CMS announcement of Medicaid and SCHIP Payment Error Rate Measurement System
CMS Notice of intent to establish a new system of records for the purpose of identifying payment errors and combating fraud and abuse in State Medicaid and SCHIP programs. CMS will contract for required services.
CMS invites comments on all portions of this notice.
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
Privacy Act of 1974; Report of a New System of Records
AGENCY: Centers for Medicare & Medicaid Services (CMS), Department of Health and Human Services (HHS).
SUMMARY OF ACTION: Notice of a New System of Records (SOR).
In accordance with the requirements of the Privacy Act of 1974, CMS is proposing to establish a new system titled, “Medicaid Program and State Children’s Health Insurance Program (SCHIP) Payment Error Rate Measurement (PERM), System No. 09-70-0578” in accordance with the requirements of Improper Payments Information Act (IPIA) of 2002 (Pub. L. 107-300).
The primary purpose of this system is to collect and maintain individually identifiable claims information to calculate payment error rates for Medicaid and SCHIP programs.
CMS will use a national contracting strategy to calculate a state-by-state, comprehensive error rate for both the Medicaid and SCHIP programs. Implementing regulations set forth state requirements to: (1) Provide claims information to CMS for the purposes of estimating improper payment in Medicaid and SCHIP; and (2) measure improper payments in the Medicaid and SCHIP based on eligibility errors.