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Medicaid Acronym of the Day – MIC

Medicaid Integrity Contractor – The MICs are private companies that conduct audit-related activities under contract to the Medicaid Integrity Group (MIG), the component within CMS that is charged by the U.S. Department of Health & Human Services with carrying out the MIP.

There are three primary MICs:

1) the Review MICs, which analyze Medicaid claims data to determine whether provider fraud, waste, or abuse has occurred or may have occurred;

2) the Audit MICs, which audit provider claims and identify overpayments; and

3) the Education MICs, which provide education to providers and others on payment integrity and quality-of-care issues.

Further reading

https://www.cms.gov/Medicare-Medicaid-Coordination/Fraud-Prevention/Provider-Audits/Downloads/MIP-Contractors-Presentation.pdf

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