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MS 0360 [1] Volume 1 – General Administration MS 0360 – R. 6/1/26 – OMTL – 697 The Quality Control (QC) System

[The state is federally required to provide a system of QC to ensure Supplemental Nutrition Assistance Program (SNAP), Medicaid benefits, Child Care Assistance Program (CCAP), and Kentucky Transitional Assistance Program (KTAP) are issued correctly. Penalties are imposed on any state that does not substantially reduce the error rate as determined by the QC process. The reviews are completed by QC analyst staff within the Office of Program Performance, with some second-level reviews completed by federal personnel. Sample cases are chosen monthly by means of systematic random sampling and are reviewed in depth to substantiate the worker's determination of eligibility and computation of the benefit allotment.

A. A QC review consists of:

1. Analysis of the case record, including adequacy of each step taken by the agency in the process of determining eligibility and the benefit allotment;

2. Interviews with benefit recipients either in person or by phone, including voice or video calls with the individual's consent.

3. Other investigations, including any collateral contacts necessary to ensure documentation of all eligibility factors and the accuracy of the benefit allotment; and

4. Preparation of form QC-343, Review Findings Notifications, as appropriate, to list errors and related observations, if any.

a. A positive QC error exists when the household receives an incorrect benefit allotment for any reason, resulting in either an over- or under- issuance of benefits. A positive QC error would also include households that were totally ineligible for benefits. These errors can be attributed to either the agency’s action or failure to act, or a household-related action.

Example: The household received $300 in benefits for the month of March. A QC review found that during the March SNAP application interview, the household failed to report their wages and exceeded the SNAP income limit for the application month.

b. A Case and Procedural Error Rate (CAPER) QC error would include when a case is denied or discontinued incorrectly, incorrect notices are issued to a household, the agency took incorrect action during certification, denies the case for incorrect reasons, etc.