The mission of the Division of Program Integrity is to provide a reasonable and consistent system of oversight of the Medicaid program which effectively encourages:
Compliance;
Accountability;
Protection of public funds;
Awareness and responsibility;
Providers meeting participation requirements;
Services being medically necessary; and
Payments in the correct amount for covered services.
The goal is to reduce and eliminate fraud, waste, and abuse in the Medicaid Program.
The duties of Program Integrity include prevention; investigation; education; audit; recovery of improper payments, and cooperation with the Medicaid Fraud Control Unit (MFCU) and other federal/local law enforcement agencies.
