Most Medicaid managed care plans are paid predetermined, per-member-per-month capitation payments to cover and coordinate all Medicaid services used by their enrollees. These payments must be ...

Editor’s Note: In the past four months, the Government Accountability Office (GAO) and Office of the Inspector General (OIG) have issued a barrage of reports scrutinizing Medicaid programs and their ...

The Deficit Reduction Act of 2005 provided the resources to establish the Medicaid Integrity Program (MIP), the first national strategy in the 40-year history of the Medicaid program to promote the ...

On October 3, the Office of Inspector General (OIG) of the US Department of Health and Human Services issued a report titled “UPICs Hold Promise to Enhance Program Integrity Across Medicare and ...

Medicaid is the joint federal-state health insurance program that provides medical coverage to almost five million low-income, elderly, disabled Floridians and children. Although the federal ...

* * * Misclassification of Drugs, Program Administration and Program Integrity Updates Under the Medicaid Drug Rebate Program Notice for Proposed Rulemaking (CMS-2434-P) The Centers for Medicare & ...

A new federal review from the U.S. Centers for Medicare & Medicaid Services shows Minnesota’s Medicaid program has an improper payment rate far below the national ...