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Medicaid Integrity Program

Author: Carolyn L. Yocom
Publisher:
ISBN: 9781457842047
Category :
Languages : en
Pages : 51

Book Description

Medicaid Integrity Program

Author: Carolyn L. Yocom
Publisher:
ISBN: 9781457842047
Category :
Languages : en
Pages : 51

Book Description

Medicaid Integrity Program :.

Author: United States. Government Accountability Office
Publisher:
ISBN:
Category :
Languages : en
Pages :

Book Description

Medicaid program integrity state and federal efforts to prevent and detect improper payments : report to the Chairman, Committee on Finance, U.S. Senate.

Author:
Publisher: DIANE Publishing
ISBN: 1428937137
Category :
Languages : en
Pages : 34

Book Description

Medicaid Integrity Program

Author: U.s. Government Accountability Office
Publisher: Createspace Independent Publishing Platform
ISBN: 9781974190843
Category :
Languages : en
Pages : 52

Book Description
" Medicaid has the second-highest estimated improper payments of any federal program that reports such data. The Deficit Reduction Act of 2005 created the Medicaid Integrity Program to oversee and support state program integrity activities. CMS, the federal agency within HHS that oversees Medicaid, established the MIG to implement this new program. This report assesses (1) the MIG's use of two types of contractors to review and audit state Medicaid claims, (2) the MIG's implementation of other oversight and support activities, and (3) CMS and state reporting on the results of their program integrity activities. GAO analyzed MIG data on its contractors' audits, training program for state officials, comprehensive state reviews, and state assessments; analyzed reports that summarized the monetary returns from MIG and state program integrity activities; and interviewed MIG officials, contractors, and state program integrity officials. "

Medicaid Program Integrity

Author: United States. General Accounting Office
Publisher:
ISBN:
Category : Medicaid
Languages : en
Pages : 36

Book Description

Medicaid Integrity Program - Eligible Entity and Contracting Requirements for the Medicaid Integrity Audit Program (Us Centers for Medicare and Medicaid Services Regulation) (Cms) (2018 Edition)

Author: The Law The Law Library
Publisher: Createspace Independent Publishing Platform
ISBN: 9781721523368
Category :
Languages : en
Pages : 24

Book Description
Medicaid Integrity Program - Eligible Entity and Contracting Requirements for the Medicaid Integrity Audit Program (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition) The Law Library presents the complete text of the Medicaid Integrity Program - Eligible Entity and Contracting Requirements for the Medicaid Integrity Audit Program (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition). Updated as of May 29, 2018 Section 1936 of the Social Security Act (the Act) (as added by section 6034 of the Deficit Reduction Act of 2005 (DRA) established the Medicaid Integrity Program to promote the integrity of the Medicaid program by requiring CMS to enter into contracts with eligible entities to: (1) Review the actions of individuals or entities furnishing items or services (whether on a fee-for-service, risk, or other basis) for which payment may be made under an approved State plan and/or any waiver of such plan approved under section 1115 of the Act; (2) audit claims for payment of items or services furnished, or administrative services rendered, under a State plan; (3) identify overpayments to individuals or entities receiving Federal funds; and (4) educate providers of services, managed care entities, beneficiaries, and other individuals with respect to payment integrity and quality of care. This book contains: - The complete text of the Medicaid Integrity Program - Eligible Entity and Contracting Requirements for the Medicaid Integrity Audit Program (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition) - A table of contents with the page number of each section

Medicaid Program Integrity

Author: U.s. Government Accountability Office
Publisher: Createspace Independent Publishing Platform
ISBN: 9781974624119
Category :
Languages : en
Pages : 26

Book Description
"Testimony The Centers for Medicare & Medicaid Services (CMS), the federal agency that oversees Medicaid, estimated that improper payments in the federal-state Medicaid program were $21.9 billion in fiscal year 2011. The Deficit Reduction Act of 2005 established the Medicaid Integrity Program and gave CMS an expanded role in assisting and improving the effectiveness of state activities to ensure proper payments. Making effective use of this expanded role, however, requires that federal resources are targeted appropriately and do not duplicate state activities. GAO was asked to testify on Medicaid program integrity. GAO's statement focuses on how CMS's expanded role in ensuring Medicaid program integrity (1) poses a challenge because of overlapping state and federal activities regarding provider audits and (2) presents opportunities through oversight to enhance state program integrity efforts. To do this work, GAO reviewed CMS reports and documents on Medicaid program integrity as well as its own and others' reports on this topic. In particular, GAO reviewed CMS reports that documented the results of its state oversight and monitoring activities. GAO also interviewed CMS officials in the agency's Medicaid Integrity Group (MIG), which was established to implement the Medicaid Integrity Program. This work was conducted in November and December 2011. GAO discussed the facts in this statement with CMS officials. What GAO Found The key challenge faced by the Medicaid Integrity Group (MIG) is the need to avoid duplication of federal and state program integrity efforts, particularly in the area of auditing provider claims. In 2011, the MIG reported that it was redesigning its national provider audit program. Previously, its audit contractors were using incomplete claims data to identify overpayments. According to MIG data, overpayments identified by its audit contractors since fiscal year 2009 were not commensurate with its contractors' costs. The MIG's redesign will result ..."