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OBSOLETE POLICY CHIP MANUAL |
End Date: June 30, 2011
Agency errors are the result of mistakes made by case managers in determining eligibility. They include:
A. Applying policy incorrectly.
B. Improper coding or incorrect information in PACMIS.
Inadvertent errors occur when the enrollee or their representative unintentionally provides incorrect information or fails to report information that affects eligibility.
Intentional violations are when a enrollee or his representative deliberately provides incorrect or misleading information or intentionally fails to report information that affects eligibility. Some intentional violations are:
A. Making false or misleading statements
B. Misrepresenting, concealing, or withholding facts
C. Intentionally receiving CHIP coverage for which the enrollee or representative knows he is not eligible.
D. Intentionally failing to report when a child obtains health insurance coverage.