Health Integrity is the Medicare Part C and Part D program integrity contractor for the Centers for Medicare & Medicaid Services (CMS) under the National Benefit Integrity Medicare Drug Integrity Contract (NBI MEDIC).
The purpose of the NBI MEDIC is to detect and prevent fraud, waste, and abuse in the Part C (Medicare Advantage) and Part D (Prescription Drug Coverage) programs on a national level.
As the NBI MEDIC, we investigate and respond to allegations of fraud, waste, and abuse in Medicare Parts C and D. Our team monitors and analyzes various types of data to detect patterns of fraud, waste, and abuse across the country and to identify for further investigation plans, providers, and beneficiaries possibly engaged in such activities.
We also work with law enforcement, Medicare Advantage Organizations, prescription drug plans, consumer groups, and other key partners in their efforts to combat fraud, waste and abuse.
MEDIC - Law Enforcement RFI
Federal law enforcement agencies may submit a Request for Information (RFI) to obtain Medicare Prescription Drug Event (PDE) data. Use the following HIPAA compliant form in lieu of Program Integrity Manual (PIM) Exhibit 25 (DOJ) or Exhibit 37 (OIG).
Download Data Request Form
- NBI Medic Data Analysis Request [pdf] (02/14/13)