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Medicare Integrity Program (MIP) contractor

These companies, on behalf of Medicare, conduct provider and supplier audits, medical reviews, cost report audits, beneficiary surveys, and provider education. CMS exercises the flexibility through MIP to contract with both Medicare claims processors and distinct fraud and abuse contractors to identify and root out improper payments. The Medicare Integrity Program was created as part of the Health Care Fraud and Abuse Control (HCFAC) program. The purpose of the MIP program is to ensure that Medicare outlays are made to the appropriate provider on behalf of eligible beneficiaries for covered services. Through HCFAC, the MIP program also coordinates with the HHS OIG, the FBI, and other fraud and abuse programs to ensure that all aspects of safeguarding payments are addressed — including preventing, identifying and/or resolving errors, fraud, waste and abuse.

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