Provider Compliance Group Interactive Map
The U.S. Resource Map allows you to access state-specific:
- Organizations that provide services in your state.
- Conctact information of various organizations.
- E-mails and websites to the different organizations within the state selected.
- Information on other US territories.
CMS Divisions Responsible for Contractors
State Point of Contact Payment Error Rate Measurement (PERM) |
State Point of Contact Comprehensive Error Rate Testing (CERT) |
|
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All 50 States |
E-Mail: permproviders@cms.hhs.gov Website: http://www.cms.gov/perm PERM Statistical Contractor (SC) - The Lewin Group PERM Review Contractor (RC) - A+ Government Solutions |
E-Mail: cert@cms.hhs.gov Website: http://www.cms.gov/cert CERT Documentation Contrator (DC) - Livanta LLC. CERT Review Contractor (RC) - AdvanceMed Corp. CERT Statistical Contractor (SC) - The Lewin Group |
Division of Data Analysis (DDA) | |
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All 50 States | To assure the integrity of Medicare Trust Fund dollars through program integrity and compliance efforts by actively seeking out suspected Medicare program vulnerabilities through a variety of methods, assessing scope and severity of risks, and working collaboratively within and outside CMS to develop, help implement, and monitor corrective actions. |
Definition of Contractors
CARRIER | A contractor that performs Medicare fee-for-service Part B claims administration services for physicians, non-physician practitioners, and suppliers, where the contract was implemented under statutory authority in effect prior to the enactment of Section 1874A of the Social Security Act. “By July 2013 all carriers and FIs will have transferred their claims administration responsibilities to the MAC in the relevant state.” |
CERT | Comprehensive Error Rate Testing (CERT) program is to measure improper payments in the Medicare fee-for-service (FFS) program. The CERT program cannot be considered a measure of fraud. Since the CERT program uses random samples to select claims, reviewers are often unable to see provider billing patterns that indicate potential fraud when making payment determinations. CERT is designed to comply with the Improper Payments Elimination and Recovery Act of 2010. |
DME MAC | Durable Medical Equipment - Medicare Administrative Contractor is a specialty MAC whose contract is awarded through competitive procedures and which provides for the processing of Medicare claims for durable medical equipment, prosthetics, orthotics, and supplies in keeping with 42 CFR 421.210. |
FI | Fiscal Intermediary is a contractor that performs Medicare fee-for-service Part A claims administration services for institutional providers (such as hospitals, skilled nursing facilities, etc.) where the contract was implemented under statutory authority in effect prior to the enactment of Section 1874A of the Social Security Act. “By July 2013 all FIs and Carriers will have transferred their claims administration responsibilities to the MAC in the relevant state.” |
HHH | Home Health and Hospice |
IH | Indian Health |
MAC | Medicare Administrative Contractor is a contractor that performs Medicare fee-for-service claims administration services that is awarded a contract through competitive procedures in keeping with Section 1874A of the Social Security Act. |
PERM | The Payment Error Rate Measurement (PERM) program measures improper payments in Medicaid and CHIP and produces error rates for each program. The error rates are based on reviews of the fee-for-service (FFS), managed care, and eligibility components of Medicaid and CHIP in the fiscal year (FY) under review. It is important to note the error rate is not a "fraud rate" but simply a measurement of payments made that did not meet statutory, regulatory or administrative requirements. |
Recovery Auditor(s) | Recovery Auditors, are tasked with identifying and recovering Medicare overpayments and identifying underpayments. |
RHHI | Regional Home Health and Hospice Intermediary |
RRB | Railroad Retirement Board |
ZPIC | Zone Program Integrity Contractors. In each jurisdiction one (ZPIC) will be responsible for program integrity oversight and functions for all Medicare-related claims. Because ZPICs will investigate cases of Medicare fraud involving all healthcare providers in a geographic region, they will have the ability to detect cross-billing and relationships among healthcare providers, which will lead to increased scrutiny of providers working across health care settings. ZPICs will also compare data from Medicare and Medicaid claims to identify fraudulent activities between the programs, a process known as Medi-Medi data matching. |
- Page last Modified: 06/07/2012 8:57 AM
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