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Claims

The Division of Child Care (DCC), Child Care Assistance Program (CCAP), Claims Section is responsible for childcare provider claims. All references to the claims policies and procedures are found in 922 KAR 2:020.

What is a claim?

Claims result from an improper payment.  The purpose of a claim is to collect the amount that was overpaid. Overpayment results from an action or inaction on the part of the child care provider, including failure to report a change in circumstance in accordance with 922 KAR 2:160, Section 11 or an agency error that provided the child care provider with an overpayment. (922 KAR 2:020, Section 2).

The Division of Child Care, Claims Section

DCC Claims is responsible for using advanced skill sets to investigate potentially fraudulent activities and interview providers to determine if a child care provider claim exists, establish the claim, negotiate repayment agreements, and maintain the claim file.

Division of Family Support

Responsible for establishing and collecting a child care client claim.

Reasons for claim establishment

  • Falsification of information on DCC-94E Child Care Daily Attendance Record shall lead to a claim. All child care providers (licensed, certified and registered) are responsible for reporting the attendance of each child who receives CCAP. The attendance is reported on the regulated DCC-94E form (922 KAR 2:160).
  • Falsification of information reported on the DCC-97 Child Care Provider Billing Form (PBF) shall result in a claim. Child care providers submit payment for CCAP using the Provider Billing Form; DCC-97.

Claim Determination can be made by, but not limited to:

  • Auditing of the DCC-94E for fraudulent activity or erroneous errors. 
  • Attendance reported on the 94E form that should be recorded legibly each time the child arrives and each time the child departs the provider’s care and signed by the parent or applicant for the child served by CCAP (922 KAR 2:160).  The 94E forms should be consistent with the billing forms/KICCS.
  • DCC-94E inconsistencies such as:
    • Days billed, but not reflected on the 94E,
  • Arrival and departure times for each child not recorded on the State approved the regulated DCC-94E, Child Care Daily Attendance Record, and
    • Missing legible parent weekly signatures and/or no provider signature at the bottom of the DCC-94E.

Notification from the Billing Team

  • The CCAP Billing section notifies the claims section of payment errors. 
  • Child Care providers may contact the billing section when they discover inadvertent payment errors. “Inadvertent error claim” means an overpayment resulting from misunderstanding or unintended error on the part of a recipient or a child care provider (922 KAR 2:020).

Random selection of Child Care Providers’ Attendance Report

  • Every month a CCAP attendance report is generated through the state-approved child care eligibility system which, generates lists of active child care providers requesting payment for CCAP children’s attendance. A random audit of attendance records is completed for child care providers from this report.

OIG Referral Line

  • If the cabinet has sufficient documentary evidence to confirm that a recipient or child care provider has committed an Intentional Program Violation (IPV), the cabinet shall refer the case to the cabinet’s Office of Inspector General (OIG) for investigation or referral for prosecution if warranted by the facts of the case  (922 KAR 2:020).
  • “Intentional Program Violation” or “IPV” means a CCAP recipient or child care provider has intentionally: (a) Made a false or misleading statement; or (b) Misrepresented, concealed, or withheld facts”).