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PERM Process

CMS has contracted with three Federal contractors to administer the PERM program:  the statistical contractor (SC), the documentation/database contractor (DDC), and the review contractor (RC).

The three PERM contractors operate in the following sequence. The SC collects the claims universes from the States and elects a sample of fee-for-service and managed care claims to be reviewed from each State. The DDC collects Medicaid and SCHIP medical policies from each State, and the provider records from the providers of the sampled claims. The RC performs the medical and data processing reviews on the sampled claims to determine if the claims were paid correctly. At the end of the process the SC calculates the State and national error rates for Medicaid and SCHIP based on the results of the RC's reviews, and the eligibility case reviews conducted by the States.

Not every State is reviewed by PERM every year. CMS created a 17-State rotation cycle to lessen the burden on States. Each State will only participate in PERM once every 3 years.

This page includes an introduction to each PERM contractor, and a letter that offers guidance to the States on educating the provider community about PERM. It also includes links to the internet-based tracking systems maintained by the PERM DDC and the PERM RC.

 

Downloads

States Selected for PERM [PDF, November 2008, 9KB]

Statistical Contractor Introduction [PDF, November 2008, 56KB]

Documentation Contractor Introduction [PDF, November 2008, 58KB]

Review Contractor Introduction [PDF, November 2008, 56KB]

PERM 101 Brochure [PDF, March 2008, 836KB]

PERM 101 Flowchart [PDF, March 2008, 58KB]

PERM 101 Handout [PDF, March 2008, 346KB]

Provider Education Letter [PDF, November 2008, 16KB]

PERM Policy Issues [PDF, November 2008, 135KB]


Related Links Inside CMS

There are no Related Links Inside CMS
Related Links Outside CMSExternal Linking Policy

DDC Tracking Website

SMERF System

 

Page Last Modified: 12/16/2008 1:56:47 PM
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