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The Centers for Medicare & Medicaid Services (CMS) implemented the Payment Error Rate Measurement (PERM) program to measure improper payments in the Medicaid program and the State Children's Health Insurance Program (SCHIP). PERM is designed to comply with the Improper Payments Information Act of 2002 (IPIA; Public Law 107-300). For PERM, CMS is using a national contracting strategy consisting of three contractors to perform statistical calculations, medical records collection, and medical/data processing review of selected State Medicaid and SCHIP fee-for-service (FFS) and managed care claims. In FY 2006, CMS reviewed only FFS Medicaid claims. Starting in FY 2007, CMS expanded PERM to include reviews of FFS and managed care claims, as well as beneficiary eligibility, in both the Medicaid and SCHIP programs.
What's New:
New PERM Policy on Lost or Destroyed Documentation
CMS has issued a new PERM policy to establish the procedure for providers in handling lost or destroyed documentation due to unintended disasters that is requested for PERM purposes. The policy is posted on the PERM Policies section.
FY 2006 and FY 2007 National Error Rate
The final FY 2006 National Medicaid and FY 2007 National Medicaid and SCHIP error rates were published in the FY 2008 Agency Financial Report (AFR), formerly known as the Performance and Accountability Report (PAR). The link for the FY 2008 AFR and the archive PAR can be found at the bottom of the Reports section.
FY 2008 PERM Eligibility Reporting Website
The PERM Eligibility Tracking Tool (PETT) website is available for FY 2008 States to submit their eligibility reporting forms. The eligibility reporting form templates as well as the instructions for using the website are located in the "Project Files" portion of the PETT website. The link for PETT is located in the Eligibility Reviews section of this website.
FY 2009 PERM Eligibility Reporting Website
The PERM Eligibility Review Tracking (PERT) website is available for FY 2009 States to submit their eligibility reporting forms. CMS has sent instructions to the States on how to report on the website. The instructions will be available on the PERM website shortly.
Difference Resolution Process Update
CMS has finalized the difference resolution process and the full document can be view under the difference resolution section. It reflects recent changes in disputing insufficient documentation (MR2) errors, as well as finalizes the process for recovering the Federal matching funds found in error.
PERM DDC Website
States can check the status of requests for provider medical records made by the PERM documentation/database contractor. Livanta has developed a secure website that allows States to monitor the attempts to obtain medical records for each sampled claim, and whether the records have been received, are still outstanding, or additional documentation has been requested. The link for the tracking system can be found in the PERM Process section. Livanta will email each State with its user name and password when they start requesting provider medical records from that State's providers.
PERM RC Website
The PERM review contractor, HealthDataInsights, has created a web based application to track and report the sampling unit findings for both the Medicaid and SCHIP claims reviewed in the each cycle. The link for the State Medicaid Error Rate Findings (SMERF) system can be found in the PERM Process section of this website.
PERM 101 documents
Three PERM 101 documents are released as an overview of the PERM process. The 3 documents include a brochure, a flowchart, and a handout document. States are encouraged to use the documents to educate their stakeholders on the PERM process.
PERM Cycle Calls
CMS hosts a series of monthly teleconferences for each PERM cycle. All States in each of the respective cycles are invited to participate. Please contact the respective PERM cycle manager for further details about the calls.
PERM Technical Advisory Group (TAG) Meeting
The PERM TAG holds 4 to 12 regularly scheduled meetings per year. States are encouraged to contact their TAG representative within their region to express their concern or if they are interested to participate.
Page Last Modified: 12/30/2008 4:13:01 PM
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