Center for Program Integrity
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.
CPI builds systems and manages programs to enroll providers in the Medicare and Medicaid programs.
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.
CPI oversees medical reviews and audits to safeguard the Medicare and Medicaid programs from fraud, waste and abuse.
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.