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Learn more about our recent work and accomplishments.

Targeted Probe and Educate

Simplifying the Medical Review Process

Our Targeted Probe and Educate (TPE) video explains this streamlined medical review process.

Have you seen our new video about TPE? The Targeted Probe and Educate (TPE) medical review process helps CMS and providers work together to improve medical claims by avoiding and correcting, through individualized education sessions, many common billing mistakes. Watch this 5 minute video to learn more.

Lab Testing Fraud

Health Care Fraud Prevention Partnership (HFPP) Publishes Latest White Paper

Paper examines clinical laboratory services fraud and abuse.

The HFPP’s latest paper, “Examining Clinical Laboratory Services: A Review by the Healthcare Fraud Prevention Partnership,” summarizes the common issues and challenges associated with laboratory services fraud and abuse. Read the paper to learn about specific types of potential clinical laboratory services fraud or abuse and the challenges with detecting it.

TPE Information

CPI Works to Reduce Burden on Providers

Spend more time with your patients, less on Medicare documentation.

Making the medical review process easier to understand and simplifying documentation are two CPI initiatives aimed at reducing burden on providers. We recently updated our website to help explain the medical review process called Targeted Probe and Educate (TPE), and to describe the work we’re doing to simplify documentation requirements.

Market Saturation Image

Mapping Market Saturation

We’ve updated the market saturation tool with even more data.

CPI’s market saturation tool shows the relationship, in population, between providers and beneficiaries within a chosen geographical location. How many home health providers are located in your zip code? What is the average number of physical & occupational therapy patients per provider in your county? Use the map to answer questions about the availability of care and the use of selected services, by population.

HFPP Partners

Healthcare Fraud Prevention Partnership (HFPP) Continues to Grow

Collectively their membership represents 74% of covered lives in the United States.

Over the last few months, the HFPP has gained several new members including: AIRIO Health Plan, Blue Cross Blue Shield of Arizona, District of Columbia Department of Health Care Finance, Care N’ Care, Louisiana Office of Attorney General – MFCU, and Vision Service Plan. They, along with over 100 other organizations, now enjoy the benefits that this voluntary, public-private partnership provides. Should your organization consider joining others from across the federal government, state and local government agencies, law enforcement, private health insurance plans, employer organizations, and healthcare anti-fraud associations to identify and reduce fraud, waste, and abuse across the healthcare sector? Watch this video to see what current members have to say about this unique and collaborative data-sharing partnership.

CONNECT WITH US

Connect with CPI as we host or attend various events throughout the year, join the conversation on Twitter around subjects that matter to all of us, or find the most appropriate vehicle to report suspected fraud, waste or abuse.

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