CMS Issues Final Rule for Payment Error Rate Measurement | Healthcare Informatics Magazine | Health IT | Information Technology Skip to content Skip to navigation

CMS Issues Final Rule for Payment Error Rate Measurement

August 11, 2010
by root
| Reprints

As part of the Administration’s enhanced efforts to reduce improper payments in Federal programs, the Centers for Medicare & Medicaid Services (CMS) issued the final regulations that will fully 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. Generally, PERM is conducted in 17 states annually; therefore a single state typically participates in the program once every three years.

With comments received from states, advocacy groups, and educational institutions, the final regulation implements changes to both programs required by the Children’s Health Insurance Program Reauthorization Act (CHIPRA) of 2009, and makes other operational changes to the programs based on stakeholder feedback. 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.

As part of the federal-state partnership, CMS will 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.


Topics

News

Report: Healthcare Organizations Struggle with Human Error in Securing PHI

In the first nine months of 2017, unintended disclosure accounted for 41 percent of healthcare data breach incidents, according to a report from specialist insurer Beazley.

Three More Providers Receive 2017 HIMSS Davies Awards

Three patient care organizations have received the 2017 global Healthcare Information and Management Systems Society (HIMSS) Enterprise Nicholas E. Davies Award of Excellence for healthcare technology innovations that improve patient outcomes.

Medtronic, American Well Team Up to Integrate Telehealth Capabilities

Medtronic and American Well announced a partnership to offer a telehealth solution focused on the unique needs of the complex, chronic, co-morbid patient population.

Medsphere Merges with RCM Vendor Stockell

Medsphere Systems Corp., developer of the OpenVista electronic health record, is merging with Stockell Healthcare Systems, which offers a suite of revenue cycle management tools.

Report: Insider Threats to Patient Data Remain Unnoticed

Of the reported healthcare data breach incidents that occurred in September, it took an average of 387 days for healthcare organizations to discover a breach had occurred, according to a report from cybersecurity software company Protenus.

Reports: Ex-Pharma Exec Alex Azar Emerges as Trump’s Top Pick for HHS Secretary

President Donald Trump could be on the verge of tapping Alex Azar, a former pharmaceutical industry executive and George W. Bush administration official, as the next HHS Secretary, according to media reports.