The final rule implements policy and operational improvements to the PERM and MEQC programs

Changes to the Payment Error Rate Measurement (PERM) and Medicaid Eligibility Quality Control Programs (MEQC) (CMS-6068-F)

The final rule implements policy and operational improvements to the PERM and MEQC programs that will reduce state burden, improve program integrity, and promote state accountability.

Under this final rule, changes to the MEQC program give states flexibility to design their MEQC active case pilots to best meet each state’s unique needs. However, should a state have consecutive PERM eligibility improper payment rates over the 3 percent threshold, CMS will provide direction for active case reviews. The improper payment rates are based on reviews of the fee-for-service (FFS), managed care, and eligibility components of Medicaid and CHIP.

CMS made changes to the eligibility measurement component of the PERM program in this final rule, and the eligibility measurement component will resume as of the effective date of the final rule for reporting in 2019.

States must submit corrective actions for identified errors.

For More information, CMS Fact Sheet