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Payment Error Rate Measurement (PERM) Audit
Illinois Medicaid - HFS·IL·Provider Notice
Effective date
Jan 9, 2015
We identified it
Jun 20, 2026
Summary
Illinois Medicaid providers are subject to Payment Error Rate Measurement (PERM) audits to identify improper payments. The notice emphasizes requirements for maintaining complete business and medical records, accurate procedure coding, medical necessity documentation, and ensuring excluded providers don't render services.
Action Required
Immediately: Billing team must ensure all Medicaid claims have complete supporting documentation including medical records (not just claim copies), verify all procedure codes are accurate, document medical necessity for all services, and routinely check the federal List of Excluded Individuals and Entities (LEIE) for all staff. Maintain business records including payment records, corporate papers, and signed billing certification forms. Failure to comply may result in overpayment recovery, provider termination, payment suspension, or civil monetary penalties.