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Medicaid Anti-Fraud and Abuse Practices

Learn about states’ promising practices to reduce Medicaid fraud and abuse

 

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This first-of-its-kind database compiles and categorizes promising practices states employ to combat Medicaid fraud and abuse. These practices were cited by the Centers for Medicare & Medicaid Services (CMS) in the agency’s state reviews.

Using the Database

Select one or more states and practice types to see what states are doing to combat fraud and abuse. To select multiple states, hold down the Ctrl key (the Command key for Macs) while clicking selections. Read more about the fraud and abuse challenges facing states and the data in this tool.

Note: CMS Noteworthy Picks are practices CMS identified in its comprehensive reviews of states that it recommends other states consider emulating.

 

The State Health Care Spending Project is an initiative of The Pew Charitable Trusts and the John D. and Catherine T. MacArthur Foundation.

Source: Centers for Medicare & Medicaid Services, Program Integrity Review Reports List: https://www.cms.gov/Medicare-Medicaid-Coordination/Fraud-Prevention/FraudAbuseforProfs/Program-Integrity-Review-Reports-List.html

Note: The Centers for Medicare & Medicaid Services’ (CMS) Medicaid Integrity Group (MIG) conducts comprehensive program integrity reviews of Medicaid programs in each state and the District of Columbia, highlighting practices it considers “noteworthy.” Pew examined all MIG reviews available online as of February 2013—accounting for all 50 states and the District of Columbia—to identify approaches reported by the states and CMS. Because a number of the reviews date back to 2008, some of the practices cited may no longer be in place.

Date:
January 31, 2013
Project:
State Health Care Spending
Issues:
Medicaid
 
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Related RESEARCH & ANALYSIS

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