Article 10 Section 4 Results and Required Responses

 

Table of Contents
 

Title

PG Cite

General

10.04.01A

Corrective Action

10.04.01B

Due Date Extension

10.04.01C

Required Response

10.04.01D

 

10.04.01 Results and Required Responses

 

10.04.01A
General

The appropriate HHSA office must:

   Review all QC error citations;

   Make all necessary corrective actions; and

   Respond to QC providing any necessary documentation along with response.

 

CMSPG LTR 13 (03/12)

 

10.04.01B
Corrective Action

The worker must take the necessary actions to correct all Benefit/Eligibility and Procedural errors cited. Corrective actions must be taken by the response due date noted on the Print Case Review form.

 

The worker will not change a certified case to a denied case when QC discovers that eligibility was certified erroneously.  Certification periods shall be terminated as outlined in the appropriate program material for the designated program.

 

CMSPG LTR 13 (03/12)

 

10.04.01C
Due Date Extension

Extensions will be considered if the request is received prior to the response due date noted on the Print Case Review form. The CAS must contact the QC Supervisor to request an extension.

 

CMSPG LTR 13 (03/12)

 

10.04.01D
Required Response

The appropriate HHSA office shall:

   Provide the QC response by the designated due date; and

   Include supporting documentation to indicate the error has been corrected.

 

CMSPG LTR 13 (03/12)