Pew releases database of state Medicaid anti-fraud strategies

The Pew Charitable Trusts' Pew Center on the States launched a new database yesterday to serve as a nationwide showcase of state-level Medicaid anti-fraud strategies. The Medicaid Anti-Fraud and Abuse database, the first resource of its kind, compiles the fraud-combatting policies and practices used in each state, based on data from the Centers for Medicare & Medicaid Services (CMS) annual state program integrity reviews.

In addition to describing each state’s anti-fraud measures, the database also identifies the practices that CMS has deemed “noteworthy” of emulation by others, including initiatives to combat fraud at the front gate—provider enrollment.

The database is designed to be a knowledge-sharing tool to help state authorities decide which fraud prevention methods may work best in their own states. Going forward, the data should take on even more relevance and insight, since comparative years of data will have been collected after the states implemented the integrity requirements mandated by the 2010 Affordable Care Act.

The Medicaid Anti-Fraud and Abuse database is part of Pew’s State Health Care Spending Project.

To learn more about CMS’ Medicaid Integrity Program, read the June 2012 report.


Topics: Advocacy , Executive Leadership , Medicare/Medicaid , Regulatory Compliance