Program Integrity Knowledge and Resource Center

Program Integrity Knowledge and Resource Center

Here you'll find a variety of opportunities to learn more about Program Integrity and how to identify and prevent fraud, waste, and abuse.

CPI’s eLearning solutions will help program integrity personnel (including medical review, program integrity and appeals contractors, CMS staff, state Medicaid agency staff, and other stakeholders) consistently interpret CMS policies and procedures. They are designed to help reduce improper payments, claim denials, and appeals.

For help with our eLearning solutions, view our Frequently Asked Questions (PDF).

Doctor with Stethoscope

National Correct Coding Initiative (NCCI)

The NCCI promotes correct coding methodologies and reduces improper coding, with the overall goal of reducing improper payments of Medicare Part B and Medicaid claims. Learn how CMS provides support through NCCI for Medicare and NCCI for Medicaid.

Learn how CMS provides support through NCCI for Medicare and NCCI for Medicaid.

 
Image Depicting Medicaid Integrity Institute

Medicaid Integrity Institute (MII)

The MII provides a variety of training tailored to meet the ongoing needs of state Medicaid employees.

Trainings include various aspects of Medicaid program integrity, including fraud investigations, data mining and analysis, provider enrollment, managed care oversight, emerging trends, and case development.

Learn more about the MII curriculum.

 
Doctor Performing Diabetic Testing

Guide to Ordering Diabetic Testing Supplies

This step-by-step guide was designed for health care providers with Medicare patients who use home glucose monitors. Learn more about the process of ordering diabetic testing supplies, as well as documentation requirements.

View the Guide to Ordering Diabetic Testing Supplies (PDF).

 
Image Depicting Annual Wellness Visits Video

Annual Wellness Visits (AWV) Video

The AWV video provides health care professionals with guidance to understand expectations and requirements when submitting AWV documentation for Medicare beneficiaries.

Watch the video.

 
Picture of a man

Targeted Probe and Educate (TPE) Video

The 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 the video.

 
Image Depicting Medicaid Integrity Program Resource Library

Medicaid Integrity Program Resource Library

Resources to fight fraud, waste, and abuse related to Medicaid and the Children’s Health Insurance Program (CHIP)

The Medicaid Integrity Program Resource Library includes resources that cover important topics in Medicaid program integrity, organized by audience and by topic.

Explore the Resource Library.

 

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:
09/10/2024 06:18 PM