Ensuring the integrity of the Medicaid program is a multi-stakeholder effort. We have grouped our resources by audience to help you easily find the most relevant material.
State Medicaid Agencies
Resources for states are designed to educate state staff, including state program integrity staff, and help them be effective in their roles. Use our best practices and provider requirements resources to learn about provider issues like enrollment and disclosure. Infographics can be used on bulletin boards to provide overviews of important information in program integrity.
A variety of toolkits and resources will help providers manage the ins and outs of Medicaid compliance in areas that are prone to errors and audits, such as documentation, personal care services, hospice, and dental care. Some toolkits also contain resources that providers can share with their patients to help beneficiaries understand their Medicaid benefits and the claims process.
These pharmacy toolkits will help pharmacists and staff avoid common mistakes in topics like dispensing and billing. We provide dosing charts and fact sheets for drug classes, such as antidepressants and stimulants, that have higher billing error rates. We have also created a 4-part Self-Auditing toolkit for pharmacies that includes instructional videos.
It’s important for beneficiaries to understand their benefits and other issues in Medicaid. These resources include fact sheets on benefits, such as hospice and non-emergency medical transportation, as well as educational materials about the risks of sharing Medicaid card information.