The Centers for Medicare and Medicaid Services (CMS) developed the Payment Error Rate Measurement (PERM) program in response to the Improper Payment Information Act, 2002 [IPIA, Public Law 107–300,] enacted November 26, 2002. This act requires federal agencies to review annually programs they oversee that are susceptible to significant erroneous payments, to estimate the amount of improper payments, to report those estimates to Congress and to submit a report of the actions the federal agency is taking to reduce erroneous expenditures. The Improper Payments Elimination and Recovery Act of 2010 (IPERA) enhances the IPIA of 2002 and aims to further reduce improper payments.
Payments made to all provider types will be part of the review process. Any claim that is paid by Vermont Medicaid between July 1, 2024 and June 30, 2025 will be part of the payment universe. A sample will be randomly drawn from each quarter's claims and subject to a PERM audit review by the federal contractor. If a claim you submitted is selected, you will be notified.
Important Notice
Empower AI, the medical review contractor for CMS, will contact providers and request a copy of their medical records to support the medical review. Empower AI will send out the request letters and, if necessary, follow-up letters and calls. Please note you are required to submit records at no cost to Empower AI. You cannot bill for cost of copying or mailing records.
Notices & Information
*Documentation for upcoming RY2026 PERM cycle coming soon*
- RY 2023 PERM Audit Information (Updated Timeline Info posted 5/12/22)
- Provider FAQ RY 2023 PERM
- Example Initial Request for Medical Records Letter - This document includes an example of the letter providers with a sampled claim will receive (on CMS letterhead), as well as submission instructions, and a cover sheet template.
- Example Additional Documentation Request Letter - This document includes an example of the letter requesting additional documentation, as well as submission instructions, and a cover sheet template.
- Claim Category Matrix - This document indicates what records are needed for different claim types.
- Previous PERM Audit Vermont Medicaid Banners
- CMS PERM Page for Providers - This webpage has links to a PERM overview in PDF or Webinar format.