Error rate low for Oklahoma Medicaid

Posted On: 1/15/2013


Oklahoma’s Medicaid error rate was the lowest of 17 states studied, according to a Dec. 20 report by the Centers for Medicare & Medicaid Services (CMS).

CMS found the Oklahoma Health Care Authority had an error rate of 0.28 percent. The average error rate CMS found in the 17 states included in this review was 5.7 percent. The highest error rate CMS found for a state was 17.8 percent.

 

Through the PERM program, CMS samples state Medicaid payments, collects documentation from providers, conducts a data processing review on sampled payments, and performs a medical record review on sampled claims. In addition, states perform eligibility reviews and submit the results of their eligibility reviews to CMS.

The PERM program uses a 17-state three-year rotation for measuring improper payments in Medicaid, so that CMS measures each state once every three years. Oklahoma has consistently performed well in PERM reviews. Oklahoma’s 1.24 percent error rate three years ago was also the lowest in the nation and compared with a national average of 8.98 percent for that period.  

The CMS PERM report was presented at the January meeting of the Oklahoma Health Care Authority board. A copy of the report is online (pg. 18).  (Rick Snyder)

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