The Documentation Gap: Reducing Medicaid & SNAP Error Rate Risk for Counties

Most Medicaid improper payment findings and SNAP payment errors aren’t fraud — they’re missing documentation. This guide shows county human services agencies how to reduce Medicaid and SNAP error rate risk before H.R. 1 penalties take effect in 2028.

• Why 81% of Medicaid improper payments trace back to documentation, not eligibility errors — and what that means for your county’s exposure
• How H.R. 1 turns error rates into repayment liability — and where your state likely stands against the new 3% and 6% thresholds
• Why the work happening isn’t the same as the system knowing it happened — and what a locked, timestamped review record actually looks like
• How findings get lost between email, spreadsheets, and a supervisor’s memory — and what it looks like to own that process instead of tracking it after the fact
• How one county closed its documentation gap — starting with the exact problem this guide solves

Own the record, not just the outcome.

Quality review runs on complex coordination — case selection, findings, corrections, rebuttals — often across teams and spreadsheets that were never built to run that work. So the proof auditors ask for ends up in inboxes and someone’s memory instead of the system. The record goes dark, and when an experienced supervisor leaves, the knowledge of how review actually works leaves with them.

SimpliGov is the government operations platform where agencies design, run, and improve how their programs operate. The teams who run quality review build and adapt it themselves — no dependency on outside consultants, no waiting on an IT backlog. When state criteria change, they update the process in days, not the next budget cycle.

The documentation gap closes exactly where ownership starts.