Corrective Action Plan Template And Instructions Page 11


Payment Error Rate Measurement (PERM)
Medicaid Evaluation of Previous Cycle Corrective Actions
A. (State)
Fiscal Year:
B. State Contact: ______________________________
Phone number: _________________________
Email address: _________________________
D. Component (fee-for-service, managed care, eligibility) ______________________
E. Medicaid Narrative:
For each corrective action listed in the states previous cycle CAP, specify whether the action was
implemented or not implemented:
 For implemented corrective actions:
 Specify when the action was implemented and whether it was implemented in
accordance with the original schedule
 Discuss the status of the corrective action. Specify if the action is complete, in
progress, ongoing, etc. Provide the expected completion date and whether or not
progress is on target
 Evaluate the effectiveness of the corrective action using concrete data. Define the
methods and procedures used for evaluation purposes
 For short term corrective actions be sure to discuss the findings and for long term
corrective actions be sure to provide a status
 For actions not implemented:
 Discuss why the action was not implemented
 Specify whether the action was discontinued, modified, terminated, or replaced with
another corrective action
Include an overall discussion of your state’s ability to meet PERM error rate targets and whether
or not your state was satisfied with the results.


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