Question

Which program assesses and measures improper medicare fee-for-service payments (based on reviewing selected claims and associated medical record documentation)?

Answer 1

Established the Payment Error Rate Measurement (PERM) program to measure improper payments in the Medicaid program and the States Children's Health Insurance Program (SCHIP)

What is the Impact of Improper Payments Information Act (IPIA) ?

The IPIA mandates that agencies adhere to a variety of methodological parameters for computing mistake rates and improper payment estimates in order to achieve consistency in improper payment reporting across federal agencies. When reporting erroneous payment amounts and rates, one obligation is to use gross values. By combining underpayments and overpayments, a gross erroneous payment amount is determined. For consistency, historical figures that were initially provided as net numbers have been converted to gross numbers unless otherwise noted. Denied claims must also be included in the sample, according to the IPIA. For both the May and November reports, the CERT program includes rejected claims in its sample. Only the November report's findings were refuted by the HPMP samples. As a result, calculations for this May report used HPMP denied claims data from the November 2007 report.

To learn more about States Children's Health Insurance Program (SCHIP) , Visit:

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