8am Alexander PPT Final...2019/08/28  · õ l ð l î ì í õ ï W/ K P v ] Ì ] } v WZKs/ Z...

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9/4/2019 1 CENTER FOR PROGRAM INTEGRITY UPDATES AND COLLABORATIVE APPROACHES August 28, 2019 8:00-8:45 AM Alec Alexander Deputy Administrator and Director CMS Center for Program Integrity (CPI) 1 2

Transcript of 8am Alexander PPT Final...2019/08/28  · õ l ð l î ì í õ ï W/ K P v ] Ì ] } v WZKs/ Z...

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CENTER FOR PROGRAM INTEGRITY UPDATES AND COLLABORATIVE APPROACHES August 28, 2019 8:00-8:45 AM

Alec AlexanderDeputy Administrator and DirectorCMS Center for Program Integrity (CPI)

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Centers for Medicare & Medicaid Centers

CMS Office of the Administrator

Center for Program

Integrity (CPI)

Center for Consumer

Information and Insurance

Oversight (CCIIO)

Center for Medicaid and CHIP Services

(CMCS)

Center for Medicare

(CM)

Center for Medicare and

Medicaid Innovation

(CMMI)

Center for Clinical

Standards and Quality(CCSQ)

Operations10 Offices

Center for Program Integrity (CPI)

CreatedDepartment of Health and Human Services (HHS) Secretary created CPI to align Medicare and Medicaid program integrity

activities in March 2010.

Budget

FY 2019: 16 funding sources totaling $ 1 billion

WorkServes as CMS’s focal point for all national and statewide Medicare and Medicaid program integrity functions and the

establishment of an integrated and coordinated national framework for program integrity-related policies and procedures.

Organization472 Employees onboard - 8 Groups - 30 Divisions including 4 field offices & Private Plans Team

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CPI Organization

PROVIDER ENROLLMENT & OVERSIGHT GROUPZabeen Chong, Dir.

Charles Schalm, Dep. Dir.

DATA SHARING AND PARTNERSHIP GROUP

Robin Usi, Dir.*

INVESTIGATIONS AND AUDITS GROUP

Kathleen McGinty, Dir.* Peter Leonis, Dep. Dir.

CONTRACT MANAGEMENT GROUP

Desiree Wheeler, Dir.Cindy Sisti, Dep. Dir.

GOVERNANCE MANAGEMENT GROUP

Jennifer Dupee, Dir.* Steve Ferraina, Dep. Dir.

PROVIDER COMPLIANCE GROUP

Connie Leonard, Dir.*Brian Elza, Dep. Dir.*

CENTER FOR PROGRAM INTEGRITYAlec Alexander, Deputy Administrator & Director

George Mills, Jr., Dep. Dir.EXECUTIVE SUPPORT

GROUPLisa Jarvis-Durham, Dir.

DATA ANALYTICS AND SYSTEMS GROUP

Raymond Wedgeworth, Dir.Kathy Wolf, Dep. Dir.

APPROVED LEADERSHIPAs of August 14, 2019

*Acting

PRIVATE PLANS TEAMJonathan Smith, Dir.

CPI Foundation and Functions

Protect beneficiaries,

safeguard tax payer dollars, balance provider burden

Provider Enrollment

Medical Review

Investigations & Audits

Data Analytics & Systems

Stakeholder Partnerships

Strategic Contracting

Education & Outreach

Policy and Strategy

CMS is responsible for national and state-wide Medicare, Medicaid, and Marketplace program integrity functions:

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CPI Mission

Program integrity requires that we protect the resources entrusted to our nation’s health care programs while also

protecting the health and well-being of beneficiaries. CMS must work every day to guarantee that it is an accountable

steward of Medicare and Medicaid program dollars and accomplishing this is one of CMS’ top priorities.

CPI Vision

CMS is developing a 21st century program integrity strategy that will better align with the changing healthcare

landscape and effectively leverage new and innovative technology.

We envision a future that elevates program integrity, unleashes the power of modern private sector innovation, prevents rather than chase fraud, waste and abuse through

smart, pro-active measures, and unburdens our provider partners so they can do what they do best – put patients

first

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CPI Priorities

• Invest in Data and Analytics

• Strengthen Collaboration and Case Coordination

• Integrate Vulnerabilities Identification and Management

• Enhance Medicaid Oversight

• Reduce Provider Burden

• Fight the Opioid Crisis

Data and Analytics

Data analytics, systems, and transparency are foundational to CPI programs: • Focuses on analytics related to fraud, waste, and abuse in CMS• Provides program integrity statistical and data analysis for providers and service trends• Identifies emerging fraud trends through data mining and other advanced analytical techniques

Provider Enrollment,

Chain & Ownership

System (PECOS)

Advanced Provider

Screening (APS)

Unified Case Management

(UCM)

Fraud Prevention

System (FPS)

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Fraud Prevention System (FPS)

WHAT IS FPS

?

