On May 22, 2020, CMS rolled out Transmittal 10146, which completely reorganizes existing Chapter 15 of the Medicare Program Integrity Manual (MPIM), CMS 100-08. These changes, effective July 24, 2020, ...

CMS is gathering information for and seeking industry feedback on a project that would consolidate the audit and investigation services for Medicare and Medicaid integrity functions, creating new ...

The Government Accountability Office has issued a report recommending CMS more clearly communicate its goals for the Medicare Integrity Program and improve the reliability of data used to calculate ...

Federal and state regulators have increased scrutiny around false claims involving medically unnecessary services in recent years. Such claims are costly to Medicare, Medicaid and other payors, and ...