CMS Launches Comprehensive Effort To Combat Medicaid Fraud And Abuse

CMS Launches Comprehensive Effort To Combat Medicaid Fraud And Abuse

In an effort to halt theft, inappropriate use and simple mistakes that drain critical Medicaid program dollars, CMS today launched an unprecedented effort to detect and prevent program fraud and abuse, announced Mark B. McClellan, M.D., Ph.D., administrator of the Centers for Medicare & Medicaid Services (CMS).

“A comprehensive and systematic approach to combating the misuse of taxpayer funds is key to helping lower health care costs for Medicaid beneficiaries,” Dr. McClellan said.  “The program we are initiating today builds upon expanded activities to combat fraud in the Medicare program that have proven successful in the past few years, as well as recent congressional action on our request for additional funding to protect the Medicaid program. These strategies will yield significant Medicaid savings to help sustain the program.”

The new Medicaid Integrity Program (MIP) was created by the Deficit Reduction Act of 2005 with funds that will rise from $5 million in 2007to $75 million by fiscal year 2009 and each year thereafter. Congress specifically required the use of contractors to review the actions of those seeking payment from Medicaid, conduct audits, identify overpayments and educate providers and others on program integrity and quality of care. Congress also mandated that the agency devote at least 100 full-time staff to the project which will also be in collaboration with state Medicaid officials. Read more at cms.hhs.gov