Medicaid Leaders Advocate for Integrated Program Integrity to Enhance Oversight and Care
Medicaid programs across the United States are facing increasing challenges due to their growing size, cost, and complexity. As a result, there is a push to integrate program integrity into the daily operations of these programs rather than treating it as a separate function. This approach aims to address issues such as fraud, waste, and abuse more effectively by embedding checks and balances into everyday processes. The traditional siloed model, where different aspects of program integrity are handled separately, is being reconsidered in favor of a more collaborative and continuous model. This integrated approach involves multiple stakeholders, including fiscal management services providers, who play a crucial role in translating program rules into operational processes. By using tools like electronic visit verification and analytics, Medicaid programs can identify and address issues early, reducing the need for resource-intensive audits and improving the experience for participants and caregivers. 
