Kev them nyiaj yuam kev Rate Measurement Program
Rov qab mus rau Qhov Chaw Tshawb Fawb Hauv Tsev
The Payment Error Rate Measurement Program (PERM) yog tsim los ntsuas thiab qhia txog lub teb chaws tsis tsim nyog them tus nqi txhua xyoo rau Medicaid thiab Children's Health Insurance Program (CHIP), raws li txoj cai Payment Integrity Information Act (PIIA) ntawm 2019. Qhov kev zov me nyuam tab tom ua haujlwm raws li PERM txoj cai kawg tshaj tawm thaum Lub Xya Hli 5, 2017 (Federal Register 82 FR 31158).
Lub Chaw rau Medicare thiab Medicaid Services (CMS) siv 17-State rotation voj voog rau PERM. Txhua lub Xeev raug tshuaj xyuas ib zaug txhua peb xyoos. Kalifonias yog lub Xeev Cycle 2 thiab tam sim no koom nrog Kev Tshawb Fawb Xyoo (RY) 2023 lub voj voog. Kev ntsuas lub voj voog yog raws li nram no:
Cycle 1 – Arkansas, Connecticut, Delaware, Idaho, Illinois, Kansas, Michigan, Minnesota, Missouri, New Mexico, North Dakota, Ohio, Oklahoma, Pennsylvania, Virginia, Wisconsin, Wyoming.
Cycle 2 – Alabama, California, Colorado, Georgia, Kentucky, Maryland, Massachusetts, Nebraska, New Hampshire, New Jersey, North Carolina, Rhode Island, South Carolina, Tennessee, Utah, Vermont, West Virginia.
Cycle 3 – Alaska, Arizona, District of Columbia, Florida, Hawaii, Indiana, Iowa, Louisiana, Maine, Mississippi, Montana, Nevada, New York, Oregon, Puerto Rico, South Dakota, Texas, Washington.
PERM yog suav nrog peb qhov kev tshuaj xyuas: Fee-for-Service (FFS) cov lus thov them nyiaj, Kev them nyiaj tswj hwm kev tswj hwm, thiab kev txiav txim siab tsim nyog. CMS koom nrog peb tus neeg cog lus los tswj PERM. Cov neeg cog lus rau PERM Cycle, RY 2026 yuav los tom ntej, tau teev tseg hauv qab no:
Tus neeg ua haujlwm txheeb cais - Lewin Group, Ib feem ntawm Optum Pab
Txheeb xyuas tus neeg cog lus - Txhawb nqa AI, Inc.
- Kev Tsim Nyog Txheeb Xyuas Tus Neeg Ua Haujlwm - Booz Allen Hamilton
Rau FFS tshuaj xyuas cov ntsiab lus ntawm PERM, qhov kev xaiv them nyiaj raug xaiv yuav raug tshuaj xyuas cov ntaub ntawv los xyuas kom meej tias cov xeev tau ua raws li txoj cai, kev tswj hwm lossis kev tswj hwm. Kev tshuaj xyuas kev kho mob kuj tseem yuav ua rau ntawm FFS cov ntaub ntawv them nyiaj kom lees paub qhov tseeb ntawm cov ntaub ntawv hauv cov ntaub ntawv kho mob.
PERM Kev Pabcuam rau Cov Chaw Pabcuam
PERM yuam kev tus nqi
Cov ntaub ntawv ntawm qhov feem ntau tam sim no thiab keeb kwm kev ua yuam kev PERM tuaj yeem pom ntawm qhov txuas hauv qab no.
Txhua nqe lus nug txog PERM tuaj yeem xa mus rau: PERM@dhcs.ca.gov
