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PERM readiness

Payment Error Rate Measurement preparation, sampling, audit defensibility, and operational readiness.

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Medicaid Payment Error Rate Measurement (PERM): A Primer

PERM readiness

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Oct 13, 2026

Medicaid Payment Error Rate Measurement (PERM): A Primer

Reference | October 2026 edition | A starting point for congressional, policy, and Medicaid readers.

Ralph Choate
Ralph Choate
PERM Eligibility Risk: From Audit Event to Operational Discipline

PERM readiness

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Oct 6, 2026

PERM Eligibility Risk: From Audit Event to Operational Discipline

Insight | An executive framework for Medicaid leaders managing eligibility accuracy, audit defensibility, and fiscal exposure.

Ralph Choate
Ralph Choate
Before 2027: What Recent State Medicaid Control Failures Are Warning Us About

Corrective action

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Oct 1, 2026

Before 2027: What Recent State Medicaid Control Failures Are Warning Us About

Perspective | A practical readiness test—and a companion checklist—for proving Medicaid corrective actions work.

Ralph Choate
Ralph Choate
PERM Corrective Action Effectiveness & Closure Checklist

Corrective action

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Oct 1, 2026

PERM Corrective Action Effectiveness & Closure Checklist

Tool | A practical worksheet for documenting corrective-action results and supporting a defensible closure decision.

Ralph Choate
Ralph Choate
The PERM Corrective-Action Gap: Fixing the Error Is Not the Same as Proving the Fix Worked

Corrective action

+2

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Sep 20, 2026

The PERM Corrective-Action Gap: Fixing the Error Is Not the Same as Proving the Fix Worked

Perspective | GAO’s new review of Medicaid eligibility errors raises a larger management question: are states using PERM’s error evidence to prove that corrective actions actually change the result?

Ralph Choate
Ralph Choate
PERM’s Center of Gravity Is Moving to Eligibility

PERM readiness

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Sep 13, 2026

PERM’s Center of Gravity Is Moving to Eligibility

Insight | The 2027 eligibility-only PERM cycle is temporary. The management lesson should not be.

Ralph Choate
Ralph Choate
PERM Measures Medicaid and CHIP, but H.R. 1 Puts Them on Different Fiscal Paths

Federal claiming

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Aug 27, 2026

PERM Measures Medicaid and CHIP, but H.R. 1 Puts Them on Different Fiscal Paths

Perspective | The same eligibility-control failure can affect both programs, but Medicaid's 3% disallowance threshold and newly constrained good-faith waiver create a different federal recovery regime.

Ralph Choate
Ralph Choate
CMS PERM RY2027 and RY2028 Cycle Resources

PERM readiness

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Aug 27, 2026

CMS PERM RY2027 and RY2028 Cycle Resources

Reference | Primary federal resources for states managing two active PERM timelines: an eligibility-only RY2027 cycle and the RY2028 Cycle 1 sampled-claim review period already underway.

Ralph Choate
Ralph Choate
Executive PERM Risk-Acceptance Template

PERM readiness

+1

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Aug 27, 2026

Executive PERM Risk-Acceptance Template

Tool | A two-page governance template for Medicaid leaders documenting material eligibility-control changes, fiscal exposure, compensating controls, and explicit residual-risk decisions.

Ralph Choate
Ralph Choate
PERM Finding Response Path

Corrective action

+2

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Aug 27, 2026

PERM Finding Response Path

Tool | An operational guide for state Medicaid leaders moving potential PERM findings from rapid factual review through resolution, corrective action, and verified closure.

Ralph Choate
Ralph Choate
Shadow PERM Implementation Guide

PERM readiness

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Aug 27, 2026

Shadow PERM Implementation Guide

Tool | An operational framework for state Medicaid leaders using internal eligibility sampling to identify accuracy, audit-defensibility, and control failures before federal selection.

Ralph Choate
Ralph Choate
PERM Pre-Cycle Readiness Matrix

PERM readiness

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Aug 26, 2026

PERM Pre-Cycle Readiness Matrix

Tool | An operational assessment for state Medicaid leaders testing policy, system, operational, and stakeholder readiness before the next PERM cycle.

Ralph Choate
Ralph Choate
Source Presentation: Wyoming’s PERM Transformation Through System Modernization

PERM readiness

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Aug 26, 2026

Source Presentation: Wyoming’s PERM Transformation Through System Modernization

Reference | Presented by the Wyoming Department of Health and Acentra Health at MESC 2026, August 19, 2026.

PERM Eligibility Risk: Executive Readiness Snapshot

PERM readiness

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Aug 26, 2026

PERM Eligibility Risk: Executive Readiness Snapshot

Tool | A concise framework for Medicaid leaders assessing eligibility accuracy, audit defensibility, and fiscal exposure.

Ralph Choate
Ralph Choate
2027 Is Not the Work-Requirement PERM Test. It May Be the Rehearsal.

PERM readiness

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Aug 26, 2026

2027 Is Not the Work-Requirement PERM Test. It May Be the Rehearsal.

Perspective | CMS will make RY2027 an eligibility-only PERM cycle while states prepare for new Medicaid community-engagement requirements. The timelines do not directly overlap—but the operational lesson does.

Ralph Choate
Ralph Choate
PERM Is Not Just an Audit

PERM readiness

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Aug 25, 2026

PERM Is Not Just an Audit

Insight | Why Medicaid leaders should treat payment error risk as an operational discipline—not a periodic compliance exercise.

Ralph Choate
Ralph Choate

PERM Insights & Perspectives

Independent research and practical analysis of Medicaid eligibility accuracy, operational accountability, and fiscal exposure.

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