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  • Title: Medicaid program and State Children's Health Insurance Program (SCHIP); payment error rate measurement. Final rule.
    Author: Centers for Medicare & Medicaid Services (CMS), HHS.
    Journal: Fed Regist; 2007 Aug 31; 72(169):50489-513. PubMed ID: 17886398.
    Abstract:
    This final rule sets forth the State requirements to provide information to us for purposes of estimating improper payments in Medicaid and SCHIP. The Improper Payments Information Act of 2002 (IPIA) requires heads of Federal agencies to estimate and report to the Congress annually these estimates of improper payments for the programs they oversee, and submit a report on actions the agency is taking to reduce erroneous payments. This final rule responds to the public comments on the August 28, 2006 interim final rule (71 FR 51050) and sets forth State requirements for submitting claims and policies to the CMS Federal contractors for purposes of conducting fee-for-service and managed care reviews. This final rule also sets forth the State requirements for conducting eligibility reviews and estimating case and payment error rates due to errors in eligibility determinations.
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