Providers: Payment Error Rate Measurement (PERM) Review - Reminder to Submit Medical Records
The Centers for Medicare & Medicaid Services (CMS) Payment Error Rate Measurement (PERM) Program for Reporting Year (RY) 2023 is currently reviewing the West Virginia Medicaid and West Virginia Children’s Health Insurance Program (WVCHIP) to measure improper payments in order to maintain the integrity of the Medicaid program. The Review Contractor, Empower AI, is authorized to collect information from providers and to review documentation to ascertain adherence to Medicaid regulations.
Empower AI may require additional documentation and/or clarification of medical records to complete the desk audit review. To facilitate this desk audit review, West Virginia Medicaid and WVCHIP appreciate your cooperation in providing the documentation within the allotted time to Empower AI. This documentation is necessary to verify compliance with Federal and State regulations. Due to the extent of the PERM review, West Virginia Medicaid and WVCHIP ask for timeliness of submissions to aid in expediting the PERM review process.
Failure to return documentation by the due date will result in West Virginia Medicaid or WVCHIP recovering the payments by either the provider refunding the amounts or recouping the amounts from future payments. A pay-hold will be placed on the provider until the amounts are recovered. If you are unable to provide the requested documentation, please respond to Empower AI in writing within the time allotted. Should you require additional information or have questions you may call CMS’ Review Contractor’s Customer Service Representatives at (800) 393-3068, for West Virginia Medicaid, your state PERM representative, Lisa Landers at Lisa.K.Landers@wv.gov or 304-558-1700 or for WVCHIP, you may contact Paula Atkinson at Paula.M.Atkinson@wv.gov or 304-414-5965.