State-of-the-art predictive analytic technology

Since June 30, 2011, the FPS has run predictive algorithms and other analytics nationwide; reviews all Medicare FFS claims

Analyzes 4.5 million claims each day using a variety of analytic algorithms (models) to generate alerts and identify suspicious patterns for further investigation

CMS is systematically applying advanced analytics against Medicare FFS pre-paid claims on a streaming, nationwide basis for program integrity purposes. FPS 2.0 launched in March 2017

Transformed Medicaid Statistical Information System (T-MSIS)

T-MSIS provides:• Both state and federal policymakers better

information about state Medicaid programs• Who is eligible to receive services• What services are provided and to whom• How much it costs• Outcomes of care

3States using T-MSIS Data

2States pending confirmation

25Currently in validation status

23To be validated by Dec. 2019

53 TotalStates and territories available to CPI for validation

CPI assesses:• Completeness and quality of T-MSIS data • Usability of T-MSIS data for Program Integrity

(PI) activities • Optimization opportunities

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Provider Enrollment and Oversight

Less Burden for States and Providers - States can screen Medicaid providers using our Medicare enrollment data (site visits, revalidation, application fees, fingerprinting)

Greater Support for States - Training on systems, best practice screening, clearer sub-regulatory guidance and direct data matching with Medicare

Increase Guidance - Medicaid Provider Enrollment Compendium (MPEC)is similar to the Medicare Program Integrity Manual

Streamline Enrollment - PECOS 2.0 works to consolidate Medicare & Medicaid Screening and Enrollment

The Center for Program Integrity manages Medicare and Medicaid enrollment:

2018 Enrollments

16,637

8,330

2,833 1,951

FY15 FY16 FY17 FY18

Revocations232,994

137,088

177,525158,964

FY15 FY16 FY17 FY18

Deactivations

DECLINE in Revocations

(Unique Enrollments) Since FY15

DECLINE in Deactivations(Unique Enrollments)

Since FY15

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Investigations and Audits

CPI’s risk-based and targeted regional and national investigations and audits approach:

• Serves as CMS’ liaison with law enforcement on investigative activities

• Partners across CMS to provide program integrity oversight of the Medicaid program, including both fee-for-service and managed care

• Conducts State Program Integrity Reviews which assess the effectiveness of the state’s program integrity efforts, including its compliance with Federal statutory and regulatory requirements

• Provides oversight of CMS program integrity contractors who conduct investigative activities • Unified Program Integrity Contractors (UPICs) for Parts A and B • National Benefit Integrity Medicare Drug Integrity Contractor (NBI MEDIC) for Medicare Parts C and D

Unified Program Integrity Contractor (UPIC)

UPIC AWARDS:

MIDWESTERN JURISDICTION AdvanceMed Corporation

NORTHEASTERN JURISDICTIONSafeGuard Services, LLC

WESTERN JURISDICTION Qlarant

SOUTHEASTERN JURISDICTION SafeGuard Services, LLC

SOUTHWESTERN JURISDICTION Qlarant

Coordinates provider investigations across Medicare

and Medicaid

Improves collaboration with States by providing a mutually

beneficial service

Increases contractor accountability through coordinated oversight

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Major Case Coordination (MCC)

Implemented: April 2018

Stakeholders: OIG, DOJ, UPICS and all components of CPI

Purpose: Maximize efforts to identify, investigate, and pursue providerswho might otherwise endanger the program

Goal: Right tool, right case, right time, and right order

Process: If there is criminal interest from OIG/DOJ, CPI will stand down pending the criminal investigation.Senior CPI, OIG, and DOJ officials review quarterly to ensure coordination and accountability

MCC Continuum

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MCC Results

• Since April 2018:• 1000+ unique case reviews• 600+ law enforcement referrals• 100+ revocation referrals• 300+ payment suspensions

• Increase in the number and quality of• law enforcement referrals

• Health care fraud scheme takedowns:• Operation Brace Yourself• Appalachian Region Prescription Opioid (ARPO) Strike Force Takedown• National Health Care Fraud Takedown

Law Enforcement Referrals

26 16 29 32 2259 78 63 47

120174

124156 142

020406080

100120140160180200

Law Enforcement Referrals by Quarter

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Healthcare Fraud Prevention Partnership (HFPP)

9% Federal

Agencies

9% Associations

State & Local

32%

50% Private Payers

State Program Integrity Offices

State Medicaid Agencies

Medicaid Inspector General Offices

Medicaid Fraud Control Units

137 Partners12 Federal Agencies13 Associations44 State and Local 68 Private Payers

Voluntary, public-private partnership between the federal government, state and local agencies, law

enforcement, private health insurance plans, employer organizations, and healthcare anti-fraud associations to identify and reduce fraud, waste, and abuse across

the healthcare sector

Enterprise Program Risk Management

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Medicaid PI Strategy

• Launched the Medicaid PI Strategy in June 2018 to reform Medicaid: flexibility, accountability, and integrity

• Ensure sound stewardship and oversight of Medicaid resources

• Create greater transparency and accountability for Medicaid program integrity performance

• Enable increased data sharing and robust analytic tools• Seek to reduce Medicaid improper payments across states

• Released Medicaid PI Strategy 1-Year anniversary webpage in June 2019 to share progress to date

Medicaid PI Strategy Initiatives

Dat

a Sh

arin

g -Optimize PI use of

T-MSIS data

-Use data innovation to empower states and conduct data analytics pilots

-Provide state access to no-cost, high quality data sources useful for PI

-Offer provider screening for states on an opt-in basis

Fina

ncia

l Ove

rsig

ht -PI focused audits of improper claiming of the Federal Match – CMS 64

-PI focused audits of Medicaid managed care –Medical Loss Ratio (MLR) and rate setting

-Conduct new audits of beneficiary eligibility determinations

-Operationalize Medicaid Eligibility Quality Control (MEQC)

Acco

unta

bilit

y &

Edu

catio

n -Ensure state compliance with Medicaid Managed Care Final Rule

-Develop PI-focused measures for Medicaid Scorecard

-Offer targeted Medicaid provider education to reduce improper payments

-PERM: state Medicaid CAP development review and implementation

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QUESTIONS?

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