CMS data show Mississippi Medicaid payment, eligibility error rates among lowest in the nation
Mississippi Medicaid’s overall payment error rate is the fourth lowest among the 34 states with publicly available results, according to new state-specific data released by the Centers for Medicare and Medicaid Services (CMS). Publicly released for the first time, the data also showed Mississippi Medicaid had the third lowest eligibility error rate in the nation.
The federal Payment Error Rate Measurement (PERM) audit process is intended to measure and report an unbiased national improper payment rate for state Medicaid programs. PERM audits are conducted annually by examining 17 states per year, or cycle, with each state reviewed once every three years.
An error does not necessarily mean that an expense should not have occurred. It may also include instances where there was insufficient or no documentation to support a payment or eligibility decision.
The PERM audit process consists of three components within the Medicaid program: beneficiary eligibility determinations made by state Medicaid agencies, fee-for-service payments made to providers, and capitation payments made to Medicaid managed care organizations.
Mississippi Medicaid’s overall projected payment error rate was almost three times below the national average of 21.69%, making it the fourth lowest among reporting state. Mississippi’s eligibility error rate was third lowest in the country and almost seven times lower than the national error rate for eligibility of 16.62%. No errors were identified in the managed care component. The fee-for-service payment component, which contained the highest percentage of errors, was 15th lowest, slightly better than the national average.
As required following each measurement cycle, the Mississippi Division of Medicaid (DOM) will develop and submit a corrective action plan designed to reduce improper payments in each program. Plans are due 90 calendar days after states receive their measurement notifications.
“While this national audit does demonstrate that the Mississippi Medicaid program compares quite favorably to its peer agencies across the country, there is always room for improvement,” said Executive Director Drew Snyder. “The Division will continue strengthening its core functions while elevating quality, and this data will help identify opportunities for improvements.”
- Appendix D – Error Rates by Provider Type and Cluster (cms.gov)
- 2019 Medicaid & CHIP Supplemental Improper Payment (cms.gov)
|Payment Error Measurement Rate Results|
|FFS Estimated Error Rate||13.9%||12.3%|
|Managed Care Estimated Error Rate||0.04%||0.0%|
For more information: PERM Error Rate Findings and Reports | CMS
– Published Jan. 14, 2022