CPI
Our Mission Priorities
Strengthen our integrity programs related to Medicare Advantage enforcement and oversight
Expand the scope of our integrity programs related to Medicaid managed care enforcement and oversight
Increase our integrity efforts related to problematic Marketplace agents/brokers
Prioritize and pursue mitigation strategies for the highest-priority program integrity vulnerabilities, while simultaneously improving the evaluation of any existing mitigation strategies
Foster a positive and inclusive hybrid workplace and workforce, while promoting excellence in all aspects of CPI’s operations
Integrate artificial intelligence and other technological improvements to reduce fraud, waste and abuse, and streamline operations
Center for Program Integrity
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What's New
Help Improve the Program for Evaluating Payment Patterns Electronic Reports & Comparative Billing Reports
The Center for Medicare & Medicaid Services (CMS) seeks information for a reevaluation of the Comparative Billing Reports (CBRs) and Program for Evaluating Payment Patterns Electronic Reports (PEPPERs) to improve the effectiveness and accessibility of the programs.
CMS seeks responses to a series of questions listed in the Request for Information (RFI) (PDF) and may use the information collected to make changes to the design of the program.
Responses are due on or before 08/19/2024 and must be provided via on-line submission at the following address:
CBRPEPPERInquiries@cms.hhs.gov.
CMS seeks responses to a series of questions listed in the Request for Information (RFI) (PDF) and may use the information collected to make changes to the design of the program.
Responses are due on or before 08/19/2024 and must be provided via on-line submission at the following address:
CBRPEPPERInquiries@cms.hhs.gov.
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:
07/18/2024 08:34 AM