State Program Integrity Reviews

State Program Integrity offices are on the front line of the fight to combat fraud, waste, and abuse in Medicaid. The Centers for Medicare & Medicaid Services (CMS) supports those efforts with regular state level reviews. From 2007-2013 CMS conducted comprehensive reviews of each state’s Medicaid Program Integrity (PI) activities and reported findings and recommendations to states. The comprehensive reviews involved an in-depth assessment of the state’s PI activities:

Regulatory compliance
Surveillance and utilization systems
Case tracking
Pre-payment and post-payment review
Provider enrollment and disclosures
Interactions with the state's Medicaid Fraud Control Unit (MFCU)
Oversight of managed care operation

As a companion to the comprehensive reviews, CMS created Frequent Findings reports. These toolkits were designed to help states better understand requirements and improve compliance with regulations for provider disclosures, federal database checks, and reporting adverse actions taken against providers to HHS-OIG.

Beginning in 2014, CMS began conducting focused reviews. Focused reviews are conducted to determine the extent of program integrity (PI) oversight of the Medicaid program by the States. Traditionally, these reviews have focused on high risk areas of managed care, Affordable Care Act provisions, personal care services and non-emergency medical transportation.

These reviews are designed to identify risks and vulnerabilities to the Medicaid program and assist states with strengthening program integrity operations. The significance and value of performing onsite program integrity reviews include:

Assess the effectiveness of the state’s PI efforts, including compliance with certain Federal statutory and regulatory requirements
Identify risks and vulnerabilities to the Medicaid program and assist states to strengthen PI operations
Help inform CMS in developing future guidance to states
Help prepare states with the tools to improve PI operations and performance

Annual Summary Reports

Search below for comprehensive and focused reports by state or year.

Date	Fiscal Year	State / Territory	Type of Report
Date 2007-11-01	Fiscal Year 2007	State / Territory Connecticut	Type of Report Comprehensive
Date 2008-03-01	Fiscal Year 2007	State / Territory Nevada	Type of Report Comprehensive
Date 2008-05-01	Fiscal Year 2007	State / Territory Arkansas	Type of Report Comprehensive
Date 2008-06-01	Fiscal Year 2007	State / Territory Delaware	Type of Report Comprehensive
Date 2008-07-01	Fiscal Year 2007	State / Territory Missouri	Type of Report Comprehensive
Date 2008-07-01	Fiscal Year 2007	State / Territory Michigan	Type of Report Comprehensive
Date 2008-07-01	Fiscal Year 2008	State / Territory Oklahoma	Type of Report Comprehensive
Date 2008-09-01	Fiscal Year 2007	State / Territory Oregon	Type of Report Comprehensive
Date 2008-11-01	Fiscal Year 2007	State / Territory Virginia	Type of Report Comprehensive
Date 2008-11-01	Fiscal Year 2008	State / Territory Iowa	Type of Report Comprehensive
Date 2008-11-01	Fiscal Year 2008	State / Territory Texas	Type of Report Comprehensive
Date 2008-12-01	Fiscal Year 2008	State / Territory Georgia	Type of Report Comprehensive
Date 2008-12-01	Fiscal Year 2008	State / Territory North Dakota	Type of Report Comprehensive
