The Centers for Medicare & Medicaid Services (CMS) established Audit Medicaid Integrity Contractors (Audit MICs) to identify Medicaid overpayments and decrease the payment of inappropriate Medicaid claims.
In 2009, CMS awarded Health Integrity the Audit MIC Task Order 5 contract to perform audits of Medicaid providers in the Midwestern United States: Illinois, Indiana, Iowa, Kansas, Michigan, Minnesota, Missouri, Nebraska, Ohio, and Wisconsin.
In the same year, we were also awarded the Task Order 1R contract to perform audits of Medicaid providers in the Southeastern United States: Alabama, Delaware, Florida, Georgia, Kentucky, Maryland, Mississippi, North Carolina, Pennsylvania, South Carolina, Tennessee, Virginia, West Virginia, and the District of Columbia.
More recently, in 2011, CMS awarded Health Integrity a third Task Order (2R) for Western and South-western states of Montana, North Dakota, South Dakota, Utah, Colorado, Wyoming, New Mexico, Oklahoma, Texas, Arkansas, and Louisiana.
Our team of auditors, audit investigators, medical claims reviewers, and data analysts review and analyze claims submitted by all types of Medicaid providers to identify aberrant claims and potential billing vulnerabilities.
An overview of the Medicaid Integrity Program (MIP) can be found at CMS’s Medicaid Integrity Program website, where CMS publications pertaining specifically to audits and the MICs can be found under the “Provider Audits” Section.
To contact Health Integrity representatives from the Audit MIC, please call (866) 269-3494.