MEMORANDUM

DISCUSSION:

States are responsible for measuring improper payments based on eligibility decisions for both MO HealthNet and Children's Health Insurance Programs (CHIP) and reporting the findings to Centers for Medicare and Medicaid Services (CMS). The name of this process is Payment Error Rate Measurement (PERM) and is similar to Food Stamp Quality Control (QC) reviews.

Myers and Stauffer, LC from Indianapolis, Indiana, is the contracted agency that is conducting PERM reviews for the State of Missouri. PERM reviews begin with Federal Fiscal Year (FFY) 2009 and are on a three-year cycle. The FFY begins October 1 and ends on September 30 of the following year.

Cases are selected randomly for review each month. QC Office Support Assistance (OSA) staff request the case files from the county office. The county office must forward the entire case record, including the Food Stamp section, to the appropriate OSA within five days of receiving the request. QC staff copies the file and returns the original file to the county office. Myers and Stauffer receive a COPY of the original record.

Below is a guide to assist staff with case requests:

• For active MO HealthNet for Families (MHF), MO HealthNet for Kids (MHK), and MO HealthNet for Pregnant Women (MPW) programs, provide information for the previous two years and the vital statistics information;
• For active adult programs such as MO HealthNet for the Aged, Blind, and Disabled (MHABD), provide information for the previous five years and the vital statistics information; and
• For closings/rejections, provide information for the previous year and the vital statistics information.

If contacted by participants with questions, Eligibility Specialists should explain the basics of PERM and encourage the participant to cooperate with Myers and Stauffer's staff.

NECESSARY ACTION:

• Review this memorandum with all appropriate staff.
• Provide complete case record within five days of request.
• Cooperate with staff from Myers and Stauffer, LC.

LH