Medicare Program Integrity Manual (Pub. 100-08), Ch. 4 § 4.4.2.2

CAP Submission

Last amended: 2022Year: 2022Length: 161 wordsOfficial source
4.4.2.2 - CAP Submission (Rev. 11218; Issued: 01-27-2022; Effective: 02-28-2022; Implementation: 02-28- 2022) The HHA must submit the CAP within 14 calendar days from the date of the MAC’s letter. In the CAP, the HHA must address the following: • A statement of the problem(s) or weakness(es) that caused the misuse of NOA identified by the MAC. • The proposed solution(s) along with other pertinent information including time frames for resolving the problem(s). • The individual responsible for monitoring the CAP who will coordinate with the MAC. • Other relevant information. If an HHA fails or refuses to submit a CAP, the MAC shall take immediate action to refer the HHA to the UPIC in accordance with Section 4.4.5. The MAC shall provide the UPICs a list of HHAs with pending or accepted CAPs on a regular basis, i.e., at least monthly. The submission or acceptance of a CAP does not preclude the UPIC from opening an investigation for potential fraud.
Medicare Program Integrity Manual (Pub. 100-08), Ch. 4 § 4.4.2.2: CAP Submission | Justis AI