CPI Resources
Resources
Featured Resource
Victimized Provider Project: Providers, don’t be held liable for overpayments for claims paid that are a result of identity theft. Learn how to spot signs of identity theft and protect yourself.
For Providers
See the changes we've made to medical reviews: When claims are submitted accurately, everyone benefits. Learn how the Targeted Probe and Educate (TPE) program better targets medical reviews, limits the number of claims requested, and emphasizes education and assistance to correct claims.
Guide to Ordering Diabetic Testing Supplies: This step-by-step guide (PDF) was designed for health care providers with Medicare patients who use home glucose monitors.
Find information about co-prescribing opioids and benzodiazepines: As required by section 6065 of the SUPPORT Act, CMS is making opioid and benzodiazepine co-prescribing information available on the CMS website. The Aggregate Data of Outlier Part D Prescribers of Opioids and Benzodiazepines (PDF) contains information about opioid and benzodiazepine co-prescribing patterns among Part D prescribers who are outliers as compared to their peers. Additional resources are available on the Prescribing Opioids page.
Learn about requirements for Annual Wellness Visits (AWVs): This video provides health care professionals with guidance to understand expectations and requirements when submitting documentation for AWVs for Medicare beneficiaries. Watch the video.
Protect yourself from identity theft: Medicare providers who have their identities stolen and used to bill Medicare may be held liable for overpayments – don’t let this happen to you. Learn the signs and protect yourself.
Find your MAC: Do you know our Medicare Administrative Contractors (MACs) can help you enroll or re-enroll, understand billing requirements, and answer other administrative questions you may have about Medicare? Access a list of CMS contractors in your state and find your MAC today.
Become a Medicare Provider: Are you a provider interested in serving Medicare patients? Enroll today.
Revalidate Your Medicare Enrollment: Already a Medicare Provider? Be sure to revalidate your Medicare enrollment.
Withdraw from Medicare: We are sorry to see you go. If you have retired, surrendered your license, or no longer want to participate in the Medicare program, you should withdraw within 90 days. Report this change online through PECOS.
Update or get a new National Provider Number (NPI): Need an NPI? Do you have one and want to make sure your information is up to date? Log in to the NPI system, known as NPPES, to get started.
Check your Open Payments data: Do you have payments reported in the Open Payments database? Find out on the Open Payments website or if you already have an account, log in to the portal to review.
Sign up for compliance updates: Subscribe to the provider compliance email list and be the first to know about events and opportunities to collaborate with CMS and your fellow providers.
Featured Resource
Medicaid Integrity Institute Training: Learn the latest in fraud schemes and detection.
For States
Comprehensive Medicaid Integrity Plan, FY 2019 – FY 2023 (PDF)
Explore the 5-year, comprehensive plan to protect taxpayer dollars in the Medicaid program by combatting fraud, waste and abuse.
Strengthen safeguards in Personal Care Services: Read about noteworthy practices and CMS guidance in the CMS Medicaid Integrity Institute paper, Vulnerabilities and Mitigation Strategies in Medicaid Personal Care Services (PDF) and the CMS FAQ on Allowability of Using National Provider Identifiers (NPIs) for Medicaid Personal Care Attendants (PCAs) (PDF).
Join the fight against the opioid epidemic: The Medicaid Integrity Institute Compendium of Promising Practices explores how states are addressing program integrity vulnerabilities produced by opioid misuse and abuse. Learn more (PDF).
Learn the latest in fraud schemes and detection: The Medicaid Integrity Institute (MII) exists to educate and train our state partners. Located in Columbia, South Carolina and developed by CMS in partnership with the Department of Justice, MII brings together experts - including law enforcement - to deliver up-to-date information on trends and strategies. See the latest course offerings on the MII training page.
Find guidance on federal Medicaid enrollment standards: The Medicaid Provider Enrollment Compendium (MPEC) is one of many resources available to state Medicaid agencies on Medicaid.gov's Medicaid program integrity resources page. Specifically, the MPEC provides guidance and clarification to help Medicaid agencies comply with regulations around Disclosure of Information by Providers, and Fiscal Agents and Provider Screening and Enrollment.
Featured Resource
Check the Open Payments Data: The Open Payments program publishes information about payments made to providers and teaching hospitals by the pharmaceutical and medical device industries. Learn more.
FOR Partners & Plans
Protect Your Information All people on Medicare are issued cards with their Medicare ID numbers, and it's important to protect your Medicare ID from unauthorized use. Anyone suspecting healthcare fraud, waste or abuse is encouraged to report it. Our Reporting Fraud page lists the different options for doing so.
Join the Healthcare Fraud Prevention Partnership: Learn how sharing data with others in the heath care industry can help fight fraud, waste, and abuse. Learn more and become a partner.
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:
11/02/2023 01:28 PM