Date 2008-12-01	Fiscal Year 2008	State / Territory Illinois	Type of Report Comprehensive
Date 2008-12-01	Fiscal Year 2008	State / Territory Wyoming	Type of Report Comprehensive
Date 2008-12-01	Fiscal Year 2008	State / Territory North Carolina	Type of Report Comprehensive
Date 2009-01-01	Fiscal Year 2008	State / Territory South Carolina	Type of Report Comprehensive
Date 2009-01-01	Fiscal Year 2008	State / Territory South Dakota	Type of Report Comprehensive
Date 2009-01-01	Fiscal Year 2008	State / Territory Utah	Type of Report Comprehensive
Date 2009-01-01	Fiscal Year 2008	State / Territory New York	Type of Report
Date 2009-02-01	Fiscal Year 2008	State / Territory Minnesota	Type of Report Comprehensive
Date 2009-03-01	Fiscal Year 2008	State / Territory New Mexico	Type of Report Comprehensive
Date 2009-04-01	Fiscal Year 2009	State / Territory New Hampshire	Type of Report Comprehensive
Date 2009-07-01	Fiscal Year 2008	State / Territory Pennsylvania	Type of Report Comprehensive
Date 2009-07-01	Fiscal Year 2009	State / Territory Maine	Type of Report Comprehensive
Date 2009-08-01	Fiscal Year 2008	State / Territory Wisconsin	Type of Report Comprehensive
Date 2009-08-01	Fiscal Year 2008	State / Territory Vermont	Type of Report Comprehensive
Date 2009-09-01	Fiscal Year 2009	State / Territory Florida	Type of Report Comprehensive
Date 2009-09-01	Fiscal Year 2008	State / Territory Puerto Rico	Type of Report Comprehensive
Date 2010-02-01	Fiscal Year 2009	State / Territory Arizona	Type of Report Comprehensive
Date 2010-03-01	Fiscal Year 2009	State / Territory Louisiana	Type of Report Comprehensive
Date 2010-03-01	Fiscal Year 2008	State / Territory Idaho	Type of Report Comprehensive
Date 2010-04-01	Fiscal Year 2009	State / Territory Alabama	Type of Report Comprehensive
Date 2010-08-01	Fiscal Year 2009	State / Territory District of Columbia	Type of Report Comprehensive
Date 2010-08-01	Fiscal Year 2008	State / Territory Tennessee	Type of Report Comprehensive
Date 2010-08-01	Fiscal Year 2009	State / Territory Mississippi	Type of Report Comprehensive
Date 2010-10-01	Fiscal Year 2009	State / Territory District of Columbia	Type of Report Focused
Date 2010-10-01	Fiscal Year 2009	State / Territory Kentucky	Type of Report Comprehensive
Date 2010-12-01	Fiscal Year 2009	State / Territory Rhode Island	Type of Report Comprehensive
Date 2010-12-01	Fiscal Year 2009	State / Territory Nebraska	Type of Report Comprehensive
Date 2010-12-01	Fiscal Year 2010	State / Territory New York	Type of Report Comprehensive
Date 2011-01-01	Fiscal Year 2009	State / Territory New Jersey	Type of Report Comprehensive
Date 2011-01-01	Fiscal Year 2009	State / Territory Washington	Type of Report Comprehensive
Date 2011-01-01	Fiscal Year 2009	State / Territory Maryland	Type of Report Comprehensive
Date 2011-01-01	Fiscal Year 2010	State / Territory Delaware	Type of Report Comprehensive
Date 2011-01-01	Fiscal Year 2009	State / Territory California	Type of Report Comprehensive
Date 2011-01-01	Fiscal Year 2009	State / Territory Colorado	Type of Report Comprehensive
Date 2011-01-01	Fiscal Year 2010	State / Territory Kansas	Type of Report Comprehensive
Date 2011-02-01	Fiscal Year 2009	State / Territory Massachusetts	Type of Report Comprehensive
Date 2011-02-01	Fiscal Year 2010	State / Territory Arkansas	Type of Report Comprehensive
Date 2011-02-01	Fiscal Year 2010	State / Territory Indiana	Type of Report Comprehensive
