NC Medicaid Claims to be Audited during 2010

This year, North Carolina is required to participate in an administrative and medical audit of its Medicaid and State Children’s Health Insurance Program (SCHIP) programs as part of the national Payment Error Rate Measurement (PERM) program implemented by CMS.  The SCHIP audit is on hold pending final rules from CMS.  However, the PERM statistical contractor, Livanta LLC, has already begun working with the Division of Medical Assistance (DMA) on the sample to be used in the first quarter of the Medicaid audit.  NC’s Medicaid program was last “PERM-ed” in 2007.

NCMS has been assured that the sampling methodology used in the audit will not target a specific provider type, type of claim, or geographical area.  If one of your claims is chosen for the audit, you will receive a medical records request in the mail from the (yet to be identified) PERM review contractor.  You will be required to furnish the requested records by a specific deadline.  For additional details, review a notice letter   sent to NCMS from DMA here.

If you encounter any problems with the Medicaid audit, please contact the NCMS right away.

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