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What does the Medicaid integrity program do?

to provide effective support and assistance to states in their efforts to combat Medicaid provider fraud and abuse; to eliminate and recover improper payments in ance with the Improper Payments Information Act of 2002.

What is the program integrity principle?

The term program integrity encompasses the concept that programs should be organizationally and structurally sound and capable of achieving their mission without compromise. It is the umbrella under which payment integrity, internal controls, fraud risk management, and improper payments prevention fall.

What is the program Integrity Manual?

the Manual addresses the detection and prevention of fraud, waste and abuse, as well as the prevention of improper payments in the Medicare fee-for-service (FFS) program.

What services does Mic provide?

MIC finds the best solutions for the needs of Medicaid enrollees, connects health plans to those solutions, and guides states on policy levers that promote innovation adoption.

What does program integrity mean?

We have historically defined program integrity very simply: pay it right. Program integrity must focus on paying the right amount, to legitimate providers and suppliers, for covered, reasonable, and necessary services provided to eligible beneficiaries while taking aggressive actions to eliminate fraud and abuse.