Date 2011-02-01	Fiscal Year 2009	State / Territory West Virginia	Type of Report Comprehensive
Date 2011-02-01	Fiscal Year 2010	State / Territory Ohio	Type of Report Comprehensive
Date 2011-03-01	Fiscal Year 2010	State / Territory Virginia	Type of Report Comprehensive
Date 2011-03-01	Fiscal Year 2010	State / Territory Alaska	Type of Report Comprehensive
Date 2011-03-01	Fiscal Year 2010	State / Territory Nevada	Type of Report Comprehensive
Date 2011-04-01	Fiscal Year 2010	State / Territory Texas	Type of Report Comprehensive
Date 2011-04-01	Fiscal Year 2010	State / Territory Missouri	Type of Report Comprehensive
Date 2011-05-01	Fiscal Year 2010	State / Territory Iowa	Type of Report Comprehensive
Date 2011-06-01	Fiscal Year 2011	State / Territory Idaho	Type of Report Comprehensive
Date 2011-06-01	Fiscal Year 2010	State / Territory Oregon	Type of Report Comprehensive
Date 2011-07-01	Fiscal Year 2010	State / Territory Michigan	Type of Report Comprehensive
Date 2011-08-01	Fiscal Year 2010	State / Territory Connecticut	Type of Report Comprehensive
Date 2011-08-01	Fiscal Year 2011	State / Territory Oklahoma	Type of Report Comprehensive
Date 2011-08-01	Fiscal Year 2010	State / Territory Montana	Type of Report Comprehensive
Date 2011-09-01	Fiscal Year 2010	State / Territory Hawaii	Type of Report Comprehensive
Date 2011-09-01	Fiscal Year 2011	State / Territory Vermont	Type of Report Comprehensive
Date 2011-10-01	Fiscal Year 2011	State / Territory South Carolina	Type of Report Comprehensive
Date 2012-01-01	Fiscal Year 2011	State / Territory Utah	Type of Report Comprehensive
Date 2012-01-01	Fiscal Year 2011	State / Territory Puerto Rico	Type of Report Comprehensive
Date 2012-01-01	Fiscal Year 2011	State / Territory Wisconsin	Type of Report Comprehensive
Date 2012-01-01	Fiscal Year 2011	State / Territory Illinois	Type of Report Comprehensive
Date 2012-01-01	Fiscal Year 2011	State / Territory Georgia	Type of Report Comprehensive
Date 2012-02-01	Fiscal Year 2011	State / Territory North Dakota	Type of Report Comprehensive
Date 2012-03-01	Fiscal Year 2011	State / Territory Tennessee	Type of Report Comprehensive
Date 2012-04-01	Fiscal Year 2011	State / Territory Wyoming	Type of Report Comprehensive
Date 2012-04-01	Fiscal Year 2011	State / Territory North Carolina	Type of Report Comprehensive
Date 2012-05-01	Fiscal Year 2011	State / Territory New Mexico	Type of Report Comprehensive
Date 2012-05-01	Fiscal Year 2011	State / Territory Pennsylvania	Type of Report Comprehensive
Date 2012-06-01	Fiscal Year 2012	State / Territory Washington	Type of Report Comprehensive
Date 2012-06-01	Fiscal Year 2012	State / Territory New Jersey	Type of Report Comprehensive
Date 2012-06-01	Fiscal Year 2011	State / Territory Minnesota	Type of Report Comprehensive
Date 2012-07-01	Fiscal Year 2012	State / Territory Florida	Type of Report Comprehensive
Date 2012-08-01	Fiscal Year 2012	State / Territory Massachusetts	Type of Report Comprehensive
Date 2012-08-01	Fiscal Year 2012	State / Territory Maine	Type of Report Comprehensive
Date 2012-11-01	Fiscal Year 2012	State / Territory New Hampshire	Type of Report Comprehensive
Date 2012-11-30	Fiscal Year 2012	State / Territory California	Type of Report Comprehensive
Date 2012-12-04	Fiscal Year 2013	State / Territory Rhode Island	Type of Report Comprehensive
