Program Integrity
Program integrity refers to the activities undertaken to prevent waste, fraud and abuse. Waste, fraud and abuse occurs in both private insurance and public health care programs such as Medicaid and Medicare. CCF experts mainly cover Medicaid program integrity.
Featured
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Long-Standing State-Based Efforts to Combat Fraud Against Medicaid Continue to Improve
CMS Administrator Dr. Oz has been on a veritable press tour trumpeting the supposed rampant fraud in Medicaid and other government programs, which nationally he claims could add up to as much as $100 billion, presumably in a single year – though he hasn’t specified a timeframe. The White House recently established the Task Force…
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CMS Weaponizes Fraud Against Medicaid in Minnesota: The District Court Rules
On April 6, U.S. District Court Judge Eric Tostrud issued a decision in Minnesota v. Oz. The case was triggered by CMS’s deferral of $259 million in federal matching funds from the Minnesota Medicaid program on February 25. In response, the State filed suit on March 2 asking the court to block the CMS action…
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The White House Task Force to Eliminate Fraud: What’s at Stake for Medicaid
On March 19, President Trump issued an Executive Order Establishing the Task Force to Eliminate Fraud. The stated purpose of the Task Force, which is chaired by Vice President J.D. Vance, is to “coordinate and accelerate a comprehensive national strategy to stop fraud, waste, and abuse within Federal benefit programs, including programs administered jointly with…
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CMS Weaponizes Fraud Against Medicaid in Minnesota: An Unexpected Development
On March 19th, CMS notified Minnesota’s Medicaid Director that it has approved the state’s corrective action plan (CAP) for addressing fraud. The state submitted the CAP on January 30 in response to a CMS determination that the state was not in compliance with federal Medicaid law and that, as a result, CMS would withhold over $2…
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CMS Weaponizes Fraud Against Medicaid in Minnesota: The State Fights Back
On March 2, the state of Minnesota filed a lawsuit against the Centers for Medicare & Medicaid Services in federal district court. The case, State of Minnesota v. Oz, is in response to two actions taken by CMS against the state for what CMS says is the state’s failure to control fraud against its Medicaid…