Effective Date: July 1, 2022
Previous Policy
The Department of Workforce Services Internal Audit Division (DWS IAD) conducts reviews of medical assistance cases to determine the accuracy and quality of eligibility decisions made by the eligibility agency, and the accuracy of payments made by DWS IAD.
Applicants and recipients of medical assistance will be asked to cooperate with DWS IAD and the eligibility agency to complete these quality reviews.
1. DWS IAD may contact an applicant or recipient as part of a quality review.
2. The applicant or recipient will be asked to provide complete and accurate information about factors related to the individual's application, medical services received or eligibility.
3. DWS IAD may ask the applicant or recipient to provide verifications of the information being reviewed. The applicant or recipient will be asked to provide any requested information to DWS IAD within 10 days of the request. Do not close the case if the applicant or enrollee does not provide the requested information.