needs more information contact us at firstname.lastname@example.org.
Quality Control and Child Care Programs
NOTES FROM IMPROPER PAYMENT TELECONFERENCE - 5/26/05
Four sites across the country are conducting random audits on 150 cases (Arkansas, Colorado, Ohio, and Illinois). Some audits took an hour, some over 4 hours. Most states looked at eligibility for that month going back up to 6 months.
They are looking at the feasibility of establishing a national error rate and what the cost would be. The federal error rate will most likely look at the number of errors in the case and the dollar amount resulting from the errors. At this time:
- There is no decision to make SSN a federal requirement for child care cases.
- There is no intention of imposing a penalty for errors found.
- It is unknown when the start date of a federal error rate will begin or how long states will have to implement changes.
At the SAMS conference there will be a technology fair August 10-11.
Arkansas looked at cases from October 2004. Many cases had missing documents.
- 85 cases were from clients with a lifetime limit of 2 years or 3 years. Only 39 of 85 records were without an error.
- 65 cases clients with low income. Five or fewer of these cases had an error.
Colorado found many items missing from the file such as signatures and income documentation. Their child care caseload is 22% TANF and 78% Non-TANF. They tried to make their audit numbers respective to the caseload percentages. In their audit process they double checked reported earnings and that the client was in actually in school if this was their reported activity.
Ohio started an imaging project so had trouble seeing hard copies until they were imaged from the warehouse. They found some areas were allowing providers to help clients complete applications and send it in electronically without required signatures. They are considering removing the original signature requirement. They are looking at revising some policies for errors found.
Illinois found documentation missing such as stubs and applications. Also copayments were not accurately assessed.Next call is 8/25/05
NOTES FROM IMPROPER PAYMENT TELECONFERENCE: CHILD CARE 3/14/05
Sponsored by ACF/Child Care Bureau
Mary Jo Thomas discussed upcoming state survey. It was expected to be approved by OMB and out before now, so not sure when it actually will go out. Survey is for state CC administrators.
Mary Jo discussed a 4-state study to determine the statewide error rate. It is based on eligibility. AR, IL, OH, and CO are the 4 states involved. CO elected to do a stratified sample, and the 3 others are doing a statewide sample. Each will look at 150 cases, giving a 95% confidence level. Desk review is the requirement. States can elect to do more than a desk review to validate findings or to obtain more info on cases that lack info. The sample month is October 2004. Hopes to draw more states into the study in phase II. Mary Jo states the study will be done in June 2005. Already have a web site on the project and will be posting information on the study (and on the survey). The report is due to OMB by September, but right now is identified as an internal document until cleared by OMB for publishing. Mary Jo said they had several states beyond these 4 who volunteered, and she appreciated the interest.
The folks from NY debated that some state eligibility requirements may be different than others so how can you compare an error rate?
For the first time the State Plan Pre-Print will include an error rate statement. The final document should be to states early May. States can go ahead and use their draft Pre-Print as final isn’t significantly changed.
Elaine Ryan discussed concerns about the impact to discretionary funds when used for studies or other new QA efforts to assess program integrity. Mary Jo appreciated the concerns, and seeks info from states on data already out there. They are very much aware of burden to add data reporting requirements.