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