Payment Error Rate Measurement (PERM) Error Rate Findings and Reports
Guidance for various reports and reference documents associated with the PERM program.
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: May 13, 2020
Welcome to the PERM reports and reference documents page. This page houses various reports and reference documents associated with the PERM program. This page will contain two cycles of improper payment rates spanning six years. For earlier improper payment rates please refer to the Archive page.
Rolling National Medicaid Improper Payment Rates
Year | PERM Cycles Included | Estimated Improper Payments (in billions) | Overall Rate | FFS Rate | Managed Care Rate | Eligibility Rate |
| 2024 | Cycle 1 - RY 2022 Cycle 2 - RY 2023 Cycle 3 - RY 2024 | $31.10 | 5.09% | 4.83% | 0.00% | 3.31% |
| 2023 | Cycle 3 - RY 2021 Cycle 1 - RY 2022 Cycle 2 - RY 2023 | $50.33 | 8.58% | 6.90% | 0.00% | 5.95% |
| 2022 | Cycle 2 - RY 2020 Cycle 3 - RY 2021 Cycle 1 - RY 2022 | $80.57 | 15.62% | 10.42% | 0.03% | 11.89% |
| 2021 | Cycle 1 - RY 2019 Cycle 2 - RY 2020 Cycle 3 - RY 2021 | $98.72 | 21.69% | 13.90% | 0.04% | 16.62% |
| 2020 | Cycle 3 – FY 2017 Cycle 1 – RY 2019 Cycle 2 – RY 2020 | $86.49 | 21.36% | 16.84% | 0.06% | 14.94% |
| 2019 | Cycle 2 – FY 2016 Cycle 3 – FY 2017 Cycle 1 – RY 2019 | $57.36 | 14.90% | 16.30% | 0.12% | 8.36% |
- The overall estimate is comprised of the weighted sum of the FFS and managed care components, plus the eligibility component, minus a small adjustment to account for the overlap between the claims and eligibility review functions.
National Rolling CHIP Improper Payment Rates
Year | PERM Cycles Included | Estimated Improper Payments (in billions) | Overall Rate | FFS Rate | Managed Care Rate | Eligibility Rate |
| 2024 | Cycle 1 - RY 2022 Cycle 2 - RY 2023 Cycle 3 - RY 2024 | $1.07 | 6.11% | 4.72% | 0.72% | 4.44% |
| 2023 | Cycle 3 - RY 2021 Cycle 1 - RY 2022 Cycle 2 - RY 2023 | $2.14 | 12.81% | 7.09% | 0.59% | 10.86% |
| 2022 | Cycle 2 - RY 2020 Cycle 3 - RY 2021 Cycle 1 - RY 2022 | $4.30 | 26.75% | 11.23% | 0.62% | 24.01% |
| 2021 | Cycle 1 - RY 2019 Cycle 2 - RY 2020 Cycle 3 - RY 2021 | $5.37 | 31.84% | 13.67% | 0.48% | 28.71% |
| 2020 | Cycle 3 – FY 2017 Cycle 1 – RY 2019 Cycle 2 – RY 2020 | $4.78 | 27.00% | 14.15% | 0.49% | 23.53% |
| 2019 | Cycle 2 – FY 2016 Cycle 3 – FY 2017 Cycle 1 – RY 2019 | $2.74 | 15.83% | 13.25% | 1.25% | 11.78% |
- The overall estimate is comprised of the weighted sum of the FFS and managed care components, plus the eligibility component, minus a small adjustment to account for the overlap between the claims and eligibility review functions.
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DISCLAIMER: The contents of this database lack the force and effect of law, except as authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically incorporated into a contract. The Department may not cite, use, or rely on any guidance that is not posted on the guidance repository, except to establish historical facts.