Quality Assurance - Control (QA - QC) 448-01-55-10

Purpose of Quality Assurance - Control (QA - QC) 448-01-55-10-05

(Revised 12/1/12 ML #3352)   

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The North Dakota Department of Human Services, Economic Assistance Policy Division includes a QA - QC unit in accordance with state and federal regulations to provide data on the accuracy for SNAP and Medicaid eligibility and issued benefits amounts. The QA - QC unit also reviews CCAP, LIHEAP, and TANF eligibility and issued benefit amounts in accordance with state CCAP, LIHEAP, and TANF policy. The data is used to determine program accuracy rates, as a management tool by state and federal administrators and a fiscal audit to validate expenditures.

 

QA - QC is a continuous review of a statistically valid, reliable, statewide random sample of active and negative (closed or denied) SNAP and Medicaid cases and active CCAP, LIHEAP, and TANF only cases. SNAP cases are also reviewed for timeliness of application processing. The review process includes:

 

• Review of case files

 

• Recipient interviews

 

• Collateral contacts to verify elements of eligibility defined by federal regulations, taking into account all approved waivers and State options that have been implemented at the time of sampled review month.

 

The U.S. Department of Agriculture (USDA) subsequently completes a re-review of a portion of sampled cases and annually completes a SNAP QC management review. The Centers for Medicare and Medicaid Services (CMS), periodically completes Medicaid QC management reviews.