Be audit-ready:
Are your oversight practices strong enough?
Answer 10 questions about your managed care organization oversight practices to get an expert recommendation.

Question 1 of 10
Does your program integrity (PI) unit or Inspector General's office meet regularly with the state agency unit that oversees your managed care contract?
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Question 2 of 10
Do you regularly check databases at your fellow state agencies to ensure member eligibility status and provider enrollment is proper?
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Question 3 of 10
Does your PI unit regularly validate encounter data from managed care organizations (MCOs)?
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Question 4 of 10
Does your PI unit penalize MCOs if they don't comply with PI reporting requirements?
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Question 5 of 10
Does your PI unit regularly analyze overpayments that MCOs recover from providers?
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Question 6 of 10
Does the PI unit regularly conduct data analysis to ensure MCOs are not paying providers who were suspended due to a credible allegation of fraud?
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Question 7 of 10
Do the MCOs you work with keep you informed about their fraud, waste and abuse investigations?
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Question 8 of 10
Do you notify all the MCOs and the Medicaid Fraud and Control Unit about all known investigations conducted by MCOs or the state?
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Question 9 of 10
Do you ask MCOs about network adequacy before payment suspension and then audit the MCOs to ensure that they immediately suspended the provider?
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Question 10 of 10
Do you audit the compliance plans for MCOs or other federal requirements annually?
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Your MCO oversight practices leave you vulnerable
Your MCO oversight practices have room to grow
Your MCO oversight practices are strong



Let's help you improve
Your program integrity may have some gaps that need to be addressed. Watch the video to hear from expert consultant Dennis Garvey about why it's important to consider seeking an outside perspective.
Program integrity consulting with experts like Dennis can help you quickly identify the best ways to improve your program integrity.
Let's get started
You're making an effort to be good stewards of public resources, but there's room for improvement. Watch the video to hear from expert consultant Dennis Garvey about why it's important to continue striving for improvement.
Program integrity consulting with experts like Dennis can help you quickly identify the best ways to take your program integrity to the next level.
Let's help keep it that way
Your program integrity is well-rounded, and you're taking good care of the resources you're providing oversight for. Are you covering everything, though? Hear from expert consultant Dennis Garvey about why it's important not to get complacent.
Program integrity consulting with experts like Dennis can help you sustain and strengthen your program integrity even further.