Sec. 15. Payment error rate measurement (PERM) audit and improvement requirements
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/bill/117/s/5015/is/section-15A research copy — for the controlling text, always check the official state or federal source. Not legal advice.
Beginning with fiscal year 2024, the Administrator shall conduct payment error rate measurement ( PERM ) audits of each State Medicaid program on a biennial basis. Beginning with fiscal year 2025, any State with an overall PERM error rate exceeding 15 percent in a PERM audit conducted with respect to the State in the previous fiscal year shall publish a plan, in coordination with, and subject to the approval of, the Administrator, for how the State will reduce its PERM error rate below 15 percent in the current fiscal year.
Not later than 6 months after the date of enactment of this Act, the Administrator shall notify the contractor conducting PERM audits of the Administrator's intent to modify contracts to require PERM audits not less than once every other year in each State. The Administrator shall direct the contractor conducting PERM audits of State Medicaid programs to identify areas known to be sources of improper payments under such programs to identify program areas or components known to be sources of high risk for improper payments under such programs.
Not later than 12 months after the date of enactment of this Act, the Administrator shall issue a State Medicaid Director letter regarding State requirements under Federal law and regulations regarding avoiding and responding to improper payments under State Medicaid programs. Not later than January 1, 2023, each State Medicaid program shall submit to the Administrator a plan, which shall include specific actions and timeframes for taking such actions and achieving specified results, for mitigating improper payments under such program.
The Administrator shall make State plans submitted under paragraph
(1)available to the public. In this section: The term Administrator means the Administrator of the Centers for Medicare & Medicaid Services. The term State has the meaning given such term for purposes of title XIX of the Social Security Act ( 42 U.S.C. 1396 et seq. ). The term State Medicaid program means a State plan under title XIX of the Social Security Act ( 42 U.S.C. 1396 et seq. ), and includes any waiver of such a plan.
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Sec. 15
Payment error rate measurement (PERM) audit and improvement requirements
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