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CAPS Policy – Program Integrity No.: CAPS/00-16 Effective Date: 10/01/2016 Revised: 03/02/2026 Revision Effective: 03/02/2026

CAPS Policy Manual

Page 99 of 109 Child Care Provider – Program Integrity Noncompliance Finding Allowable Sanctions Provider billed for child care during a period of time when child care services are subsidized in full as part of the parent’s employment. CAPS may recoup any payments for subsidies issued when it is discovered that an employer has covered the cost of child care.

16.5.4.4 Categories of child care provider noncompliance include provider errors and program violations. A. Provider errors are a result of unintentional submission or omission of documentation or information. (1) Provider errors identified through provider self-reporting, compliance reviews, or investigations that resulted in incorrect payment issuance will be pursued for recoupment and a claim will be established. (2) Provider errors less than $600 may be processed by CAPS. Provider errors $600 or more will be referred to DECAL’s Audits and Compliance Division for investigation. B. Program violations are the result of intentional noncompliance with CAPS policy and may result in further investigation. At DECAL’s discretion, program violations may result in mandatory training, payment suspension, payment recoupment, dismissal, or disqualification. (1) Disqualification from CAPS may jeopardize the provider’s ability to participate in other DECAL programs. (2) Program violations may be considered fraud if established by a court of jurisdiction. 16.5.4.5 If DECAL actions result in a reclaim of funds, providers may request reconsideration or an administrative hearing. The provider must request reconsideration or an administrative hearing 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 issued of the appealable action taken by DECAL. A. When a provider receives a notice for the establishment of an overpayment from DECAL or its representatives, they may submit additional documentation to support their request for payment. (1) Any request for reconsideration must be accompanied by supporting documentation. (2) Reconsideration shall only include requests for clarification or review of existing documents already submitted and shall only cover the time period and children previously reviewed. Any request for reconsideration must be accompanied by supporting documentation. (3) Reconsideration shall not include the opportunity to submit new documentation that has been previously requested but not submitted unless authorized by DECAL in writing for unique circumstances. (4) DECAL will review the reconsideration request and supporting documentation in a timely manner. After this review, the Audits and Compliance Division will send the child care provider a Reconsideration Notice notifying the provider of any change in the amount of overpayment resulting from reconsideration. B. As prescribed in CAPS Administrative Hearings Policy (CAPS/00-18), child care providers participating in CAPS have a right to request an appeal and receive a hearing regarding DECAL actions resulting in a reclaim of funds.

16.5.5 DECAL may pursue any and all legal or equitable remedies available to the CAPS program in accordance with applicable state and federal laws or regulations to collect claims in full. CAPS is responsible for pursuing, collecting, tracking, and reporting overpayments identified by DECAL or its representative. 16.5.5.1 The provider shall refund any overpayments assessed by DECAL or its representatives.