- February 22, 2023
- Alerts
Payment Error Rate Measurement Program for Florida Medicaid and Chip Providers
On February 17, 2023, Florida Medicaid released a Health Care Alert reminding providers of their obligations under the Centers for Medicare and Medicaid Services (“CMS”) Payment Error Rate Measurement (“PERM”) program. The PERM program measures claims for improper payments by Medicaid and Children’s Health Insurance Program (“CHIP”) and produces payment error rates for each program. The PERM error rates are based on reviews of the fee-for-service, managed care, and eligibility components of Medicaid and CHIP in the federal fiscal year under review. The error rate is a measurement of payment made that did not meet statutory, regulatory, or administrative requirements.
In the coming months, providers may receive a request for medical records from EmpowerAI, the CMS contractor conducting Florida Medicaid and CHIP PERM audits. If you receive a request from EmpowerAI, note that this is a legitimate request and is part of a federally mandated-PERM audit. Providers must submit medical records witihin seventy-five (75) days from the date they are contacted by EmpowerAI. If the requested supporting medical documentation is not submitted, the claim will be coded as an error and monies paid by Medicaid or CHIP will be subject to recoupment. Further, error rates will be extrapolated to all claims submitted by a provider for the year under review. Thus, recoupment will likely extend beyond the claims coded as an error.
Click here to view the full Florida Medicaid release:
Should you have any questions regarding the above or would like assistance in submitting records to EmpowerAI, please contact Susan St. John at 754-228-3853 or sstjohn@garfunkelwild.com, or your primary Garfunkel Wild attorney.
In the coming months, providers may receive a request for medical records from EmpowerAI, the CMS contractor conducting Florida Medicaid and CHIP PERM audits. If you receive a request from EmpowerAI, note that this is a legitimate request and is part of a federally mandated-PERM audit. Providers must submit medical records witihin seventy-five (75) days from the date they are contacted by EmpowerAI. If the requested supporting medical documentation is not submitted, the claim will be coded as an error and monies paid by Medicaid or CHIP will be subject to recoupment. Further, error rates will be extrapolated to all claims submitted by a provider for the year under review. Thus, recoupment will likely extend beyond the claims coded as an error.
Click here to view the full Florida Medicaid release:
Should you have any questions regarding the above or would like assistance in submitting records to EmpowerAI, please contact Susan St. John at 754-228-3853 or sstjohn@garfunkelwild.com, or your primary Garfunkel Wild attorney.