Synthetic demonstration data — State of Cascadia is fictional. Methodology is real.
SEAM FINDER
Provenance Advisors
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Federal reporting / audit reconstruction failure

Point-in-Time Reconstruction Failure

12,081
Members affected
$20.2M
Estimated exposure
6.7
Avg months at risk
$15.1M–25M
Exposure range

What this is

Members whose current record looks compliant, but whose span history contains overlapping or retroactively edited spans with no audit trail — the state cannot reproduce what eligibility was on a given past date.

Why single-system review misses this

Every current-status report passes. The break only appears when you ask the historical question federal auditors ask: what was this member's eligibility on date X?

One member, two systems

Member CAS-00000187 — the eligibility record and the payment record, on one clock. The hatched window is the seam.

CBES eligibility spanMMIS enrollment spanthe seam — history cannot be reconstructed
2023202420252026History cannot be reconstructed — 6.4 mo≈ $711/mo at riskvendor cutover 10/25run date 06/26CBESeligibilityMMISpaymentCBES TANF-CHILD · Firlands County · 2022-07-07 → 2024-03-22TANF-CHILDCBES FOSTER-CARE · Firlands County · 2023-08-22 → 2024-03-04FOSTER-CARECBES TANF-CHILD · Firlands County · 2024-10-15 → openTANF-CHILDMMIS TANF-CHILD · Pacifica Health · CASCADE_LEGACY · 2022-07-07 → 2024-03-22 · capitation YTANF-CHILD · LEGACYMMIS TANF-CHILD · Pacifica Health · MERIDIAN · 2024-10-15 → open · capitation YTANF-CHILD · MERIDIAN≈ $711 paid this month≈ $711 paid this month≈ $711 paid this month≈ $711 paid this month≈ $711 paid this month≈ $711 paid this month

The exposure math, in the open

members × avg monthly capitation × avg ambiguous months × 35% at-risk factor

12,081members×$711avg per month×6.7avg months≈$20.2Mestimated exposure
Example members:CAS-00000187CAS-00000197CAS-00000616CAS-00000963CAS-00001709