[Provider] MaineCare Participation in CMS Payment Error Rate Measurement (PERM) Audit

[Provider Notification]

ATTENTION:  All MaineCare Providers

 

Over the next year you may be asked to submit medical records for
MaineCare Members to a contractor who is conducting an audit of
MaineCare eligibility and claims for the federal Center for Medicare and
Medicaid Services (CMS).   CMS is required to audit each state once
every three years.  Maine is being audited for federal fiscal year 2008
(October 2007 through September 2008). 

 

This audit is part of the Payment Error Rate Measurement program (PERM).
PERM was developed by the Centers for Medicare & Medicaid Services (CMS)
to comply with the Improper Payments Information Act (IPIA) of 2002. 

 

PERM measures improper payments in Medicaid and the State Children's
Health Insurance Program (SCHIP) and produces state and national-level
error rates for each program. 

 

If you are contacted by the contractor collecting samples of MaineCare
claims, it is critical for you to submit complete records within 90
days.   If records are not submitted on time, or if the records are not
complete, Maine will be charged with an error.  If the error involves a
claim, Maine may have to reimburse the federal government for the
federal match. If Maine has to reimburse the federal government, we may
seek reimbursement from providers who did not comply with federal law. 

 

You will be contacted by telephone. If the contractor is unable to
contact you, Maine will be charged with an error.  The telephone number
the contractor will use is based on the telephone number MaineCare has
for you. If you have recently changed your telephone number please
contact MaineCare Provider Enrollment by calling 1-800-321-5557, Option
6.  

 

A memorandum is attached to this message with further details on the
PERM program.  This letter is also being mailed to all active MaineCare
providers.

 

 

This is a one-way communication.  Please do not respond to this message.

 

 

 

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