CPI Landing

Center for Program Integrity 

Protecting the Medicare & Medicaid Programs from Fraud, Waste, and Abuse
illustration of the united states

One Year of Medicaid Program Integrity Strategy

Strengthen your fight against Medicaid fraud with new and enhanced initiatives.
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$9.35 billion paid to doctors and hospitals in 2018

The Open Payments program tells you who drug and device companies paid, and how much.
Gavel and stethoscope

Keeping fraud out of Medicare and
Medicaid

A new rule will prevent repeat offenders from threatening valuable resources.
Healthcare Fraud Prevention Partnership

Healthcare Fraud Prevention Partnership continues to grow

More than 130 partners with one goal: eliminating health care fraud, waste, and abuse.
 

Who We Are

At the Center for Program Integrity (CPI), our mission is to detect and combat fraud, waste and abuse of the Medicare and Medicaid programs. We do this by making sure CMS is paying the right provider the right amount for services covered under our programs. We work with providers, states, and other stakeholders to support proper enrollment and accurate billing practices. Our work focuses on protecting patients while also minimizing unnecessary burden on providers.

See the complete list of CPI's Leadership Team.

What We Do

 

Provider Enrollment

CPI builds systems and manages programs to enroll providers in the Medicare and Medicaid programs.

Data Analysis

Using predictive analytics, we identify and seek to prevent fraud, waste and abuse. See an example of how data is used to understand the health care landscape with the Market Saturation and Utilization map.

Medical Reviews & Audits

CPI oversees medical reviews and audits to safeguard the Medicare and Medicaid programs from fraud, waste and abuse.

Collaboration with States

CPI offers support and venues for states to collaborate and share best fraud-fighting practices, making the Medicaid program stronger and protecting the care of states’ Medicaid populations.

Our Focus in 2019

CPI’s priorities in 2019 focus on investing in data and analytics to support fraud detection and prevention efforts, reducing burdensome documentation requirements for providers, and improving communication and collaboration with all our partners.

Stay Up to Date with CPI

Connect with CPI as we host or attend various events throughout the year, join our mailing list to stay informed on Program Integrity news, or find the most appropriate vehicle to report suspected fraud, waste, or abuse.

Page Last Modified:
12/06/2019 05:58 PM