Date 2013-01-01	Fiscal Year 2012	State / Territory Nebraska	Type of Report Comprehensive
Date 2013-01-01	Fiscal Year 2013	State / Territory West Virginia	Type of Report Comprehensive
Date 2013-01-01	Fiscal Year 2012	State / Territory Arizona	Type of Report Comprehensive
Date 2013-01-03	Fiscal Year 2012	State / Territory Colorado	Type of Report Comprehensive
Date 2013-02-15	Fiscal Year 2012	State / Territory Mississippi	Type of Report Comprehensive
Date 2013-05-22	Fiscal Year 2012	State / Territory Maryland	Type of Report Comprehensive
Date 2013-05-22	Fiscal Year 2012	State / Territory Kentucky	Type of Report Comprehensive
Date 2013-06-01	Fiscal Year 2012	State / Territory Alabama	Type of Report Comprehensive
Date 2013-12-31	Fiscal Year 2012	State / Territory Louisiana	Type of Report Comprehensive
Date 2014-01-31	Fiscal Year 2013	State / Territory Arkansas	Type of Report Comprehensive
Date 2014-02-01	Fiscal Year 2012	State / Territory District of Columbia	Type of Report Comprehensive
Date 2014-02-21	Fiscal Year 2013	State / Territory Alaska	Type of Report Comprehensive
Date 2014-02-28	Fiscal Year 2013	State / Territory Montana	Type of Report Comprehensive
Date 2014-06-28	Fiscal Year 2013	State / Territory Hawaii	Type of Report Comprehensive
Date 2014-07-31	Fiscal Year 2013	State / Territory New York	Type of Report Comprehensive
Date 2014-07-31	Fiscal Year 2013	State / Territory Kansas	Type of Report Comprehensive
Date 2014-08-01	Fiscal Year 2013	State / Territory Ohio	Type of Report Comprehensive
Date 2014-10-01	Fiscal Year 2013	State / Territory Michigan	Type of Report Comprehensive
Date 2014-12-31	Fiscal Year 2013	State / Territory Oregon	Type of Report Comprehensive
Date 2014-12-31	Fiscal Year 2013	State / Territory Georgia	Type of Report Comprehensive
Date 2015-01-01	Fiscal Year 2013	State / Territory North Dakota	Type of Report Comprehensive
Date 2015-01-01	Fiscal Year 2013	State / Territory Iowa	Type of Report Comprehensive
Date 2015-01-01	Fiscal Year 2013	State / Territory South Dakota	Type of Report Comprehensive
Date 2015-01-31	Fiscal Year 2013	State / Territory Indiana	Type of Report Comprehensive
Date 2015-09-01	Fiscal Year 2014	State / Territory New Mexico	Type of Report Focused
Date 2015-09-01	Fiscal Year 2014	State / Territory Illinois	Type of Report Focused
Date 2015-12-01	Fiscal Year 2014	State / Territory Minnesota	Type of Report Focused
Date 2015-12-01	Fiscal Year 2014	State / Territory District of Columbia	Type of Report Focused
Date 2015-12-31	Fiscal Year 2014	State / Territory Massachusetts	Type of Report Focused
Date 2015-12-31	Fiscal Year 2015	State / Territory Tennessee	Type of Report Focused
Date 2016-01-31	Fiscal Year 2014	State / Territory New Jersey	Type of Report Focused
Date 2016-02-01	Fiscal Year 2014	State / Territory Michigan	Type of Report Focused
Date 2016-02-02	Fiscal Year 2014	State / Territory Ohio	Type of Report Focused
Date 2016-02-16	Fiscal Year 2015	State / Territory Delaware	Type of Report Focused
Date 2016-03-01	Fiscal Year 2015	State / Territory Nevada	Type of Report Focused
Date 2016-03-01	Fiscal Year 2015	State / Territory Pennsylvania	Type of Report Focused
Date 2016-03-01	Fiscal Year 2014	State / Territory New York	Type of Report Focused
Date 2016-03-25	Fiscal Year 2014	State / Territory California	Type of Report Focused
