CMS Releases 5-Year Medicaid Integrity Plan

In compliance with the requirement, as dictated by the Social Security Act, for the Secretary of Health and Human Services to establish and update, every five years, an ongoing plan to ensure Medicaid program integrity, the Centers for Medicare and Medicaid Services (CMS) on November 14 released its Comprehensive Medicaid Integrity Plan (CMIP).

The plan's four pillars, protecting programs, engaging state partners, advancing equity, and driving innovation, provide the framework for CMS' future focus. The five key areas include: Medicaid managed care oversight, participant access to care and program sustainability, high-risk vulnerabilities, data sharing and collaboration, and education and technical assistance. As an ongoing planning document, this is likely to have nominal effect at the provider level, though states may find nuggets alluding to future program enforcement.

The full CMIP is available here.