PERM Medical Review Process

June 23, 2023

Empower AI is the Federal contractor for the Payment Error Rate Measurement (PERM) Medical Record Reviews.

Empower AI began contacting providers in June 2023 to collect CHIP and Medicaid records for claims that have been sampled for review. Providers must respond to Empower AI within the timeframe indicated in the record request letter, submit all requested documentation, and return the documentation with the claim-specific cover letter for each claim pulled for review. If no documentation or incomplete records are provided to Empower AI, the claim will be considered in error and the State will seek an overpayment recovery.

Provider participation during the PERM review is required under the Federal Improper Payments Elimination and Recovery Act (IPERA) of 2010.

Providers may visit the CMS provider webpage to become familiar with the entire PERM process. Providers should monitor Blue Review newsletters for future PERM updates.

Please contact Heather Smith, DPHHS Program Compliance Bureau, for any PERM questions at (406) 444-4171 or HeatherSmith@mt.gov, or Valerio Varani at (406) 444-9365 or Valerio.Varani@mt.gov.