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Triennial State program integrity reviews play a critical role in how CMS provides effective support and assistance to States in their efforts to combat provider fraud and abuse. The reviews are comprehensive, including examinations of provider enrollment, provider disclosures, program integrity, managed care and the State's relationships with the Medicaid Fraud Control Unit (MFCU). Through these reviews, CMS assesses the effectiveness of the State's program integrity efforts, including its compliance with Federal statutory and regulatory requirements. The reviews also assist in identifying effective State program integrity activities which may be considered particularly noteworthy and shared with other States. (For comprehensive State program integrity review reports, click on the "Downloads" below.) CMS also conducts focused program integrity reviews on an as-needed basis. Focused reviews examine specific areas of program integrity concern in one or more states. The Program Integrity Review Annual Summary report is a compendium of data collected from 19 comprehensive integrity reviews conducted in federal fiscal years 2007-2008 for which final reports have been issued. The report includes information about effective practices, areas of vulnerability and areas of non-compliance. The Medicaid Integrity Group will publish this report annually in its efforts to provide effective support and assistance to the States. (For the 2008 Program Integrity Review Annual Summary Report, click on the "Downloads" below.)
Page Last Modified: 10/19/2009 9:40:35 AM
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