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CAPS Policy – Provider Rights and Responsibilities No.: CAPS/00-12 Effective Date: 10/01/2016 Revised: 03/02/2026 Revision Effective: 03/02/2026

CAPS Policy Manual

Page 75 of 109 A. CAPS may recoup any payments for subsidies issued when it is discovered that an employer has covered the cost of child care.

12.4.12 Change in Provider Rates 12.4.12.1 If a provider changes its rates, rates must be updated in the CAPS administration and payment system. CAPS will make adjustments to child care scholarships according to the new rates no later than 30 calendar days after rates have been provided. 12.4.13 Invoices 12.4.13.1 All child care providers must submit invoices electronically through the CAPS administration and payment system. Any child care provider that does not submit invoices through the CAPS administration and payment system will not receive its reimbursement and may not participate in the CAPS program. 12.4.13.2 The provider shall submit invoices that accurately report information about attendance in the CAPS administration and payment system within 60 calendar days of providing services. Invoices not submitted within 60 calendar days of service will delay payments to the provider. Invoices submitted after 90 calendar days of services will not be processed for payment and will not be reimbursed. 12.4.13.3 Payments of all invoices submitted by the provider that have been identified by the CAPS administration and payment system to have a potential billing error will be placed on a temporary hold for further review and verification by CAPS and may be subject to adverse action. Any adjustments of future payments that are made as a result of internal or provider error, intentional or not, are not appealable. 12.4.13.4 Invoices that are determined to be inaccurate, misleading, or false shall be subject to recoupment, sanctions up to and including dismissal and disqualification from CAPS, or may be referred for investigation or prosecution. 12.4.14 Overpayments 12.4.14.1 The provider shall refund any overpayments assessed by DECAL or its representatives. Overpayments may include any amounts received in error as a result of the provider’s error or automation error. 12.4.14.2 The CAPS program may offset all future subsidy payments until the overpayment is paid in full or pursue any and all legal actions DECAL deems appropriate which are permissible under state and federal law to recover overpayments. 12.4.14.3 The provider shall assume responsibility for all billing to the CAPS program and is legally responsible for overpayments resulting from erroneous billing and inaccurate invoices. Providing billing passwords and identification access to others does not reduce accountability or repayment of any overpayments resulting from incorrect billing. 12.4.14.4 Payment disputes, questions, and concerns can be addressed through CAPS. Providers must request an appeal in writing. The written request must be postmarked by the deadline listed on the notice or within 14 calendar days from the date of the notice on an appealable or adverse action taken by DECAL. Refer to the CAPS Administrative Hearings Policy (CAPS/00-18). 12.4.15 Adverse Actions 12.4.15.1 Adverse actions are penalties for noncompliance with CAPS policies and rules, including sanctions for program integrity violations and enforcement actions related to health and safety standards. A. Suspension refers to payments on an active scholarship placed on hold for a specified period of time as determined by DECAL. Payments to a provider will be suspended for: