Which acronym refers to a private contractor that performs CMS audits?

Which acronym refers to a private contractor that performs CMS audits?

• A. Medicaid Integrity Contractor
• B. Medicare Integrity Contractor
• C. Medicare Information Center
• D. Medicaid Audit Service

Answer: (A)

A private entity that works with CMS to scrutinize Medicaid program payments and prevent fraud is called a Medicaid Integrity Contractor. These contractors are hired by CMS to perform audits, investigations, and other integrity activities across the Medicaid program, helping to detect improper payments and enforce compliance. The term Medicare Integrity Contractor exists for Medicare-related integrity work, but when the focus is CMS audits specifically tied to Medicaid, the standard acronym used is Medicaid Integrity Contractor. The other options don’t reflect the established CMS contractor terms for Medicaid or Medicare integrity work.

A private entity that works with CMS to scrutinize Medicaid program payments and prevent fraud is called a Medicaid Integrity Contractor. These contractors are hired by CMS to perform audits, investigations, and other integrity activities across the Medicaid program, helping to detect improper payments and enforce compliance. The term Medicare Integrity Contractor exists for Medicare-related integrity work, but when the focus is CMS audits specifically tied to Medicaid, the standard acronym used is Medicaid Integrity Contractor. The other options don’t reflect the established CMS contractor terms for Medicaid or Medicare integrity work.