Medicaid Integrity Program

Medicaid Integrity Program

Since 2006, the Centers for Medicare & Medicaid Services’ Medicaid Integrity Program has been collaborating with states to promote best practices and awareness of Medicaid and Children’s Health Insurance Program (CHIP) fraud, waste, and abuse. Our oversight and educational work help preserve Medicaid dollars and support states as they serve the needs of Medicaid beneficiaries.

Oversight Activities

We undertake various oversight activities to ensure that Medicaid dollars are spent appropriately and accurately. For additional information, see our 5-year, Comprehensive Medicaid Integrity Plan (PDF) for FYs 2019-2023 to protect taxpayer dollars in the Medicaid program and CHIP by combatting fraud, waste, and abuse.

Educational Efforts

We provide a variety of educational resources online to help states, health plans, providers, and others in the fight against fraud, waste, and abuse. These resources cover important topics and best practices to support state program integrity staff. We also provide toolkits that explain Medicaid benefits that are prone to errors, such as non-emergency medical transportation, personal care services, and more.

Medicaid Integrity Institute

We provide training year-round to State Medicaid Program Integrity personnel through the Medicaid Integrity Institute.

Learn More

• Comprehensive Medicaid Integrity Plan for FYs 2019-2023 (PDF) – Read our detailed plan to protect taxpayer dollars in the Medicaid program and CHIP by combatting fraud, waste, and abuse.
• Annual Reports to Congress – Medicaid and Medicare Program Integrity Programs – Get a detailed understanding of how we use our funds and the effectiveness of our efforts in our annual reports to Congress.
• State Program Integrity Reviews – Learn from the experience of other states by reading our annual state and topical reviews.

Report Suspected Fraud, Waste, and Abuse

Medicaid fraud, waste, and abuse can happen at the provider, supplier, and beneficiary level. Because each state manages its own Medicaid program, you should contact your state to report suspicious activity. You can also learn how to report Medicare fraud, waste, or abuse.

Stay in Touch

Contact us by email with questions or suggestions at Medicaid_Integrity_Program@cms.hhs.gov.