Improper Medicaid Payment Audits Underway

New York is participating in the national Payment Error Rate Measurement (PERM) Project, which will engage in medical review of randomly selected Medicaid claims to measure improper payments in the Medicaid program. The reviews may impact any type of Medicaid service provider or plan, including home care providers, nursing homes, Medicaid Assisted Living Programs, Medicaid managed care plans, and others who submit Medicaid claims.

If claims that your organization has submitted are randomly selected, you will receive a request from the national contractor, Chickasaw Nation Industries (CNI) Advantage, LLC, to submit documentation to substantiate the claims. Those receiving document requests will be instructed to submit materials to both the national contractor and the New York State Office of Medicaid Inspector General (OMIG). The review involves claims from federal fiscal year 2017 (Oct. 1, 2016 – Sept. 30, 2017).

New York has participated in this program in the past, most recently in 2014. Failure to provide requested records will result in a determination of erroneous payment, and OMIG will pursue recovery. PERM project staff may be reached at 518-402-7041 or by email at PERMNY@omig.ny.gov.

Contact: Darius Kirstein, dkirstein@leadingageny.org, 518-867-8841