CPI

The Center for Program Integrity
The Center for Program Integrity

Our Mission Priorities

Strengthen Medicare Advantage Oversight

Strengthen our integrity programs related to Medicare Advantage enforcement and oversight

Increase Medicaid Managed Care Oversight

Expand the scope of our integrity programs related to Medicaid managed care enforcement and oversight

Enhance Marketplace Agent/Broker Oversight

Increase our integrity efforts related to problematic Marketplace agents/brokers

Prioritize and Mitigate Top Vulnerabilities

Prioritize and pursue mitigation strategies for the highest-priority program integrity vulnerabilities, while simultaneously improving the evaluation of any existing mitigation strategies

Promote Excellence in Operations

Foster a positive and inclusive hybrid workplace and workforce, while promoting excellence in all aspects of CPI’s operations

Leverage Technology and Innovation

Integrate artificial intelligence and other technological improvements to reduce fraud, waste and abuse, and streamline operations

What We Do
Provider Enrollment

CPI builds systems and manages programs to enroll providers in the Medicare and Medicaid programs.

Medical Reviews & Audits

CPI oversees medical reviews and audits to safeguard the Medicare and Medicaid programs from fraud, waste and abuse.

Data Analysis

Using predictive analytics, we identify and seek to prevent fraud, waste and abuse. See an example of how data is used to understand the health care landscape with the Market Saturation and Utilization map.

Collaboration with States

CPI offers support and venues for states to collaborate and share best fraud-fighting practices, making the Medicaid program stronger and protecting the care of states’ Medicaid populations.

Page Last Modified:
09/18/2024 03:45 PM