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MS 0390 [1]

Volume 1 – General Administration MS 0390 – R. 6/1/26 – OMTL – 697 Refusal to Cooperate with Quality Control (QC)

[If form QC-343, Review Finding Notification, indicates an individual refused to cooperate with QC, take the following action:

A. For Medicaid:

1. The QC analyst sends the individual an appointment letter advising them that an analyst will call them at the time specified in the letter. While there are no sanctions or disqualifications placed against a recipient who refuses to cooperate with a Medicaid QC review, QC can ask for the case to be discontinued for failure to complete their eligibility review. When notified by QC that a Medicaid recipient failed to comply, discontinue their case using the non-cooperation option in the Withdrawal module.

2. If the Medicaid case discontinues due to not complying with QC, the Medicaid recipient may reapply at any time, following normal application policy, verification requirements, and procedures. There is no time frame the recipient must wait before reapplying for Medicaid.

B. For Kentucky Transitional Assistance Program (KTAP) and Kentucky Works Program (KWP), the QC analyst conducts a desk review of KTAP and/or KWP cases. No recipient interview is required; therefore, the cooperation of the recipient is not required, and no penalties are imposed.

C. For Kinship Care, the QC analyst contacts the household to request certain verifications and acquires independent verifications. There are no sanctions placed against a recipient who refuses to cooperate with the Kinship Care QC review.

D. For Supplemental Nutrition Assistance Program (SNAP):

1. If a household refuses to cooperate with the QC analyst in completing the case review, disqualify the household from further participation until the household cooperates with QC and provides the necessary information to complete the review.

a. When notified by QC that a household has refused to cooperate, enter a disqualification on the individual who refused to comply with QC. QC will identify this person on form QC-343. If QC cannot determine which member refused to cooperate, apply the disqualification to the head of household. Document this in case notes.

b. Once the disqualification has been applied, Worker Portal discontinues the case and issues a notice to the household, indicating the household’s refusal to cooperate as the reason for termination or denial of benefits, and states the actions the household must take if it wishes to reapply and cooperate.