Quality Control (QC) Review – CAPER Errors
(01/01/19 - 12/31/19)
The Office of Program Evaluation (OPE) selects cases for review, based upon the following actions:
Cases that are denied.
Cases that are closed.
Cases that are closed, then reopened due to the participant requesting an appeal and continued benefits.
Cases approved for zero ($0) benefits. (See NA Categorically Eligible-No Pay)
These QC reviews are referred to as Case and Procedural Error Rate (CAPER) errors. The purpose of reviewing CAPER actions is to determine the accuracy of the decision to deny or stop benefits, or to approve zero ($0) benefits.
When OPE is unable to determine a valid reason for the action, an invalid CAPER is cited. OPE completes the actions listed in QC Review Process.
When designated staff from the FAA office, Region office, or the Policy Support Team (PST) disagrees with the error, follow the QC District X procedures.