PERM • Introduction

The Payment Error Rate Measurement (PERM) program, implemented by the U.S. Department of Health and Human Services (HHS), Centers for Medicare and Medicaid Services (CMS), is federally mandated under the Improper Payments Information Act of 2002 and measures improper payments in the Medicaid program and the Children’s Health Insurance Program, known in Alaska as Denali KidCare (DKC). Some of the benefits of the PERM program include identification of program vulnerabilities that result in improper payments, promoting efficient program operations, and helping to ensure medical services are provided to those eligible for the program.

At 0.59%, Alaska had the lowest error rate of the 2008 PERM cycle. Alaska’s second PERM review has begun and will focus on claims from Federal Fiscal Year 2011 (October 2010 through September 30, 2011).

Not all providers will be required to submit documentation. For those providers with claims selected, medical records must be furnished within 75 days from the date of the request. Providers are urged to respond to these requests promptly upon receiving the request letter. Provider cooperation is critical to the success of the PERM project. Failure to respond to a request and/or insufficient documentation will be considered a payment error. The provider will be required to repay the claim and Alaska Medicaid will be required to return the federal portion of any amount found in error.

If you have questions about the PERM review process, please contact Lori Campbell at 907.269.3020 or at Lori.Campbell@alaska.gov. Please do not include any protected health information in unsecured email transactions.