Date 2016-05-03	Fiscal Year 2015	State / Territory North Carolina	Type of Report Focused
Date 2016-05-03	Fiscal Year 2015	State / Territory Missouri	Type of Report Focused
Date 2016-05-03	Fiscal Year 2015	State / Territory Connecticut	Type of Report Focused
Date 2016-07-05	Fiscal Year 2015	State / Territory Wisconsin	Type of Report Focused
Date 2016-08-02	Fiscal Year 2016	State / Territory Puerto Rico	Type of Report Focused
Date 2016-10-04	Fiscal Year 2015	State / Territory Vermont	Type of Report Focused
Date 2016-12-01	Fiscal Year 2015	State / Territory Texas	Type of Report Focused
Date 2017-02-01	Fiscal Year 2016	State / Territory Virginia	Type of Report Focused
Date 2017-03-07	Fiscal Year 2016	State / Territory Maryland	Type of Report Focused
Date 2017-05-01	Fiscal Year 2016	State / Territory Kentucky	Type of Report Focused
Date 2017-05-31	Fiscal Year 2016	State / Territory New Hampshire	Type of Report Focused
Date 2017-06-01	Fiscal Year 2016	State / Territory Rhode Island	Type of Report Focused
Date 2017-06-01	Fiscal Year 2016	State / Territory Nebraska	Type of Report Focused
Date 2017-06-01	Fiscal Year 2016	State / Territory West Virginia	Type of Report Focused
Date 2017-06-01	Fiscal Year 2016	State / Territory South Carolina	Type of Report Focused
Date 2017-06-01	Fiscal Year 2016	State / Territory Utah	Type of Report Focused
Date 2017-07-28	Fiscal Year 2016	State / Territory Alabama	Type of Report Focused
Date 2017-07-28	Fiscal Year 2017	State / Territory Arizona	Type of Report Focused
Date 2017-08-01	Fiscal Year 2017	State / Territory District of Columbia	Type of Report Focused
Date 2017-08-01	Fiscal Year 2017	State / Territory Louisiana	Type of Report Focused
Date 2017-10-02	Fiscal Year 2017	State / Territory Colorado	Type of Report Focused
Date 2017-11-01	Fiscal Year 2017	State / Territory Indiana	Type of Report Focused
Date 2018-01-01	Fiscal Year 2017	State / Territory Iowa	Type of Report Focused
Date 2018-01-03	Fiscal Year 2017	State / Territory Florida	Type of Report Focused
Date 2018-02-01	Fiscal Year 2017	State / Territory South Dakota	Type of Report Focused
Date 2018-03-30	Fiscal Year 2017	State / Territory Mississippi	Type of Report Focused
Date 2018-04-30	Fiscal Year 2017	State / Territory New York	Type of Report Focused
Date 2018-11-01	Fiscal Year 2018	State / Territory Oregon	Type of Report Focused
Date 2018-11-30	Fiscal Year 2018	State / Territory Georgia	Type of Report Focused
Date 2018-12-03	Fiscal Year 2018	State / Territory Arkansas	Type of Report Focused
Date 2018-12-03	Fiscal Year 2018	State / Territory Wyoming	Type of Report Focused
Date 2019-01-01	Fiscal Year 2018	State / Territory Kansas	Type of Report Focused
Date 2019-01-04	Fiscal Year 2018	State / Territory Washington	Type of Report Focused
Date 2019-01-08	Fiscal Year 2018	State / Territory Idaho	Type of Report Focused
Date 2019-01-08	Fiscal Year 2018	State / Territory Illinois	Type of Report Focused
Date 2019-01-09	Fiscal Year 2018	State / Territory Minnesota	Type of Report Focused
Date 2019-01-31	Fiscal Year 2018	State / Territory Oklahoma	Type of Report Focused
Date 2019-01-31	Fiscal Year 2018	State / Territory Texas	Type of Report Focused
Date 2019-01-31	Fiscal Year 2018	State / Territory Delaware	Type of Report Focused
Date 2019-07-01	Fiscal Year 2019	State / Territory North Dakota	Type of Report Focused
Date 2019-07-01	Fiscal Year 2019	State / Territory Tennessee	Type of Report Focused
