Corrective Action Plan Template And Instructions Page 8


Payment Error Rate Measurement (PERM)
CHIP Detailed Corrective Action Plan
A. (State)
Fiscal Year:
B. State Contact: ______________________________
Phone number: _________________________
Email address: _________________________
C. Component (fee-for-service, managed care, eligibility) ______________________
D. CHIP Narrative:
 Data Analysis: (address all errors by listing by clusters of errors, causes, characteristics, and
nature of each error).
Error Element:
 Program Analysis: This is the most critical part of the corrective action process. Describe
why a particular program/operational procedure caused the error and identify the root causes
of errors.
Specific Causes:
Root Causes of Errors:
 Corrective Action Planning: Identify the corrective actions planned for major error causes.
For each corrective action planned, describe the expected results. Based on the data and
program analysis, States must determine what corrective actions are to be implemented.
States must address each payment error, deficiency/technical error, and case error, however,
it remains the State’s decision which corrective actions they take to decrease or eliminate
errors. It may not be cost effective to implement corrective actions for each and every error.
States are encouraged to use the most cost effective corrective actions that can be
implemented to best correct and address the root causes of the errors. A cost benefit analysis
will aid the State in calculating the total expected cost of corrective actions against the
benefits of corrective actions. If the State determines that the cost of implementing a
corrective action outweighs the benefits then the final decision of implementing the
corrective action is the State’s decision. The cost benefit analysis and the final decision
should be documented in the State’s Corrective Action Plans submitted to CMS.
 Address all identified errors including deficiencies, technical errors, and
eligibility active and negative case errors
 the specific errors causes being targeted
 the expected results- listing expected due dates for resolving the causes of errors


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