January 9, 2014

OHCA Contacts: Jo Kilgore - (405) 522-7474, Jennie Melendez - (405) 522-7404

OKLAHOMA CITY – SoonerCare, Oklahoma Medicaid, has the lowest payment error rate among 17 states in a recent federal comprehensive review. The Centers for Medicare & Medicaid Services (CMS) measures improper Medicaid payments through the Payment Error Rate Measurement (PERM) program. Oklahoma’s error rate for federal fiscal year (FY) 2012 was 0.28 percent; the national average error rate was 5.8 percent.

“This is a true measure of our agency’s continued fight against waste, fraud and abuse,” OHCA CEO Nico Gomez said.

“I am very proud of our staff that is committed to be responsible stewards of the taxpayers’ dollars while ensuring quality health care is available to our SoonerCare members.  I also need to thank our health care providers for their continued compliance and service to the program.”

CMS uses a 17-state rotation to determine PERM rates, evaluating each state every three years.  Oklahoma is in Cycle 1, along with Arkansas, Connecticut, Delaware, Idaho, Illinois, Kansas, Michigan, Minnesota, Missouri, New Mexico, North Dakota, Ohio, Pennsylvania, Virginia, Wisconsin and Wyoming. In FY 2012 Oklahoma had the lowest PERM rate of the cycle; the highest PERM rate reported in this cycle was 17.8 percent.

The PERM initiative is a comprehensive review of Medicaid services including a review of member eligibility, medical necessity of the services rendered, and appropriate processing of the claims paid. To learn more, visit http://www.cms.hhs.gov/PERM.

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