Date 2019-10-01	Fiscal Year 2019	State / Territory Ohio	Type of Report Focused
Date 2019-10-31	Fiscal Year 2019	State / Territory Connecticut	Type of Report Focused
Date 2019-11-01	Fiscal Year 2019	State / Territory Maine	Type of Report Focused
Date 2020-02-01	Fiscal Year 2019	State / Territory Massachusetts	Type of Report Focused
Date 2020-02-01	Fiscal Year 2019	State / Territory Pennsylvania	Type of Report Focused
Date 2020-02-01	Fiscal Year 2019	State / Territory Montana	Type of Report Focused
Date 2020-03-01	Fiscal Year 2019	State / Territory New Jersey	Type of Report Focused
Date 2020-03-01	Fiscal Year 2019	State / Territory Vermont	Type of Report Focused
Date 2020-03-02	Fiscal Year 2019	State / Territory New Mexico	Type of Report Focused
Date 2020-03-02	Fiscal Year 2019	State / Territory Missouri	Type of Report Focused
Date 2020-03-02	Fiscal Year 2019	State / Territory New Jersey	Type of Report Focused
Date 2021-12-01	Fiscal Year 2021	State / Territory Alabama	Type of Report
Date 2022-01-01	Fiscal Year 2021	State / Territory Iowa	Type of Report
Date 2022-02-01	Fiscal Year 2021	State / Territory West Virginia	Type of Report
Date 2022-04-01	Fiscal Year 2021	State / Territory Rhode Island	Type of Report
Date 2022-05-01	Fiscal Year 2021	State / Territory Kentucky	Type of Report
Date 2022-05-01	Fiscal Year 2021	State / Territory Wisconsin	Type of Report
Date 2022-06-01	Fiscal Year 2021	State / Territory Michigan	Type of Report
Date 2022-06-01	Fiscal Year 2021	State / Territory Utah	Type of Report
Date 2022-10-17	Fiscal Year 2021	State / Territory Maryland	Type of Report
Date 2022-10-17	Fiscal Year 2021	State / Territory Nevada	Type of Report
Date 2022-10-17	Fiscal Year 2021	State / Territory Virginia	Type of Report
Date 2022-10-18	Fiscal Year 2021	State / Territory South Carolina	Type of Report
Date 2023-04-03	Fiscal Year 2022	State / Territory Nebraska	Type of Report Focused
Date 2023-04-05	Fiscal Year 2022	State / Territory Hawaii	Type of Report
Date 2023-05-17	Fiscal Year 2022	State / Territory Arizona	Type of Report Focused
Date 2023-05-17	Fiscal Year 2022	State / Territory Colorado	Type of Report Focused
Date 2023-06-01	Fiscal Year 2022	State / Territory Mississippi	Type of Report Focused
Date 2023-06-01	Fiscal Year 2022	State / Territory New Hampshire	Type of Report Focused
Date 2023-08-01	Fiscal Year 2022	State / Territory District of Columbia	Type of Report Focused
Date 2023-09-01	Fiscal Year 2022	State / Territory California	Type of Report Focused
Date 2023-10-10	Fiscal Year 2022	State / Territory Indiana	Type of Report Focused
Date 2023-10-10	Fiscal Year 2022	State / Territory Louisiana	Type of Report Focused
Date 2023-10-10	Fiscal Year 2022	State / Territory South Dakota	Type of Report Focused
Date 2024-02-08	Fiscal Year 2022	State / Territory Alaska	Type of Report Comprehensive
Date 2024-03-13	Fiscal Year 2022	State / Territory North Carolina	Type of Report Focused
Date 2024-05-29	Fiscal Year 2023	State / Territory Washington	Type of Report Focused
Date 2024-07-01	Fiscal Year 2023	State / Territory Illinois	Type of Report Focused
Date 2024-10-16	Fiscal Year 2023	State / Territory Minnesota	Type of Report Focused
Date 2024-10-22	Fiscal Year 2023	State / Territory Kansas	Type of Report Focused

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