Cooperating With Quality Control (QC)
This subject contains information about the Quality Control review process for NA.
Policy
Arizona is responsible to conduct Quality Control (QC) reviews in accordance with federal and state regulations to ensure proper NA benefits are being provided.
The budgetary unit is required to cooperate with requests from the Office of Program Evaluation (OPE) and FAA during the QC review process, regardless of their reporting requirements. Not cooperating with the QC process can result in the NA benefits being denied or stopped and can delay future application processing. A notice is sent to the budgetary unit with QC contact information. The budgetary unit can also contact the QC main line at (602) 255-4100 to cooperate with the QC process.
Federal regulations require all of the following:
●Sampling methods and schedules to select cases for QC review.
●Field investigations to be conducted by OPE staff.
●Corrective action to be taken on all improperly authorized or denied cases, including determining the cause and prevention of improper actions.
●Information to be reported to the appropriate federal departments from QC review findings, for statistical analysis purposes.
The QC review process is completed by the OPE and consists of all of the following:
●Completing the case review process.
●Documenting the findings on the Quality Control Review Reports (QC-100).
●Notifying the appropriate FAA office of the finalized QC-100 and verification documents.
Review of the QC-100 allows the state to assess the accuracy of eligibility determinations and benefits levels.
OPE reviews all of the following types of cases:
●Nutrition Assistance Actives (NAA) – cases that are in an open status.
●Case and Procedural Error Rate (CAPER) – NA cases that are denied, closed, and approved for zero-dollar ($0) benefits. Cases that are closed and then reopened due to the participant requesting an appeal and continued benefits are also considered a CAPER.
The budgetary unit is considered not cooperating with OPE when any of the following occur:
●The budgetary unit fails to cooperate when any of the following occur:
The budgetary unit is unaware that QC is attempting to contact them to complete the QC review of their case.
QC is attempting to contact a third-party source to complete the QC review of their case and is unsuccessful.
The budgetary unit is unable to provide verification to OPE from a third-party source and informs OPE of the situation.
●The budgetary unit refuses to cooperate when the budgetary unit is aware that QC is attempting to complete a review of their case but refuses to take the necessary actions to assist QC in completing the review.
After a budgetary unit refuses to cooperate, FAA cannot authorize benefits until notification is received from OPE that the budgetary unit has cooperated with the QC review. A budgetary unit selected for a QC review can only be approved for benefits when one of the following occurs:
●OPE confirms that the budgetary unit cooperated with the QC review and all eligibility factors are verified.
●When the non-cooperating budgetary unit reapplies on or after February 3rd of the following Federal Fiscal Year (October 1 through September 30), and all eligibility factors are verified. (See Example 1)
Verification
The participant has the primary responsibility for providing verification. (See Participant Responsibilities – Providing Verification for additional policy.)
The Quality Control (QC) process requires verification of all eligibility factors. See Eligibility Factors Table (CA NA) and select the eligibility factor for acceptable verification sources.
Examples
1) Federal Fiscal Year (FFY) runs from October 1st through September 30th. A case selected for a Quality Control (QC) review for the sample month of November 2022 (FFY 2023). The non-cooperative budgetary unit can reapply for NA benefits on or after 02/03/2024.
A case selected for a QC review for the sample month of August 2023 (FFY 2023). The non-cooperative budgetary unit can reapply for NA benefits on or after 02/03/2024.
A case selected for a QC review for the sample month of October 2023 (FFY 2024). The non-cooperative budgetary unit can reapply for NA benefits on or after 02/03/2025.
Legal Authorities
7 CFR 273.2(a)(1)
7 CFR 273.2(d)(2)
7 CFR 273.2(e)(1)
7 CFR 275.10
45 CFR 206.10(a)(2)(i)
last revised 04/22/2024