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CMS has contracted with three Federal contractors to administer the PERM program: the Lewin Group is the statistical contractor (SC), Livanta, LLC is the documentation/database contractor (DDC), and HealthDataInsights, Inc. is the review contractor (RC). The three PERM contractors operate in the following sequence. The SC selects a sample of fee-for-service and managed care claims to be reviewed from each State. The DDC collects Medicaid and SCHIP medical policies from each State, and the medical records from the providers of the sampled claims. The RC performs the medical and data processing reviews on the sampled claims to determine if the claims were paid correctly. At the end of the process the SC calculates the State and national error rates for Medicaid and SCHIP based on the results of the RC's reviews, and the eligibility case reviews conducted by the States. Not every State is reviewed by PERM every year. CMS created a 17-State rotation cycle to lessen the burden on States. Each State will only participate in PERM once every 3 years. This page includes an introduction to each PERM contractor, and a letter that offers guidance to the States on educating the provider community about PERM. It also includes links to the internet-based tracking systems maintained by the PERM DDC and the PERM RC.
Page Last Modified: 09/03/2008 2:59:37 PM
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