Payment Error Rate Measurement

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, 2021 and June 30, 2022 will be part of the payment universe review. A sample of claims will be randomly drawn from each quarter, and these will be the claims reviewed by the federal contractor. If a claim you submitted is selected, you will be notified.


Important Notice

NCI Information Systems, the medical review contractor for CMS, will contact providers and request a copy of their medical records to support the medical review. NCI Information Systems 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 NCI Information Systems. You cannot bill for cost of copying or mailing records.


Notices & Information

RY 2023 PERM Audit Information

PERM Audit Vermont Medicaid Banners Update coming soon!

Provider FAQ RY 2023 PERM

Request for Records RY 2020 Update coming soon!

Sample Request Letter RY 2020 Update coming soon!

How to Submit Documentation RY2020 Update coming soon!

Claim Category Matrix RY2020 Update coming soon!


Links

CMS Providers Link 

PERM Video

Department of Vermont Health Access

280 State Drive
Waterbury, Vermont 05671-1010
Phone: 802-879-5900
Fax: 802-241-0260

Department Contact List for customer service, program telephone and fax numbers, and staff email

Hours of Operation: Monday-Friday (Excluding Holidays) 7:45am - 4:30pm

Public Record Requests
Kelly Provost
DVHA Public Records Officer
AHS.DVHALegal@Vermont.gov
Visit the Agency of Administration site for the Public Records Database