Medicaid Integrity Program

 Background

In February 2006, the Deficit Reduction Act (DRA) of 2005 was signed into law and created the Medicaid Integrity Program (MIP) under section 1936 of the Social Security Act (the Act).  The MIP is the first comprehensive Federal strategy to prevent and reduce provider fraud, waste, and abuse in the $300 billion per year Medicaid program. CMS is required to report to Congress annually on the effectiveness of the use of funds appropriated for the MIP. 
Although the States are primarily responsible for combating fraud in the Medicaid program, CMS provides technical assistance, guidance and oversight in these efforts. CMS has two broad responsibilities under the Medicaid Integrity Program:

• To hire contractors to review Medicaid provider activities, audit claims, identify overpayments, and educate providers and others on Medicaid program integrity issues 
• To provide effective support and assistance to States in their efforts to combat Medicaid provider fraud and abuse

On these pages, you will find the latest information on the MIP program, AHA's advocacy efforts and educational activities, and links to CMS resources.