April 23, 2025
As part of its Payment Error Rate Measurement program, the Centers for Medicare & Medicaid Services has completed its review of improper payments in Medicaid and the Children’s Health Insurance Program for 2024. The program produces national error rates for each program.
The Montana Department of Public Health and Human Services shared the most common errors identified through the program:
- Provider records didn’t support the number of units billed.
- Number of units billed is more than number of units documented.
- One or more documents are missing from the record that are required to support payment.
What this means for you: If you provided CMS with records for PERM review and didn’t receive an overpayment follow-up, then the claims were correct, according to DPHHS.
About PERM claims error rates: PERM error rates are based on reviews of the fee-for-service, managed care and eligibility components of Medicaid and CHIP in the fiscal year under review. The error rate isn’t a fraud rate, but a measurement of payments made that didn’t meet statutory, regulatory or administrative requirements.
If you have questions about PERM, contact Valerio Varani with the DPHHS Program Compliance Bureau. Refer to CMS for more information on PERM.
The information in this article is provided by the Montana Department of Public Health and Human Services and is being provided by Blue Cross and Blue Shield of Montana as a courtesy to and on behalf of the Montana Department of Public Health and Human Services.