What's New in Program Integrity

Check here for updates, announcements, and information about the Medicaid Integrity Program (MIP) activities.

Medicaid Program Integrity Education 

Educational resources, tools, and other media to educate providers, beneficiaries and other stakeholders in promoting best practices and to enhance awareness of Medicaid fraud, waste and abuse.

The Annual Summary Report of the Medicaid Integrity Institute (MII) and Related Educational Activities for FY08 - FY12 (PDF) 

The report provides information about MII education activities such as expenditures, educational curriculum and state participation results.

(PDF)Getting the Best Dental Care for Your Child brochure (PDF)

Provides information for proper pediatric dental care, what to expect from your child's dentist and how to report improper practices. (updated: 3/13)

(PDF)Frequently Asked Questions (FAQs) on the Medicaid RAC Program (PDF) 

The FAQs address questions about various operational aspects of the implementation of state Medicaid RACs. It serves as guidance on such topics as appeals, contingency fees, and State reporting. 

(PDF)CMS Center for Program Integrity (CPI) Strategic Direction and Antifraud Activities (PDF)

Provides an overview of CMS' CPI including CPI's mission, vision, organization and strategic direction. The article also outlines CPI's key anti-fraud activities in the areas of prevention, detection, transparency and accountability, recovery and CPI's future direction. 

Medicaid Integrity Manual (MIM) 

The purpose of the MIM is to promote continuity and consistency of the MIP by providing a comprehensive guide to its overall operations. It serves as a reference tool to assist State Medicaid programs, providers, health care organizations, and other stakeholders.

(PDF)Drug Diversion in the Medicaid Program (National Bulletin, Revised January 2012) (PDF) 

An informative background about drug diversion and what steps are being taken to educate state partners.  Additional information includes strategies for combating controlled prescription drug diversion.

Annual Report to Congress (RTC) on the Medicare and Medicaid Integrity Programs:
October 1, 2015 through September 20, 2016 (PDF)

This report fulfills CMS' statutory requirement to summarize the use of funds appropriated under the Deficit Reduction Act of 2005 for the MIP.  The RTC, in summarizing the MIP, not only informs Congress of the work performed by CMS in curbing fraud, waste, and abuse, but also reflects the contribution each state's Medicaid program integrity function makes to ensure our nation's health care system remains viable and trustworthy. 

(PDF)2011 Integrity Program Best Practices Annual Summary (PDF) 

A compendium of data collected from state comprehensive program integrity reviews (FYs 2009 and 2010) for which final reports were issued. The report includes information about best practices, areas of vulnerability, and areas of non-compliance. 

CMS Center for Program Integrity (CPI) – Center for Medicaid, CHIP and Survey & Certification (CMCS) Bulletin CPI-B 11-05 - 5/31/2011 

Guidance to States regarding implementation of Affordable Care Act Section 6501 - Termination of Provider Participation under Medicaid if Terminated under Medicare or other State Plan. (Click on "Related Links" below.)

Page Last Modified:
11/13/2019 04:54 PM