FAA6.F Administrative : 04 Quality Control (QC) - Overview : A Quality Control (QC) - Performance Reporting
A Quality Control (QC) - Performance Reporting
States are required to provide for a continuing system of Quality Control (QC) in accordance with federal and state regulations. The QC system operates under policies and procedures outlined in QC manuals issued by appropriate federal departments.
From analysis of QC review information, it is possible to make accurate assessments about the accuracy of eligibility determinations and benefit payment levels.
Federal and State regulations require the following:
Sampling methods and schedules to select cases to review (including QC negative case actions)
Field investigations to be conducted by QC staff (including face-to-face contact for cases under review)
Corrective action to be taken on all improperly authorized or denied cases (including determining cause and prevention of improper actions)
Information to be reported to the appropriate federal departments from QC review findings, for statistical analysis purposes
The Quality Support Team (QST) is responsible for completing the following:
Establishing methods for random sampling selection of cases and reviewing the cases for accuracy of the eligibility determination and benefit levels
Root cause analysis to prevent future occurrences
Reporting results of QC review findings to the appropriate federal departments
QST documents case review findings on the Quality Control Case Review Report (QC‑100). The QC‑100, which contains information related to error elements, is forwarded to appropriate local offices as applicable.
QST also documents the QC‑100 when an error that is not countable is found or other information is discovered that could affect benefit months other than the review month.