Report Examines the Potential Impact of New Federal Initiative To Review Payment and Eligibility Errors in Medicaid

Publication Date: February 2008

Publisher: Henry J. Kaiser Family Foundation

Author(s):

Research Area: Health

Type: Report

Coverage: United States

Abstract:

The federal government has launched a new initiative, Payment Error Rate Measurement (PERM), to estimate the number of errors states make in determining eligibility for Medicaid and the State Children’s Health Insurance Program (SCHIP). This paper reports on interviews of state officials conducted during the summer of 2007. The primary findings include:

* State officials generally find measuring errors to ensure program integrity a worthwhile goal.

* Most of the state officials responsible for executing PERM reviews remain unclear about what PERM requires -- and about key elements of the PERM process.

* Most states expect PERM to significantly increase their focus on maintaining documentation, which could undermine longstanding efforts to facilitate the enrollment of eligible people.

* Implementing the new Medicaid citizenship documentation requirement could lead to high PERM errors in some states.