Improper Payment Pre-Testing and Assessment (IPPTA) (CMS-10829)

To comply with the Payment Integrity Information Act of 2019 (PIIA), HHS is proposing the IPPTA to prepare State Exchanges for the measurement of improper payments of advance payments of the premium tax credit (APTC), to test processes and procedures that support HHS’s review of determinations of APTC made by State Exchanges, and to provide a mechanism for HHS and State Exchanges to share information that would aid in developing an efficient measurement process. The PIIA requires executive agencies to report on Federal programs susceptible to significant improper payments. The APTC program was identified as a Federal program susceptible to significant improper payments Currently in operation are 18 State Exchanges, which do not use the Federal platform to perform eligibility and enrollment determinations. Each State Exchange will be selected to participate in the IPPTA data collection for a period of 1 calendar year, which would occur either in 2024 or 2025. To facilitate collection of the required data and data documentation, HHS created a pre-testing and assessment data request form with instructions. This collection of data and data documentation is intended to allow HHS to test the data elements as specified in the scenarios provided to each State Exchange in the pre-testing and assessment data request form to enable HHS to comply with the requirements of the Payment Integrity Information Act of 2019 (PIIA) and implementing guidance.

The latest form for Improper Payment Pre-Testing and Assessment (IPPTA) (CMS-10829) expires 2028-01-31 and can be found here.