Updated on: June 22, 2012

CMS Issues Final Rule for Medicaid, CHIP Payment Error Rate Measurement

Original story posted on: August 10, 2010

The Centers for Medicare & Medicaid Services (CMS) today issued the final regulations to implement improvements to the Payment Error Rate Measurement (PERM) for Medicaid and the Children's Health Insurance Program (CHIP).


PERM measures improper payments in Medicaid and CHIP and produces national-level error rates for each program.  These reviews are conducted to determine whether the sampled cases meet applicable Medicaid and CHIP fee-for-service, managed care, and eligibility requirements


The rule changes the process for reviewing cases in which states have used simplified enrollment efforts such as self-declaration for eligibility cases; eliminates duplication of effort between eligibility reviews administered in the same fiscal year; extends the timeframe for providers to submit documentation; and provides states additional time to submit corrective action plans.


CMS, in a news release, said it would conduct educational sessions with state oversight staff  "to ensure there is a complete understanding of the changes to the programs set forth by the final rule and will work with them on ways to further reduce payment errors in Medicaid and CHIP."



Chuck Buck

Chuck Buck is the publisher of RACmonitor and is the program host and executive producer of Monitor Monday.

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