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The Centers for Medicare & Medicaid Services' (CMS) Medicaid Integrity Program provides technical assistance and support to the states by initiating many projects, developing numerous products, and conducting program integrity training – all designed to provide guidance and tools to the states in order to perform their jobs more efficiently and effectively. Guidance to States: Best Practices For Medicaid Program Integrity Units' Interactions With Medicaid Fraud Control Units - provides guidance for interactions between State Program Integrity Units (PIUs) and their Medicaid Fraud Control Units (MFCUs) and contains specific examples of actions taken by States that have created well-functioning and committed partnerships between the two entities. (See the Downloads section displayed below). Performance Standard For Referrals of Suspected Fraud From a Single State Agency To A Medicaid Fraud Control Unit – developed to determine the percentage of acceptable referrals provided by a State Medicaid agency to its MFCU in accordance with 42 CFR 455.21(a)(1). (See the Downloads section displayed below). Medicaid Integrity Program Provider Audit Fact Sheet – provides information on the national Medicaid audit program to identify overpayments and to decrease the payment of inappropriate Medicaid claims. (See the Downloads section displayed below).
Page Last Modified: 01/14/2009 12:05:52 PM
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