Situation Report | December 14, 2020
New York State will be participating in the federal Payment Error Rate Measurement (PERM) program, which is an upcoming measurement of improper payments to health care providers in the Medicaid and State Child Health Insurance programs.
The U.S. Centers for Medicare and Medicaid Services (CMS) has contracted with NCI, Inc., in partnership with the state Office of the Medicaid Inspector General (OMIG), to request documentation for randomly selected claims in order to perform a medical review. For such claims, NCI, Inc. and OMIG will request documentation in writing to substantiate claims paid in the federal review period of July 1, 2019 through June 30, 2020.
If home care or hospice providers receive such letters, they should submit copies of the specific medical documents for selected patients directly to the CMS contractor and send second copies to OMIG at the following address: Office of the Medicaid Inspector General, 800 North Pearl Street, First Floor, Albany, NY, 12204, Attention: PERM.
Requests and subsequent receipt or non-receipt of documentation will be tracked. Failure to provide requested records will result in a determination by CMS of erroneous payment and OMIG will pursue recovery.
Questions should be directed to the PERM Project Staff at (518) 474‑3499 or via e-mail at PERMNY@omig.ny.gov.