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Department of Human Services
Michelle R.B. Saddler, Secretary
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WAG 22: Related Program Provisions
WAG 22-09-00: Quality Control (Medicaid, SNAP)
PM 22-09-00
(BSNAPI/BMI)
Sends the FCRC notification of the cases to be reviewed at least 3 workdays before the date case records will be audited.
Notifies the client of the interview location, date, and time. The notice lists the documents and verifications needed from the client to complete the review.
(QC Liaison)
Pulls the complete case record for QC review. Documents needed include:
Earned Income Redetermination Application (Form 4765);
Notice of Change (Form 157);
Instructions to Client (Form 267);
Action Taken on Your SNAP Case (Form 360A);
Information on Case History (Form 514), with most recent recordings;
Authorization of Assistance Action (Form 552), covering the month of review;
Worksheets for TANF computations, if manually completed;
Redetermination Report Form (Form 643);
Redetermination Report Form (Form 643CF), most recent before review date;
TANF Eligibility Information (Form 4002);
Application for Food Stamps (Form 683);
SNAP Eligibility Worksheet (Form 683A);
SNAP Calculation Sheet (Form 683B)
or the ACM SNAP Calculation if saved in Content Management;
Determination of Monthly Income from Self-Employment (Form 683C);
Summary of Case Information (Form 1376 or Form 1376C), if applicable;
Continuing Your SNAP Benefits (Form 1979);
Notice of Decision in Response to Reported Change in Household Circumstances - SNAP (Form 1988);
Redetermination of Eligibility (Form 2027), most recent before review date;
Either a printout of Summary Data and Actual Screens (ACM Form 2201), or the Earned Income Verification Record (manual Form 2201), for cases with earned income;
Long Term Care Authorization (Form 2299), if applicable;
Request for Financial Assistance - Medical Assistance - SNAP (Form 2378C), for most recent application
if saved in Content Management;
AABD MANG Computation Sheet - Community Case (Form 2382A);
Long Term Care/Supportive Living Facility Resource Calculation (Form 2500);
Record of Medical Expenses - MANG Spenddown (Form 2430SP);
Summary of Medical Expenses - Spenddown (Form 2430ASP);
Long Term Care Update Authorization Document (Form 2449), if applicable;
Shelter Arrangement - Change of Address Worksheet (Form 2467);
any centrally generated client notice sent for the month of review:
a copy of the "IM Change Notices Issued Centrally/Intake Notices Issued Centrally" listing for the client notice under review, or
Form 552 used to process the action, or
ACID clearing showing the action taken;
most current BENDEX report, if applicable;
information not yet filed in the case record;
other information that documents eligibility and issuance for the review month.
(BSNAPI/BMI)
Returns the case material to the FCRC when the review is finished.
(BSNAPI/BMI)
Notifies FCRC Administrator of additional items that were needed from the case file but not located or received.
Related Links
WAG 22-09-01: Family Community Resource Center Role
WAG 22-09-02: Corrective Action
WAG 22-09-03: Refusing to Cooperate With QC Review (FS)
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