Payment Error Rate Measurement (PERM) Audit
Maine Department of Health & Human Services sent this bulletin at 05/19/2017 02:08 PM EDT
Payment Error Rate Measurement (PERM) Audit
In the coming months, you may receive a request for claims information from Chickasaw Nation Industries. Please be advised that this is a legitimate request and is part of the federally mandated Payment Error Rate Measurement Program (PERM). PERM measures improper payments in Medicaid and the State Children’s Health Insurance Program and produces state and national-level error rates for each program as required by the Improper Payments Information Act (IPIA) of 2002 and amended in 2010 by the Improper Payments Elimination and Recovery Improvement Act or IPERA, and the Improper Payments Elimination and Recovery Improvement Act of 2012 IPERIA). See the CMS PERM Laws and Regulations webpage for more detail.
Chickasaw Nation Industries has contracted with the federal Centers for Medicare and Medicaid Services to conduct an audit of MaineCare claims and will be reviewing claims for the FFY17 time period (10/1/16 – 9/30/17). Per MaineCare policy, providers who are contacted by Chickasaw Nation Industries are required to respond to their requests for information and provide the necessary documentation so they can conduct their reviews. Please see Chapter 1, Section 1.03 of the MaineCare Benefits Manual for more information on this requirement.
It is critical that providers respond to requests for documentation in a timely fashion; records that are submitted late will result in Maine being charged with an error. If the error involves a claim, Maine may have to reimburse the federal government for the federal match and may seek reimbursement from the providers who did not comply with federal law.