NCMS Secures Crucial Delay of Federal Medicaid Audit

The North Carolina Medical Society (NCMS) has persuaded the Centers for Medicare & Medicaid Services (CMS) to delay – for approximately one month – a major federal audit of NC Medicaid providers and payments.

On Wednesday, CMS and NC Medicaid announced that a federal audit called the Payment Error Rate Measurement (PERM) program, would commence immediately in North Carolina.  PERM measures the state’s ability to pay claims correctly, and requires medical practices to respond to medical record requests.  The announcement came in the midst of Medicaid’s massive transition to the NC Tracks claims system, which has not been smooth for many physician practices.

The North Carolina Medical Society immediately contacted CMS, informed officials that the bumpy migration to NC Tracks was already burdening practice administration and affecting patient care, and requested an immediate delay of all PERM activity in the state.  Today, CMS notified us that they will delay all documentation requests until mid-August.  Additional details are included below.

Thanks to CMS and NC Medicaid for coordinating to arrange for this brief delay.  NCMS is pleased to have pursued this on behalf of NC physicians, and hopes it will allow you more time to concentrate on providing quality health care to your patients and on completing the transition to NC Tracks.

Important details about the delay

  • A+ Government Services is the federal contractor handling the medical records requests for the PERM audit.  Documentation requests will originate from that company.
  • Forty-one (41) medical records were requested before the decision was made to delay.  Unfortunately these cannot be retracted.  If you have already received one of these requests, you will have the normal 75-day span in which to respond.  CMS has also stated that, “[i]f those providers need a little extra time and send the documentation in late we will still accept it.”
  • CMS (through A+ Government Services) makes documentation requests in batches once data for each quarter is available. When the requests resume in mid-August, CMS will be seeking records from Q1 and Q2.  Requests based on Q3 data will commence later in the fall.
  • The number of documentation requests for the entire PERM cycle is expected to number close to 800 statewide.

 More information on the PERM program is available here.


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