PERM pearls: What CMS’ Payment Error Rate Measurement data offers

8 minute read

Medicaid program integrity has never been under as much scrutiny as it is right now under states’ unwinding of autoenrollment imperatives of the Public Health Emergency.

Stakeholders use many tools to minimize negative impacts of noncompliance or inaccurate compliance with regulations, policies, and guidelines per redeterminations so that Medicaid and the Children’s Health Insurance Program (CHIP) work as intended and for those who need it. It has widely been reported that roughly 10 million beneficiaries will no longer be Medicaid-eligible from the swells of the pandemic, yet the U.S. Department of Health & Human Services estimates that roughly 6.8 million will lose Medicaid coverage despite being eligible.[1]

One tool stakeholders can use to identify negative impacts of the massive administrative undertaking and to mitigate effects of current and new Administration policies in response to the COVID-19 pandemic is the Centers for Medicare & Medicaid Services’ (CMS) Payment Error Rate Measurement (PERM) data. CMS has been using PERM since 2007 to help states improve accuracy of Medicaid and CHIP payments.

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