More collaboration between Medicare and Medicaid fraud detection programs is needed, report finds

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More communication is needed between Medicare and Medicaid's respective program integrity officials, a new report suggests.

The functions of Medicare recovery audit contractors (RACs) and Medicaid integrity contractors (MICs) often overlap, which results in duplication of services, according to a report released by the National Association of Medicaid directors. This doubling up also has happened in fraud detection programs, such as the Payment Error Rate Measurement (PERM) program and the Medicare-Medicaid Data Match Program.

To improve efficiency between Medicare and the Department of Health and Human Services Office of the Inspector General, the report recommends the creation of a taskforce run out of the Centers for Medicare & Medicaid Services' Medicare-Medicaid Coordination Office.

The task force should focus on breaking down communications barriers among Medicare, Medicaid, and the HHS OIG; cut duplicative integrity programs; give state Medicaid programs access to Medicare's data analytics and allocating federal resources to individual state Medicaid initiatives.

Click here to read the full NAMD report.

 

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